Abstract:
:Obesity and specimen weight have both been associated with a higher incidence of complications for patients undergoing reduction mammaplasty. However, obesity has been arbitrarily and inconsistently defined, and the degree of obesity has not been considered in these previous studies. Because insurance companies are increasingly demanding weight loss before authorizing surgery, the relationship of obesity and breast size to complications is of great importance. Upon critical review of the literature, a number of fundamental questions remain unanswered. If complications are more frequent in the obese patient, are these complications directly proportional to the degree of obesity? Also, if the patient is required to lose weight before surgery, is weight loss effective in reducing complication rates? In an attempt to clarify these issues, 395 patients who underwent reduction mammaplasty over a 10-year period were reviewed retrospectively. Patients were arbitrarily divided into five groups in which, depending on their degree of relative obesity, they were classified as less than 5 percent, 5 to 10 percent, 10 to 15 percent, 15 to 20 percent, or greater than 20 percent above average body weight. To evaluate the relationship of specimen weight to complications, patients were also arbitrarily divided into five groups according to weight of the breast reduction specimen, which was classified as less than 300 g, 300 to 600 g, 600 to 900 g, 900 to 1200 g, and greater than 1200 g reduction per breast. Complications were then divided into local and systemic and major and minor. When bilateral reductions alone were analyzed (n = 267), there was a statistically significant increase in complication rate in the obese (p = 0.01). However, when the obese population was further subdivided according to their degree of obesity (less than 5 percent, 5 to 10 percent, 10 to 15 percent, 15 to 20 percent, and greater than 20 percent above average body weight), no further correlation was found. However, the relationship between specimen weight per breast and complications was much stronger with a direct correlation existing between increasing specimen weight and the incidence of complications. Although this study has shown that patients who are average body weight have fewer complications than obese patients after breast reduction surgery, it has not shown an increasing incidence of complication with increasing degrees of obesity. The implications of these findings and their relationship for denying patients surgery on the basis of weight alone are discussed in detail.
journal_name
Plast Reconstr Surgjournal_title
Plastic and reconstructive surgeryauthors
Zubowski R,Zins JE,Foray-Kaplon A,Yetman RJ,Lucas AR,Papay FA,Heil D,Hutton Ddoi
10.1097/00006534-200010000-00006subject
Has Abstractpub_date
2000-10-01 00:00:00pages
998-1003issue
5eissn
0032-1052issn
1529-4242journal_volume
106pub_type
杂志文章abstract::Currently, spinal cord stimulation is used to treat ischemia and ischemic pain, with the best results observed in vasospastic cases. It was earlier demonstrated that spinal cord stimulation may attenuate experimentally induced vasospasm in an island flap in the rat. The present study was designed to investigate whethe...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199904040-00018
更新日期:1999-04-01 00:00:00
abstract::This study delineates the vascular anatomy of the upper extremity with particular attention toward the size, location, and number of vascular pedicles supplying each muscle. Ten cadaver upper extremities were dissected. A total of 440 muscles and 2209 pedicles were identified. The major "named" arterial source, number...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198803000-00007
更新日期:1988-03-01 00:00:00
abstract::A retrospective quantitative analysis of 40 infants who underwent surgery for sagittal craniosynostosis was conducted to determine whether any difference in outcome, with respect to cranial index (cranial width/cranial length x 100), could be associated with either the age at surgery or the extent of the operation. Ch...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199905060-00004
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:The dorsal metacarpal artery perforator flap is a versatile solution for resurfacing soft-tissue defects of fingers. The authors present their experience in applying this flap for a variety of finger wounds for which conventional means may not be amenable. METHODS:Fifty-eight dorsal metacarpal artery perfor...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318221ddfa
更新日期:2011-09-01 00:00:00
abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Discuss the critical anatomic structures of the nose that are affected in naso-orbital ethmoid fractures. 2. Discuss the advantages of early, complete nasal reconstruction of these fractures. 3. Apply a clinical algorithm to such nas...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000195081.39771.57
更新日期:2006-01-01 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:BACKGROUND:Pierre Robin sequence is characterized by mandibular retrognathia and glossoptosis resulting in airway obstruction and feeding difficulties. When conservative management fails, mandibular distraction osteogenesis or tongue-lip adhesion may be required to avoid tracheostomy. The authors' goal was to prospecti...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000003167
更新日期:2017-04-01 00:00:00
abstract::Costochondral grafts are commonly used to restore dysplastic mandibular condyles. Despite their worldwide use, the growth of the condyle-ramus unit constructed with a costochondral graft is highly unpredictable, excess growth being the most common consequential problem. In a recent series of experiments on rats, it be...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199410000-00003
更新日期:1994-10-01 00:00:00
abstract::As the most prominent facial feature, the nose carries an increased risk of traumatic injury. Nasal fracture is the most common bone injury of the adult face and frequently results from motor vehicle accidents, sports-related injuries, and altercations. Although often initially considered minor, nasal fracture may eve...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000260722.91183.50
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Attempted separation of craniopagus twins has continued to be associated with devastating results since the first partially successful separation with one surviving twin in 1952. To understand the factors that contribute to successful separation in the modern era of neuroimaging and modern surgical technique...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0000000000002269
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:After excess skin and fat are removed, a body-lift suture advances skin and suspends ptotic breasts, the mons pubis, and buttocks. For women, the lift includes sculpturing adiposity. While some excess fat may need removal, muscular men should receive a deliberate effort to achieve generalized tight skin clos...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0000000000000933
更新日期:2015-02-01 00:00:00
abstract::Just as everyone has a different learning style, teachers too approach the task from different perspectives. There are five basic teaching perspectives or styles: transmission, apprenticeship, developmental, nurturing, and social justice. The acronym BIAS is useful to describe the beliefs, intentions, assessments, and...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318252f182
更新日期:2012-06-01 00:00:00
abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Evaluate patients seeking breast augmentation using key variables to assist in selection from the choices for incision, implant type and size, and plane of dissection. 2. Minimize the need for revisionary surgery to factors beyond th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/01.prs.0000305933.31540.5d
更新日期:2008-04-01 00:00:00
abstract::Muscle transplantation has become an indispensable tool to restore the smile in patients with long-standing or congenital facial paralysis. However, little is known of the effect of this surgical intervention on craniofacial growth and development or of the adaptation of the transplant to its recipient site under circ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-200001000-00020
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Lymphedema is a common and debilitating condition. Management options for lymphedema are limited and controversial. The purpose of this prospective study was to provide a preliminary analysis of lymphaticovenular bypass for the treatment of upper limb lymphedema in breast cancer patients. METHODS:Twenty pat...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e3181e5f6a9
更新日期:2010-09-01 00:00:00
abstract::Breast reconstruction after a radical mastectomy using the temporary subcutaneous tissue expander is described. The main principle of this method is recovery of the amount of lost tissue through expansion of the remaining chest skin to large proportions and filling of the breast envelope with a smaller permanent mamma...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-198202000-00001
更新日期:1982-02-01 00:00:00
abstract::Two cases of heel damage that were reconstructed with a T-shaped distally based island fasciocutaneous flap in the sural area are presented. This flap is vascularized by the distal sural arterial network. The advantages of this flap are: (1) It does not sacrifice any major arteries of the leg. (2) It covers the whole ...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199404000-00036
更新日期:1994-04-01 00:00:00
abstract::The aims of this anatomic investigation were to examine the levator veli palatini, tensor veli palatini, and salpingopharyngeus muscles in relation to normal eustachian tube function and to analyze the clinical implications of these data for tubal physiology in cleft palate individuals. Detailed dissections under 3.2x...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199709001-00003
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:There are many approaches to the medial orbital wall. However, most of them have problems with limitation of exposure, scarring, and postoperative inflammatory symptoms related to the eye. The authors used an upper eyelid crease approach to overcome these problems and investigate the usefulness of this appro...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318262f3d9
更新日期:2012-10-01 00:00:00
abstract::Postbariatric body contouring surgery has grown in prevalence, mirroring the ascent of weight loss surgery. With the rise in prevalence of this subset of plastic surgery procedures, we are gaining wisdom about technique, safety, and outcomes associated with this patient population. The pearls of patient management inc...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章,评审
doi:10.1097/PRS.0b013e318262f545
更新日期:2012-10-01 00:00:00
abstract::A new surgical technique with a set of instruments has been developed for the release of carpal tunnel. The technique allows division of the transverse carpal ligament through a short transverse skin incision (1.5 to 2 cm) of the wrist flexion crease under direct visualization. The technique has been used on 237 patie...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199608000-00016
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:Successful clinical application of dermal filler products requires an understanding of their physical characteristics and in vivo behavior. This study reviewed the data for hyaluronic acid dermal filler products derived from an animal source--the rooster comb. METHODS:A review of the hyaluronic acid literat...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000248806.70402.7b
更新日期:2007-11-01 00:00:00
abstract::A variety of useful recipient sites exist for breast reconstruction with free flaps, and correct selection remains a significant decision for the surgeon. Among the main pedicles, the disadvantages of the internal mammary vessels are the necessity of costal cartilage resection and the impairment of future cardiac bypa...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000129074.88594.d7
更新日期:2004-07-01 00:00:00
abstract::Recent controversy encountered with silicone breast implants has increased the use of autogenous tissue for breast reconstruction following mastectomy. Surveillance of patients who have undergone autogenous tissue reconstruction is important in the evaluation of recurrent or new cancer. Magnetic resonance imaging (MRI...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199501000-00010
更新日期:1995-01-01 00:00:00
abstract::We describe 3 patients with the Pierre Robin Syndrome who developed severe problems of airway obstruction after having the cleft palate closed and a pharyngeal flap done simultaneously. We now believe that, even at a later age, pharyngeal flaps should be done in these patients only after a most careful assessment of t...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-197608000-00007
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND:The universal adoption of muscle perforator flaps has been hampered by a lack of uniformity that would ensure the reliable harvest of the requisite vascular pedicle. Anatomical anomalies of their vascular supply are the anticipated norm, creating a conundrum inasmuch as retention of an adequate circulation i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/PRS.0b013e318199f7d2
更新日期:2009-03-01 00:00:00
abstract::The use of nonpenetrating clips to accomplish wound closure as an alternative to suture in the repair of simulated cleft lips in partially exteriorized fetuses has been described previously. In this study, the fetus is approached endoscopically, and clipped (n = 8) and sutured (n = 4) intrauterine endoscopic repairs i...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199807000-00001
更新日期:1998-07-01 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::We present a series of six patients with eight flaps in whom computer-generated models were used for fabrication of vascularized bone grafts in complex facial restorations. Preoperative CT data, digitalized on tape, were converted by the CEMAX (Santa Clara, Calif.) 1500 Integrated Hardware and Software System to a thr...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/00006534-199302000-00007
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND:The Madame Butterfly procedure of lower eyelid reconstruction addresses lower eyelid retraction after blepharoplasty caused by middle lamellar tethering. After scar lysis and subperiosteal midface lift, the surgical procedure uses a lower eyelid spacer graft to prevent further postoperative contraction of th...
journal_title:Plastic and reconstructive surgery
pub_type: 杂志文章
doi:10.1097/01.prs.0000177694.39466.b2
更新日期:2005-09-01 00:00:00