Abstract:
BACKGROUND:Management of the nipple-areola complex is an important issue in primary breast reconstruction. When nipple-sparing mastectomy is not suitable, alternatives are immediate nipple-areola complex replantation and delayed reconstruction. The aim of this study was to examine whether patients benefit more from nipple-areola complex preservation by immediate replantation or delayed nipple-areola complex reconstruction. METHODS:Postoperative results and patient satisfaction after 54 primary breast reconstructions with immediate nipple-areola complex replantation or delayed nipple-areola complex reconstruction were retrospectively evaluated. RESULTS:The nipple-areola complex was replanted immediately in 37 cases and reconstructed later with nipple sharing and full-thickness skin grafting in 17 cases. Compared with immediate replantation, delayed reconstruction resulted in significantly better postoperative nipple projection (P = 0.01*, Mann-Whitney U test), greater similarity of color and projection with the contralateral side and greater patient satisfaction (Breast-Q). Complete loss of projection occurred in 4 of the 37 replanted nipple-areola complexes. No complete nipple-areola complex necrosis or tumor recurrence was observed in any patient. CONCLUSIONS:Immediate nipple-areola complex replantation is a safe and reliable procedure for selected patients with contraindications for nipple-sparing mastectomy who have a strong desire to maintain their own nipple-areola complexes, or in bilateral cases. However, drawbacks of this procedure include loss of projection and depigmentation. Delayed reconstruction with nipple sharing and full-thickness skin grafting is a good alternative, especially in unilateral cases; it leads to better postoperative results and greater patient satisfaction, but it involves a nipple-areola complex-free period.
journal_name
Ann Plast Surgjournal_title
Annals of plastic surgeryauthors
Nedomansky J,Nickl S,Maier B,Dubsky P,Haslik W,Schroegendorfer KFdoi
10.1097/SAP.0000000000000883subject
Has Abstractpub_date
2017-04-01 00:00:00pages
379-385issue
4eissn
0148-7043issn
1536-3708journal_volume
78pub_type
杂志文章abstract::Terror attacks have been progressively increasing worldwide through the present era. The management of the consequences of terrorism events is under debate in almost every scientific area. The organization and advancement of health services constitute important components of the crisis management. Similar to other spe...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000001238
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Current trends in the management of medial orbital wall fractures are toward the development of transconjunctival incisions and the use of endoscopic-assisted methods. Different authors have suggested variations of the medial transconjunctival approach. METHODS:(1) In 30 fresh cadaver orbits, the classic tr...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000531
更新日期:2016-03-01 00:00:00
abstract::The superior dermoglandular pedicle technique of breast reduction and its results in 193 reductions are presented. This technique offers aesthetically pleasing results, sensate nipple/areola complex, and safety. The natural shape obtained results from preservation of the superior portion of the breast tissue (where ti...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199209000-00004
更新日期:1992-09-01 00:00:00
abstract::Lymphatic vasculature is known to spontaneously reconnect after hand replantation. Nonetheless, lymphatic outflow has not been specifically studied in hand transplantation.Lymphedema was studied clinically and scintigraphically in 3 bilateral upper limb transplants performed in Valencia, Spain, since 2006. Case 1 was ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31828349ff
更新日期:2013-07-01 00:00:00
abstract::Thirteen breast reconstructions in 11 patients, averaging 58 years of age, underwent mastectomies. The technique uses a saline implant either totally or partially covered with a human acellular dermal matrix. The mean postoperative follow-up time was 14 months. Ninety percent of the patients were considered high risk;...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000185460.31188.c1
更新日期:2006-01-01 00:00:00
abstract::Transverse rectus abdominis musculocutaneous (TRAM) breast reconstruction in patients with advanced breast cancer is controversial. Management of these patients is often complex and consists of surgical extirpation, postoperative radiation, chemotherapy, and in some cases bone marrow transplantation. Few studies have ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.SAP.0000069075.27321.BC
更新日期:2003-06-01 00:00:00
abstract::Basal cell carcinoma is the most common type of malignant cutaneous neoplasm found in man. Rarely, however, is it life-threatening or does it metastasize. A review of the literature revealed 138 cases of metastatic basal cell carcinoma. We describe 3 additional patients with metastatic basal cell carcinoma who were tr...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198312000-00017
更新日期:1983-12-01 00:00:00
abstract::Blepharoptosis surgery is one of the most common oculoplastic procedures, and the aim is to clear the visual axis. Many surgical techniques for the correction of ptosis have been described and performed, but the operative approach is based on the extent of eyelid excursion, the amount of levator function, and the degr...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181de838a
更新日期:2011-03-01 00:00:00
abstract::Tattooing is increasingly common in Western society. The aim of the study was to create an overview of the surgical options when a tattoo is present in the operative site and to present an algorithm for the surgical plan.A literature-based study was conducted, using the Pubmed database. The following search terms have...
journal_title:Annals of plastic surgery
pub_type: 杂志文章,评审
doi:10.1097/SAP.0b013e3181b1429f
更新日期:2010-01-01 00:00:00
abstract:PURPOSE:Patients with necrotizing fasciitis are managed with multiple prompt, radical surgical debridements and critical care support. Debridement and reconstruction are often provided by different surgical teams. Anecdotally, single-specialty management seemed to be a more efficient management strategy. This study aim...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000173
更新日期:2014-05-01 00:00:00
abstract::An unusual case of extensive cutaneous leishmaniasis of the upper limb in a patient with leukemia is presented. A trial of medical therapy (sodium stibogluconate) resulted in rapid healing of the large ulcers. The incidence of leishmaniasis is increasing globally as a result of the ease of travel and migrating populat...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-200206000-00018
更新日期:2002-06-01 00:00:00
abstract::The purpose of this study was to evaluate third-year medical students' knowledge of and exposure to cleft palate before and after a rotation in plastic surgery. A 26-item questionnaire was administered to 37 students before and after their 12-week rotation that included the evaluation and management of patients with c...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199604000-00009
更新日期:1996-04-01 00:00:00
abstract::Ischemia/reperfusion injury (IRI) after free tissue transfer of the small intestine results in transmural tissue damage. This study examined the effects of IRI on the jejunum. Wistar rats served either as controls (N=10) or underwent clamping of the infrarenal aorta for 1 hour followed by 1 hour of reperfusion (N=10)....
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-199806000-00008
更新日期:1998-06-01 00:00:00
abstract:PURPOSE:Rhabdomyolysis often occurs after traumatic compartment syndrome, and high morbidity and mortality have been reported with the acute kidney injury that develops subsequently. We focused on the risk factors for rhabdomyolysis and acute kidney injury in patients with traumatic compartment syndrome. We also analyz...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000460
更新日期:2015-05-01 00:00:00
abstract::Long vein loops derived from the major upper extremity superficial veins may be accessed for venous outflow in difficult cases of trunk, arm, or head and neck free tissue transfers when local possibilities have proved inadequate. This technique may negate the need for an interposition vein graft to a deep venous syste...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198811000-00005
更新日期:1988-11-01 00:00:00
abstract::Gynecomastia is an abnormal enlargement of the breast tissue in men. It is the most common disorder of the male breast. Surgical sharp resection of the excess breast tissue is still the mainstay of treatment when medical treatment modalities are proved to be ineffective. The authors believe that areolar incisions give...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000143513.77819.7a
更新日期:2005-02-01 00:00:00
abstract::The indications for and limitations of cryosurgery for various types of hemangiomas on the body surface or in the intraoral region are reported based on our clinical experience. In our opinion, cryosurgery is not the method of choice in the management of hemangiomas but is useful under certain conditions, as with a lo...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198006000-00005
更新日期:1980-06-01 00:00:00
abstract:BACKGROUND:Breast capsular contracture (BCC) is a commonly adverse event postmammoplastly characterized by an immune response mediated by cytokines and transforming growth factor (TGF)-β1 resulting in excessive synthesis and deposit of extracellular matrix around the breast implant. Presence of TGF-β1 polymorphisms has...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31822284f4
更新日期:2013-01-01 00:00:00
abstract::Apert syndrome is characterized by craniosynostosis, central nervous system anomalies, midface hypoplasia, and syndactyly. Current research has focused on genetic and neurologic correlates. Cognitive assessment has been primarily limited to global intellectual evaluations, which can fail to detect the diverse cognitiv...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
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journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31803c9b66
更新日期:2007-12-01 00:00:00
abstract::Only 38 cases of blunt traumatic rupture of the anterior abdominal wall musculature have been described in the literature to date. We describe a patient who sustained a complete transection of the right and a partial disruption of the left rectus abdominis muscle as well as multiple associated injuries secondary to bl...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198407000-00012
更新日期:1984-07-01 00:00:00
abstract::Forelimb buds of rat embryos at day 13 of gestation were cut and cultured in Dulbecco's modified Eagle medium. In the absence of serum, the epidermis did not cover the wound surface. In the presence of fetal calf serum or ultroser G, a serum substitute, epidermal wound closure appeared in a concentration-dependent man...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198912000-00002
更新日期:1989-12-01 00:00:00
abstract::Intraoperative navigation is a tool that provides surgeons with real-time, interactive access to their patient's diagnostic imaging studies while in the operating room. This modality allows for anatomic localization and facilitates intraoperative planning and diagnosis. The application of intraoperative navigation to ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31822a3ec3
更新日期:2012-09-01 00:00:00
abstract::A new genioplasty technique has been described and performed on 16 patients since 1995. The technique has been developed to avoid some undesired results of the current osseous genioplasty techniques and to achieve a more natural appearance in advancement genioplasty. According to the authors' technique, a rectangular ...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:
更新日期:1999-08-01 00:00:00
abstract::A severe case is reported of a rare skin disorder characterized by multiple intracutaneous cystic lesions; the condition is difficult to manage and impossible to cure. The complicating cystic infections that accompany the condition are treated acutely using sound surgical principles, yet long-term management remains a...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/00000637-198409000-00010
更新日期:1984-09-01 00:00:00
abstract::Pleural space problems after lung resection and persistent air leaks are among the commonest challenges posed to thoracic surgeons. Surgical repair of air leaks are indicated when conventional tube thoracostomy has failed to solve the problem. We would like to propose the novel application of the combined latissimus d...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e31818a6609
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:International adoptees with cleft lip and palate (CLP) are a growing population in the United States. They represent a clinical challenge, presenting at various ages and stages of cleft repair. METHODS:A retrospective review of patients seen at the CLP Program at the Children's Hospital of Philadelphia (CHO...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0000000000000863
更新日期:2016-10-01 00:00:00
abstract::The repair of complex chest wall defects presents a challenging problem for the reconstructive surgeon. Although the majority of such defects could be repaired with the use of local and regional musculocutaneous flaps, more complicated cases require increasingly sophisticated reconstructive techniques. This study revi...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/01.sap.0000122653.09641.f8
更新日期:2004-05-01 00:00:00
abstract::We developed a new operative procedure involving the combination of 5 flaps to treat little toe polysyndactyly. We applied this procedure to 4 toes of 3 patients who had severe polysyndactyly involving skin fusion of the area from the distal interphalangeal joint to the periphery. In all 3 patients, this procedure all...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e3181cbfcf2
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Historically, dissection of the temporoparietal fascia immediately above the zygomatic arch has been avoided due to the risk of transection of the temporofrontal rami of the facial nerve. METHODS:A total of 8 fresh cadaveric hemi-faces have been dissected to investigate the relationship of the temporofronta...
journal_title:Annals of plastic surgery
pub_type: 杂志文章
doi:10.1097/SAP.0b013e318221b563
更新日期:2012-06-01 00:00:00