Abstract:
BACKGROUND:Reduction mammaplasty has been shown to be efficacious in reducing the burden of symptoms and improving the quality of life for patients with macromastia. However, most insurance carriers will not reimburse for mammaplasties involving less than 1000 g of total tissue resected. To refute this arbitrary policy, the authors set out to examine the effect of reduction mammaplasty in which less than 1000 g of breast tissue was resected on patients' macromastia-related symptoms and macromastia-related quality-of-life factors. METHODS:All patients were given a custom-designed questionnaire designed to evaluate macromastia-related symptoms and other macromastia-related quality-of-life issues. Patients were then provided the same questionnaire at their final postoperative visit between 3 and 12 months after surgery. RESULTS:A total of 59 patients underwent reduction mammaplasty of less than 1000 g. Reduction mammaplasty less than 1000 g resulted in significant decreases in all macromastia-related symptoms analyzed, including upper back pain, lower back pain, neck pain, arm pain, shoulder pain, hand pain, breast pain, headaches, rashes, and/or itching and painful bra strap grooving (all p < 0.00002). Furthermore, reduction mammaplasty resulted in significant improvement in all quality-of-life factors analyzed, including difficulty buying clothes and bras, difficulty participating in sports, and difficulty running (all p < 0.00001). CONCLUSIONS:Reduction mammaplasty totaling less than 1000 g offers substantial relief of macromastia-associated symptoms and results in significant improvement in patients' quality of life. This prospective study conclusively demonstrates that reduction mammaplasty totaling less than 1000 g should be a fully reimbursable procedure.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Spector JA,Karp NSdoi
10.1097/01.prs.0000277660.49802.76subject
Has Abstractpub_date
2007-09-15 00:00:00pages
845-850issue
4eissn
0032-1052issn
1529-4242pii
00006534-200709150-00004journal_volume
120pub_type
杂志文章abstract:BACKGROUND:Dexmedetomidine is an alpha2-agonist anesthetic with several properties that are advantageous in aesthetic facial surgery. By attenuating sympathetic nervous system activity, it induces sedation and analgesia while lowering blood pressure and preventing pain-induced hemodynamic fluctuations. It spares the re...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000293867.05857.90
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Control and maintenance of nasal tip position are critical in rhinoplasty. Two frequent methods of exerting tip control are columellar strut and caudal septal extension graft. However, no quantitative data exist comparing the two methods over time. The purpose of this study was to analyze maintenance of tip ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000006178
更新日期:2019-11-01 00:00:00
abstract::We have achieved functional reconstruction for a bilateral upper alveolar bone, gingival, and palatal defect that has various problems originating from instability of the prosthesis using the fibula osteocutaneous flap with osseointegrated implants. The flap had three bone segments and two skin paddles. The combined b...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199510000-00032
更新日期:1995-10-01 00:00:00
abstract::Injection of aspirated fat for the correction of tissue defects is a common procedure in plastic surgery. The reported rates of fat cell survival vary greatly in the medical literature, and different techniques of harvesting, processing, and reinjecting the fat cells are claimed to be responsible for these differences...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::For breast reconstruction, we have found that breast symmetry can be created optimally when the patient is brought to a totally upright position with the trunk vertical and perpendicular to the floor. The size of the opposite breast can better be appreciated. Nipple and areola position can be determined accurately eve...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198601000-00010
更新日期:1986-01-01 00:00:00
abstract::The anatomy of the inframammary fold has been a subject of controversy. This report describes the anatomic location and the histologic structure of the inframammary fold on the basis of caderveric dissections and microscopic examination. Ten breast cadaver dissections were performed on female cadavers (ages 35 to 72)....
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199809040-00017
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Wound healing, a coordinated process, proceeds by sequential changes in cell differentiation and terminates with the deposition of a new connective tissue matrix, a scar. Initially, there is the migratory fibroblast, followed by the proliferative fibroblast, then the synthetic fibroblast, which transforms in...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000263363.28474.e9
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:The purpose of the study was to investigate the morphologic changes of distraction osteogenesis performed on the mandible in growing minipigs. METHODS:Eighteen piglets were divided into four groups. In group A (n = 6), animals received unilateral osteotomy and the distractor device was activated for 2 weeks...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000163326.63031.30
更新日期:2005-06-01 00:00:00
abstract::Vascularized and conventional autogenous rib grafts were used to reconstruct 6-cm ulnar defects in the forelegs of the nine dogs. Each dog served as its own control. Biomechanical torsional testing of the grafted ulnas showed that vascularized grafts were 234 percent stronger than the conventional grafts. Bone toughne...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198403000-00007
更新日期:1984-03-01 00:00:00
abstract:BACKGROUND:Unilateral cleft lip revision may be necessary to address visible scars, unequal anatomical boundaries, vermillion inequities, or some combination thereof. In the setting of more than one stigma, a complete recreation of the defect and repair is necessary. This study anthropometrically evaluates the results ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000001560
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Le Fort III osteotomy represents the foundation of surgical correction for midface hypoplasia. One serious complication of Le Fort III osteotomy is severing the internal maxillary artery or its branches during osteotome advancement for pterygomaxillary dysjunction. This study sought to characterize the relev...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003084
更新日期:2017-03-01 00:00:00
abstract::A detailed description of the anatomical relationships of the supraorbital nerve as it courses across the forehead and under the scalp cannot be found in most anatomy textbooks, and illustrations of the nerve beyond the superior orbital rim frequently misrepresent its course. Because the supraorbital nerve is a struct...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199509000-00007
更新日期:1995-09-01 00:00:00
abstract::Ischemia-reperfusion injury occurs when tissue is reperfused following a prolonged period of ischemia. It is a subject of interest to plastic surgeons involved in replantation, free tissue transfer, and composite tissue allotransplantation, as it can have a significant impact on the overall success of these procedures...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e318230c57b
更新日期:2011-12-01 00:00:00
abstract::As we have gained experience with the extended superficial musculoaponeurotic system (SMAS) technique in face lifting, refinements in our procedure have led to increased consistency in results. The important factors that have led to our technical modifications include the following: (1) the significance of the retaini...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200001000-00046
更新日期:2000-01-01 00:00:00
abstract::Craniosynostosis is characterized by premature fusion of the cranial sutures. At the molecular level, mutations in homeobox genes, transcription factors, and growth factor receptors have been implicated in the pathogenesis of this disorder, but the specific etiologic pathways have not yet been elucidated. To further s...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200208000-00023
更新日期:2002-08-01 00:00:00
abstract::The coverage of large soft-tissue defects usually requires a large flap transfer, especially in a combination and expanded form. However, some large soft-tissue defects still cannot be covered by such flaps. In this article, we present a case of a civil war injury in a patient from Afghanistan who had severe trauma to...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200008000-00024
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Reconstruction of the defects of the upper lateral lip is still one of the most difficult challenges for plastic surgeons. No method specific to the superficial and larger defects of the upper lateral lip has been proposed before. Nasolabial rotation flaps based on the upper lateral lip subunit for superfici...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31825dc09f
更新日期:2012-09-01 00:00:00
abstract::Traditional microsurgery involves the use of bulky and expensive stereo microscopes that have limited portability. Recent advances in video technology have enabled the exploration of alternative visualization methods. The purpose of this study was to evaluate standard laparoscopic equipment for microvascular anastomos...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200109150-00008
更新日期:2001-09-15 00:00:00
abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Identify the subtypes of squamous cell carcinoma of the skin. 2. Identify factors that affect recurrence and/or metastasis. 3. Develop a surgical management plan for treating high-risk squamous cell carcinoma of the skin. In treating...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000138243.45735.8a
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:The financial reimbursement for breast reconstruction is perceived to be low. The authors evaluated the financial impact of providing breast reconstruction for an academic medical practice and health care system. METHODS:The authors examined the billing records for 97 patients undergoing postmastectomy brea...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181a0722d
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Limb-sparing surgery, consisting of wide-margin tumor resection and preoperative or postoperative radiotherapy/chemotherapy, has become the surgical treatment of choice for extremity sarcomas. However, adequate tumor resection can sometimes compromise crucial limb function, necessitating functional restorati...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000187140.83705.cf
更新日期:2006-01-01 00:00:00
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journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/PRS.0b013e3181c82d24
更新日期:2010-02-01 00:00:00
abstract::To find an alternative to synthetic mesh closure of abdominal fascial defects after transverse rectus abdominis musculocutaneous (TRAM) flap harvest, dermal autografts were removed from tissue to be discarded and used for fascial closure. Dermal grafts have been used for herniorrhaphy and fascial repair after TRAM har...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199812000-00001
更新日期:1998-12-01 00:00:00
abstract::We have detailed our experience with abdominoplasty. The technique is based on undermining of the rectus abdominis muscle, treatment of the posterior sheath, and limited resection of the medial edge of the rectus muscle. The fatty and muscular redundancy in the epigastric region has been eliminated by resection of the...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198505000-00007
更新日期:1985-05-01 00:00:00
abstract::During the ischemia/reperfusion phenomenon, adhesion molecules seem to play a critical role in the recruitment of neutrophils to sites of eventual tissue injury. E-selectin is an endothelium-derived molecule that mediates adhesion of neutrophils to activated endothelial cells. In vitro expression of E-selectin, after ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199711000-00016
更新日期:1997-11-01 00:00:00
abstract::Previous work by this laboratory introduced the pig fibula bone flap as a model for the study of the pathophysiology of vascularized bone flaps. Anatomic and hemodynamic studies demonstrated a significant (p < 0.05) decrease in vascular perfusion after a series of segmental osteotomies and rigid fixation (lag screws a...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199904050-00012
更新日期:1999-04-01 00:00:00
abstract::The high incidence of complications during tissue expansion may be related to overexpansion with subsequent tissue necrosis and implant extrusion. Subjective parameters such as pain or capillary fill may be poor guidelines for determining the end point of a given session of expansion. In an attempt to rectify this pro...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00006534-198603000-00013
更新日期:1986-03-01 00:00:00
abstract::A modification of the insertion level of Orticochea flaps is proposed. The purpose of the modification is to place the pharyngoplasty at a higher site, in the area of attempted velopharyngeal contact. The site of velopharyngeal contact can be identified using lateral radiographic techniques. A success rate of 93 perce...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198406000-00003
更新日期:1984-06-01 00:00:00
abstract::Two cases of toxic shock syndrome following chemical face peel are reported. Toxic shock syndrome is a severe toxin-mediated multisystem disease. The major signs are fever, rash, desquamation, and hypotension. It can occur in males as well as females and is not necessarily related to menstruation. The surgical wound d...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198707000-00020
更新日期:1987-07-01 00:00:00
abstract::A new operative technique for treatment of xanthelasma or xanthoma palpebrarum was introduced. The merits of this technique are (1) no skin excision with the tumor, (2) making the flap from the skin covering the tumor, (3) no need for donor site, (4) no significant cosmetic problem, and (5) reoperation performed by sa...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199809040-00040
更新日期:1998-09-01 00:00:00