Abstract:
:As the inclusion criteria for breast conservation therapy have continued to evolve to include lower quadrant tumors, very large breasts, and central tumors, the potential for significant disfigurement after breast conservation therapy has also increased. This has led some centers to develop coordinated oncology-plastic surgery approaches to ensure both adequate cancer resection and aesthetic appearance to the breasts. The authors applied this principle to a specific group of breast cancer patients--women with macromastia--who would benefit from reduction mammaplasty. Eleven women were identified from the senior author's (S.L.S.) reconstructive practice who underwent breast conservation therapy followed by breast reconfiguration and bilateral reduction mammaplasty. Preoperative brassiere sizes ranged from 34D to 46D. All women had immediate reduction after frozen sections from the lumpectomy/partial mastectomy margins were determined to be negative. A total of 22 reduction mammaplasties were performed (eight free-nipple grafts, five inferior pedicle flaps, seven superomedial pedicle flaps, and two superolateral flaps) and an average of 1085 g was removed per breast. All patients underwent radiation therapy postoperatively. There were eight minor complications in six patients (one hematoma, one keloid, one radiation burn, two cases of nipple hypopigmentation, and three cases of fat necrosis). After an average of 24 months' follow-up, there were no local recurrences and one death from distant metastasis. Seven of the 11 patients were available and agreed to rate their aesthetic satisfaction on the basis of a scale from 1 to 4, with 4 being the best. The mean satisfaction score was 3.3. Aesthetic outcomes before radiation therapy and after radiation therapy were evaluated by a panel of plastic surgery residents blinded to the purpose of the study. Using a scale of 1 to 4, the aesthetic mean before radiation therapy was 2.9 and the aesthetic mean after radiation therapy was 3.03. By combining breast conservation therapy with breast reconfiguration or reduction in large-breasted women, multiple benefits are derived. Larger segmental or partial mastectomies can be performed without disfigurement risk, ensuring adequate surgical margins. Immediate reconfiguration of the breast with reduction of the contralateral side creates symmetric, aesthetically pleasing breasts; allows contralateral breast tissue to be evaluated; and spares women from undergoing a second operative procedure. Such a coordinated program gives women an important boost, both physically and psychologically, during management of their breast cancer.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Spear SL,Pelletiere CV,Wolfe AJ,Tsangaris TN,Pennanen MFdoi
10.1097/01.PRS.0000046491.87997.40subject
Has Abstractpub_date
2003-03-01 00:00:00pages
1102-9issue
3eissn
0032-1052issn
1529-4242journal_volume
111pub_type
杂志文章abstract:BACKGROUND:Breast augmentation with subglandular versus subpectoral implants may differentially impact the early detection of breast cancer and treatment recommendations. The authors assessed the impact of prior augmentation on the diagnosis and management of breast cancer in women undergoing mastectomy. METHODS:Breas...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003342
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:The ability of the immature skull to spontaneously heal large bony defects created after craniofacial procedures was examined over a 25-year period of craniofacial surgery at the Children's Hospital of Philadelphia. METHODS:Only patients who underwent frontal orbital advancement and reconstruction, had at l...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000232353.44086.af
更新日期:2006-09-15 00:00:00
abstract::The ischemia tolerance of free-muscle flaps was investigated in the rat by orthotopic and syngeneic transplantation of muscle flaps measuring 4 x 2.5 cm. The effects of ischemia with a maximal duration of 7 hours on the raised flaps and of anoxia caused by occlusion of the flap vessels were studied for the first time ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199303000-00015
更新日期:1993-03-01 00:00:00
abstract::Three-dimensional surface reconstruction from computed tomographic (CT) data has been used to plan craniofacial operations. Cephalometric and anthropometric databases were integrated with three-dimensional CT reconstructions to quantitate the skeletal deformity and to assist in the design of the surgical procedure. In...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract::Electrosurgical coagulation in the presence of blow-by oxygen is a potential source of fire in facial surgery. A case report of a patient sustaining partial-thickness facial burns secondary to such a flash fire is presented. A fiberglass facial model is then used to study the variables involved in providing supplement...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract::A thick nostril is a disturbing deformity and one for which surgeons and patients may be reluctant to employ the traditional "piece of pie" skin excisions commonly described. As an alternative in selected circumstances, a method of internally thinning the nostril rim using an alar base groove incision known as alar ri...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199604000-00023
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:Posttraumatic facial paralysis is a disabling condition. Current surgical management by faciofacial nerve suture provides limited recovery. To improve the outcome, the authors evaluated an add-on strategy based on a syngeneic transplantation of nasal olfactory stem cells in a rat model of facial nerve injury...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000007367
更新日期:2020-12-01 00:00:00
abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Understand the difference between battery and assault in U.S. law and the concepts of the phrase "child abuse" and "elder abuse." 2. Understand that state statutes vary and can define abuse narrowly or with great specificity, and tha...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000227620.31296.2c
更新日期:2006-08-01 00:00:00
abstract::Static suspension remains an option for certain patients with facial paralysis. Endoscopically assisted facial suspension obviates the need for a counter-incision at the oral commissure to distally inset the fascia lata graft as described in the standard technique. The endoscopic technique is simple, allows secure pla...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199903000-00031
更新日期:1999-03-01 00:00:00
abstract::Twenty patients with microvascular fibula flap reconstruction of oromandibular defects were selected for implant-retained prosthodontic rehabilitation. A total of 71 osseointegrated implants were placed within the grafted fibulas. Four patients had immediate implant placement at the time of their reconstructive surger...
journal_title:Plastic and reconstructive surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00006534-199702000-00008
更新日期:1997-02-01 00:00:00
abstract::This study demonstrates the feasibility of acute extraluminal expansion to elongate arteries intraoperatively in order to overcome defects too large to be repaired primarily. Twenty Sprague-Dawley rats were divided into two groups: an expander-elongation group and a nonexpanded control group of 10 rats each. Arterial ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199209000-00016
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:Narcotic pain medications are a significant component of most postoperative pain control regimens. Although they are usually effective, they produce several untoward side effects and sometimes provide inadequate analgesia. The continuous infusion of local anesthetic agents (via pain pump) has been used to su...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.prs.0000299372.91051.1b
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Soft-tissue reconstruction following vulvar cancer resection is a difficult challenge because of the functional, locational, and cosmetic importance of this region. Although numerous flaps have been designed for vulvar reconstruction, each has its disadvantages. METHODS:The authors introduce the gluteal fol...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000227683.47836.28
更新日期:2006-08-01 00:00:00
abstract::A case is presented in which a filleted flap from the unreplantable forearm was used successfully to cover the upper arm amputation stump after 55 hours of cold ischemia. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198607000-00014
更新日期:1986-07-01 00:00:00
abstract::The purpose of the study was to determine the feasibility of preserving ovarian function after heterotopic transplantation by means of microvascular anastomosis of the transplanted vascular pedicles to a set of preselected vessels. Six groups of 10 Sprague-Dawley inbred rats were used in this study. Group I underwent ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.PRS.0000055731.22839.74
更新日期:2003-04-15 00:00:00
abstract::Reconstruction of the pharynx and esophagus with revascularized segments of jejunum remains a time-proven entity. Most thromboses and subsequent flap failures have occurred within the first 24 hours after revascularization of the flap. What would therefore be desirable is a safe, proven monitoring system to assess the...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198905000-00024
更新日期:1989-05-01 00:00:00
abstract::The adenosine triphosphate (ATP) content of keloids and scars resected from patients was demonstrated by high-performance liquid chromatography. The surface color of hypertrophic scars was red or pink and that of atrophic scars was white. The ATP content of red scars was (in mmol/g protein) 1.06 +/- 0.14, of pink scar...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199909030-00012
更新日期:1999-09-01 00:00:00
abstract::The modified Dingman forceps provides several advantages over currently designed plate-holding forceps. The rubber tubing prevents metal-to-metal contact of the forceps on the plate and provides increased stability to the plate. The long lingual jaws of the Dingman forceps are applied to the lingual bone at a point re...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198678060-00022
更新日期:1986-12-01 00:00:00
abstract::A case is reported in which a closed compression capsulotomy for fibrous capsular contracture was followed by rupture of the implant bag with the immediate appearance of silicone gel in the axilla. A possible mechanism, analogous to that of high-pressure injection injuries of the hands, is hypothesized. ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197812000-00013
更新日期:1978-12-01 00:00:00
abstract:BACKGROUND:Although nearly all medical students pursuing integrated plastic surgery residency participate in elective rotations away from their home medical school, the value and costs of these "away" rotations have not been well studied. METHODS:The authors surveyed all integrated plastic surgery program directors an...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000002029
更新日期:2016-04-01 00:00:00
abstract::The efficacy of the carbon dioxide laser for skin deepithelialization in humans was initially demonstrated using reduction mammaplasty as a clinical model. Twenty-two additional successful cases including use of this technique as an adjunct for other flap transpositions and overgrafting of skin grafts are described. T...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198904000-00020
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:Although postoperative monitoring of microsurgical reconstruction is key to discovering early vascular compromise, monitoring a buried flap can be problematic. METHODS:A single surgeon's tracheal and pharyngoesophageal reconstructions with fasciocutaneous free flaps performed between 2002 and 2007 are revie...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318196b9a3
更新日期:2009-02-01 00:00:00
abstract::The blood supply to the brachioradialis muscle and the skin of the forearm was studied in latex-injected arms. The dominant perforator to the muscle arose from the brachial artery (27.3 percent), radial recurrent artery (33.3 percent), or radial artery (39.4 percent). In all cases, adequate perforators exist from the ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199410000-00015
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:In 1984, Terzis introduced the "babysitter" procedure, a new concept in facial reanimation. It involves two stages, with coaptation of ipsilateral 40 percent hypoglossal to facial nerve on the affected side, performed concomitantly with cross-facial nerve grafting and secondary microcoaptations 8 to 15 month...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31819ba4bb
更新日期:2009-03-01 00:00:00
abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Describe the differential diagnosis of breast tumors in adolescent girls. 2. Compare and contrast surgical options for the management of adolescent breast tumors. 3. Recognize the utility of a reduction mammaplasty technique when res...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000264396.03452.62
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Tissue engineering of patient-specific adipose tissue has the potential to revolutionize reconstructive surgery. Numerous models have been described for the production of adipose tissue with success in the short term, but little has been reported on the stability of this tissue-engineered fat beyond 4 months...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181b59ff6
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Lymphedema remains a challenging clinical problem that often lacks curative treatment options. Recent reports have shown that microvascular lymph node transfer from the groin area into axillas of lymphedematous patients may improve lymphatic drainage, but the effect on donor-site lymphatic flow has not been ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e31826d1682
更新日期:2012-12-01 00:00:00
abstract::Increasing numbers of plastic surgery procedures are performed in diverse environments, including traditional hospital operating rooms, outpatient surgery centers, and private offices. Just as plastic surgeons develop areas of specialization to better care for their patients, anesthesiologists have specialized in outp...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181c2a268
更新日期:2010-01-01 00:00:00
abstract::A number of materials, both biologic and alloplastic, have been used for nasal augmentation. Although biologic bone and cartilage grafts are associated with lower infection rates, they are also associated with long-term resorption and donor-site morbidity. Alloplastic materials, in particular silicone, have been assoc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199809040-00052
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Weight gain is common in breast cancer patients and increases the risk of recurrence and mortality. The authors assessed the impact of autologous breast reconstruction on body mass index patterns after diagnosis in mastectomy patients. METHODS:Women undergoing therapeutic mastectomy at the authors' institut...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003841
更新日期:2017-12-01 00:00:00