24 results on '"Breast Implantation adverse effects"'
Search Results
2. How often does delayed latissimus/implant-based breast reconstruction following postmastectomy radiation result in a significantly undesirable outcome?
- Author
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Liu R, Chambers S, Grant A, Maciver A, and Latosinsky S
- Subjects
- Female, Humans, Mastectomy, Postoperative Complications etiology, Treatment Outcome, Breast Implantation adverse effects, Breast Implants adverse effects, Breast Neoplasms radiotherapy, Breast Neoplasms surgery, Mammaplasty adverse effects
- Published
- 2020
- Full Text
- View/download PDF
3. The evolution of breast prostheses.
- Author
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Vinci V, Domenico C, Luca M, Silvia G, Alessandra V, Barbara C, Valeria B, Andrea B, Mattia S, Federico B, Andrea Vittorio Emauele L, and Marco K
- Subjects
- Female, Humans, Breast Implantation adverse effects, Breast Implants adverse effects, Breast Neoplasms, Mammaplasty
- Abstract
Every year approximately 1.5 million prostheses are implanted worldwide for breast augmentation and reconstructive indications. The modern breast implant as we know was released to the open market in 1963. It has gone through intense phases of development which have improved the initially primitive and limited devices to current-day devices, which exhibit a tremendous range of surface textures, sizes, gel consistencies, and anatomical shapes. This article explores the evolution of breast implants providing historical facts and technical details., (© 2020 Wiley Periodicals LLC.)
- Published
- 2020
- Full Text
- View/download PDF
4. The decline of textured implants in single-stage breast reconstruction in Alberta.
- Author
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Nicholas C, Mack L, Webb C, and Temple-Oberle C
- Subjects
- Alberta, Female, Humans, Breast Implantation adverse effects, Breast Implants adverse effects, Breast Neoplasms surgery, Lymphoma, Large-Cell, Anaplastic, Mammaplasty
- Published
- 2020
- Full Text
- View/download PDF
5. Synchronous silicone-induced granuloma (SIG) of breast implant capsule (BIC) and gluteal implant capsule (GIC): What to learn.
- Author
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Castro C, Campos MSDDA, Roveda D Jr, and Fleury EFC
- Subjects
- Female, Granuloma chemically induced, Humans, Silicones adverse effects, Breast Implantation adverse effects, Breast Implants adverse effects, Breast Neoplasms surgery
- Published
- 2020
- Full Text
- View/download PDF
6. Identifying patients at risk of breast implant-associated anaplastic large cell lymphoma: A commentary.
- Author
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Hill WF, Mack L, Webb C, and Temple-Oberle C
- Subjects
- Female, Humans, Breast Implantation adverse effects, Breast Implants adverse effects, Breast Neoplasms etiology, Breast Neoplasms surgery, Lymphoma, Large-Cell, Anaplastic etiology
- Published
- 2020
- Full Text
- View/download PDF
7. Osteomyelitis of the costal arches after breast prosthesis implantation.
- Author
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Carrara GFA, de Oliveira-Junior I, Haikel RL, Bailão-Junior A, Micheli RAD, Viana CR, Galvão Ribeiro MGR, and Vieira RADC
- Subjects
- Female, Humans, Breast Implantation adverse effects, Breast Neoplasms surgery, Osteomyelitis diagnostic imaging, Osteomyelitis etiology
- Published
- 2020
- Full Text
- View/download PDF
8. Nipple malposition after bilateral nipple-sparing mastectomy with implant-based reconstruction: Objective postoperative analysis utilizing BCCT.core computer software.
- Author
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Hart A, Doyle K, Losken A, and Carlson GW
- Subjects
- Female, Humans, Mastectomy, Nipples diagnostic imaging, Nipples surgery, Reproducibility of Results, Software, Breast Implantation adverse effects, Breast Neoplasms diagnostic imaging, Breast Neoplasms surgery
- Abstract
Nipple-sparing mastectomies (NSMs) are accepted as safe oncologic procedures for select patient populations, but objective evaluation of aesthetic outcomes has not been clearly established. The purpose of this study was to utilize BCCT.core computer software to objectively evaluate NAC malposition following bilateral NSM with implant reconstruction and compare the analysis to an expert panel. Postoperative photographs of 43 patients who underwent bilateral NSM were analyzed with the BCCT.core and by an expert panel of plastic surgery residents and attendings. The panel was asked to only evaluate nipple asymmetry and position. The intraclass correlation coefficient (ICC) was used to determine interrater reliability (n = 12) and between expert panel ratings and BCCT.core ratings. Statistics were performed using SPSS statistical package version 24.0. The ICC for the expert panel interrater reliability was excellent (ICC = 0.941, 95% CI: 0.912-0.964). The analysis between BCCT.core individual parameters, specifically the breast retraction assessment (ie, BRA score = the difference in nipple position between the two breasts assessing breast symmetry) and expert panel, showed statistically significant positive correlation. The parameters provided by the BCCT.core software were correlated with both the mean expert panel rating and BCCT.core ratings. Therefore, it is plausible that BCCT.core parameters could be used to objectively quantify NAC malposition/asymmetry and guide treatment in patients undergoing bilateral NSM with implant reconstruction., (© 2020 Wiley Periodicals, Inc.)
- Published
- 2020
- Full Text
- View/download PDF
9. Silicone-induced granuloma of breast implant capsule mimicking anaplastic large cell lymphoma.
- Author
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Castro C, Fernandes D, Mendonça M, Roveda Junior D, Badan G, and Fleury EFC
- Subjects
- Female, Granuloma, Humans, Silicones adverse effects, Breast Implantation adverse effects, Breast Implants adverse effects, Breast Neoplasms diagnostic imaging, Lymphoma, Large-Cell, Anaplastic diagnosis, Lymphoma, Large-Cell, Anaplastic diagnostic imaging
- Published
- 2020
- Full Text
- View/download PDF
10. When breast implants get alive?
- Author
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Fleury E
- Subjects
- Adult, Equipment Failure Analysis, Female, Humans, Image Enhancement methods, Magnetic Resonance Imaging methods, Organ Size, Breast diagnostic imaging, Breast pathology, Breast Implantation adverse effects, Breast Implantation instrumentation, Breast Implants adverse effects, Granuloma, Foreign-Body diagnosis, Granuloma, Foreign-Body etiology, Silicone Gels adverse effects
- Published
- 2019
- Full Text
- View/download PDF
11. Operative risk stratification in the obese female undergoing implant-based breast reconstruction.
- Author
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Rudolph M, Moore C, and Pestana IA
- Subjects
- Adult, Aged, Breast Neoplasms radiotherapy, Breast Neoplasms surgery, Female, Humans, Middle Aged, Postoperative Complications etiology, Radiotherapy adverse effects, Risk Assessment, Risk Factors, Breast Implantation adverse effects, Breast Neoplasms complications, Obesity complications, Postoperative Complications epidemiology
- Abstract
The prevalence of obesity is growing, and breast reconstruction in the obese patient is becoming the norm rather than the exception. Our aim was to evaluate implant reconstruction outcomes in the obese female in the presence of coincident surgical risk factors and identify potential risk-reducing interventions. A review of consecutive obese women (BMI ≥ 30) who underwent mastectomy and implant breast reconstruction was performed. Patient demographics, comorbidities, oncologic treatments, and reconstructive procedures and their complications were recorded. A total of 151 women (242 breast reconstructions) were included with mean follow-up of 28 months. Average BMI was 36. Eighty percent of cases were immediate and 20% delayed. ADMs were utilized in 58% of cases. About 25% of patients had diabetes with one-third achieving perioperative glycemic control. About 18% of women were active smokers, and 33% had radiotherapy. Major and minor complications occurred in 42% and 11% of patients, respectively. About 24% of reconstructed breasts required implant removal. Obese patients with prior radiation were three times as likely to develop infection (P = 0.008) and 2.5× as likely to undergo explantation (P = 0.002). Skin flap necrosis was three times as likely in obese smokers (P = 0.01). Increased rates of wound breakdown were identified in obese patients with increasing age (P = 0.005), smoking (P = 0.0035), and radiation (P = 0.023). In the obese radiated and smoking patient subgroups, surgical modifications (use of autologous tissue, delayed breast reconstruction timing, and no ADM) were associated with reduction in the relative risk for implant complications. While obesity alone increases implant breast reconstruction complication rates, the presence of additional risk factors compounds these rates. The use of surgical modifications may reduce the occurrence of perioperative complications in the obese female with coincident surgical risk factors undergoing implant breast reconstruction., (© 2019 Wiley Periodicals, Inc.)
- Published
- 2019
- Full Text
- View/download PDF
12. Mastectomy flap necrosis after nipple-sparing mastectomy and immediate implant-based reconstruction: An evaluation of tumescence and sharp dissection technique on surgical outcomes.
- Author
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Ng T, Knowles S, Brackstone M, and Doherty C
- Subjects
- Adult, Breast Implantation adverse effects, Breast Implantation methods, Breast Neoplasms surgery, Dissection methods, Electrocoagulation methods, Female, Humans, Middle Aged, Necrosis etiology, Nipples surgery, Postoperative Complications etiology, Retrospective Studies, Surgical Flaps blood supply, Dissection adverse effects, Electrocoagulation adverse effects, Mammaplasty methods, Mastectomy, Subcutaneous methods, Surgical Flaps pathology
- Abstract
Nipple-sparing mastectomy (NSM) with immediate implant-based reconstruction has better esthetic outcomes and improved patient satisfaction, in addition to being oncologically safe. A known complication of NSM is skin flap necrosis. The use of tumescence and sharp dissection may decrease this complication compared to the standard NSM technique using electrocautery. This is a retrospective review of patients who underwent a NSM between 2014 and 2017 at a regional cancer center. Tumescence with sharp dissection was compared to electrocautery. The primary outcome was skin flap necrosis. The secondary outcomes were operative time and management of the complication. A total of 62 patients underwent a NSM with 116 breasts being operated on. Full-thickness necrosis occurred more frequently in the standard electrocautery group (12.8%) compared to the tumescence and sharp dissection group (1.3%; P = 0.02). Partial-thickness necrosis also occurred more frequently in the standard group (33.3%) compared to the sharp dissection group (13.0%; P = 0.01). The operative time was significantly shorter in the sharp dissection group with the mean (SD) time being 183.5 (48.9) minutes compared to the standard electrocautery group at 202.9 (33.8) minutes (P = 0.03). NSM using tumescence and sharp dissection have a lower rate of the complications of partial- and full-thickness necrosis. Shorter operative time was also seen with the tumescent technique., (© 2019 Wiley Periodicals, Inc.)
- Published
- 2019
- Full Text
- View/download PDF
13. Risk of breast implant-associated anaplastic large cell lymphoma in patients submitted to breast implantation: A systematic review.
- Author
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Wohlgemuth FB, Brasil MBQ, and d'Acampora AJ
- Subjects
- Breast Neoplasms surgery, Case-Control Studies, Cohort Studies, Female, Humans, Incidence, Risk Assessment, Breast Implantation adverse effects, Breast Implants adverse effects, Lymphoma, Large-Cell, Anaplastic etiology
- Abstract
Although breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare disease, its incidence has been increasing. The aim of this study was to assess the risk of BIA-ALCL in women with breast implants. A systematic search was carried out in Pubmed, Scopus, ScienceDirect, LIVIVO, Cochrane Library, Google Scholar, and OpenGrey databases. The risk assessment of bias was based on the Newcastle-Ottawa Scale. The rarity of BIA-ALCL was a major limitation. Although we have found evidence of an increased risk of BIA-ALCL, further studies are needed to understand why some large samples did not present any case of the disease., (© 2019 Wiley Periodicals, Inc.)
- Published
- 2019
- Full Text
- View/download PDF
14. Delayed-immediate hybrid breast reconstruction-Increasing patient input and precision in breast reconstruction.
- Author
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Momeni A and Kanchwala S
- Subjects
- Adult, Aged, Breast Implantation adverse effects, Female, Free Tissue Flaps, Humans, Mammaplasty adverse effects, Mastectomy adverse effects, Middle Aged, Patient Satisfaction, Retrospective Studies, Surgical Wound Dehiscence etiology, Surgical Wound Dehiscence prevention & control, Breast Implantation methods, Mammaplasty methods
- Abstract
The benefits of breast reconstruction via free tissue transfer with simultaneous implant placement, that is, hybrid breast reconstruction, in select patients are well-known. Challenges exist, however, and are related to proper implant selection as well as postoperative mastectomy skin necrosis. Here, the authors present an approach that increases reconstructive precision while minimizing postoperative mastectomy skin necrosis. A retrospective analysis of patients who underwent immediate prepectoral tissue expander placement (stage 1) followed by delayed-immediate hybrid breast reconstruction (stage 2) was performed. Parameters of interest included patient demographics, postoperative complications, and revision rates. A total of 31 patients with a mean age of 48.7 years (range, 30-67 years) and a mean BMI of 26.3 kg/m
2 (range, 21.0-35.3 kg/m2 ) who underwent bilateral breast reconstruction were included. Of the 62 free abdominal flaps, 45 (72.6%) and 17 (27.4%) were MS-TRAM and DIEP flaps, respectively. The most common implant volume was 240 cc (range, 140-445 cc). Following stage 1, minor and major complications were observed in nine (29%) and one (3.2%) patients, respectively. No major complications were noted after stage 2. Of note, no patient developed mastectomy skin necrosis or requested a change in implant size following stage 2. Delayed-immediate hybrid breast reconstruction improves the ability to more precisely match patient expectations related to breast size and is associated with a reduction in the rate of mastectomy skin necrosis following the critical second stage of reconstruction., (© 2019 Wiley Periodicals, Inc.)- Published
- 2019
- Full Text
- View/download PDF
15. Incidence of complications following two-stage expander/implant breast reconstruction: The impact of cancer diagnosis in prophylactic mastectomy.
- Author
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Simpson AM, Moores N, Swistun L, Ying J, and Agarwal JP
- Subjects
- Adult, Breast Implantation methods, Breast Implants, Breast Neoplasms diagnosis, Breast Neoplasms surgery, Female, Humans, Incidence, Mammaplasty methods, Middle Aged, Retrospective Studies, Tissue Expansion Devices, Breast Implantation adverse effects, Mammaplasty adverse effects, Postoperative Complications epidemiology, Postoperative Complications etiology, Prophylactic Mastectomy adverse effects
- Published
- 2019
- Full Text
- View/download PDF
16. Identifying risk factors for postoperative major complications in staged implant-based breast reconstruction with AlloDerm.
- Author
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Remington AC, Gurtner GC, Wan DC, Nguyen D, and Momeni A
- Subjects
- Adult, Body Mass Index, Breast Implants adverse effects, Breast Neoplasms therapy, Cohort Studies, Female, Humans, Middle Aged, Patient Readmission, Retrospective Studies, Tissue Expansion Devices adverse effects, Breast Implantation adverse effects, Collagen, Mammaplasty adverse effects, Postoperative Complications etiology
- Abstract
Acellular dermal matrices (ADM) have reportedly been associated with postoperative complications following breast reconstruction. The purpose of this study was to identify risk factors predictive of major postoperative complications after staged implant-based breast reconstruction with ADM. A retrospective study of all patients who underwent implant-based breast reconstruction with AlloDerm between 2013 and 2017 was conducted. Demographic information, procedural data, and postoperative complications were retrieved. The main objective was to analyze patient and procedural factors associated with the occurrence of major complications, including postoperative readmission and loss of reconstruction. A total of 166 patients (288 breasts) were included. Major complications were noted in 19.9%. The overall rate of infection and mastectomy skin necrosis was 16.9% and 6.6%, respectively. Readmission occurred in 16.3% and loss of reconstruction occurred in 8.4% of patients. Risk factors for major complications included body mass index (BMI) >27.0 kg/m
2 (OR 2.46; p = 0.041), higher tissue expander volume (p = 0.049), history of chemotherapy (OR 2.20; p = 0.047) and radiotherapy (OR 2.22; p = 0.040). Loss of reconstruction was associated with a BMI >27.0 kg/m2 (OR 4.00; p = 0.012), tobacco use (OR 6.64, p = 0.006), and higher tissue expander volume (p = 0.035). Similarly, readmission was associated with higher tissue expander volume (p = 0.042). In conclusion, a variety of factors were identified to be associated with major complications, including higher BMI, increased tissue expander volume, as well as history of chemotherapy and radiation. This information is valuable for pre-operative counseling and for future comparative studies between different ADM types., (© 2019 Wiley Periodicals, Inc.)- Published
- 2019
- Full Text
- View/download PDF
17. Breast implant-associated anaplastic large cell lymphoma: Clinical and imaging findings at a large US cancer center.
- Author
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Dashevsky BZ, Gallagher KM, Grabenstetter A, Cordeiro PG, Dogan A, Morris EA, Horwitz SM, and Sutton EJ
- Subjects
- Adult, Aged, Biopsy, Fine-Needle, Breast Implantation adverse effects, Breast Neoplasms therapy, Female, Humans, Lymphoma, Large-Cell, Anaplastic therapy, Magnetic Resonance Imaging, Mammaplasty adverse effects, Middle Aged, Time Factors, Ultrasonography, Mammary, Breast Implants adverse effects, Breast Neoplasms diagnostic imaging, Breast Neoplasms pathology, Lymphoma, Large-Cell, Anaplastic diagnostic imaging, Lymphoma, Large-Cell, Anaplastic pathology
- Abstract
Purpose: Evaluate the clinical presentation and imaging findings of breast implant-associated anaplastic large cell lymphoma (BIA ALCL) at a large US cancer center., Materials and Methods: HIPAA-compliant IRB approved retrospective study, for which informed consent was waived. The Hospital Information System was screened for women who underwent implant reconstruction and were diagnosed with BIA ALCL between 2010 and 2016. Two radiologists reviewed images in consensus. Clinical and imaging characteristics were summarized using means and ranges for continuous variables and percentages for categorical variables., Results: Patient cohort included 11 women with BIA ALCL (mean age at diagnosis = 54 years, range: 35-77), including women with (9/11) and without (2/11) history of breast cancer. Mean time from breast implant placement to diagnosis was 10 years (range: 6-14). BIA ALCL was identified in patients with saline (4/11) and silicone (5/11) implants. Implants were textured in 7/11 (63%) and unknown in 4/11 (36%) cases. All patients presented with a peri-implant seroma, (9/11 documented on imaging). Two of 11 patients had a mass within this seroma. Ten of 11 patients (91%) presented with symptoms., Conclusions: Saline and silicone breast implants may predispose patients to a rare lymphoma subtype, BIA ALCL, which presents on imaging as a peri-implant fluid collection ± mass., (© 2018 Wiley Periodicals, Inc.)
- Published
- 2019
- Full Text
- View/download PDF
18. Management of Late Seroma in Patients with Breast Implants: The Role of the Radiologists.
- Author
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Graña López L, Vázquez Caruncho M, and Villares Armas Á
- Subjects
- Adult, Biopsy, Needle methods, Breast Implantation adverse effects, Female, Humans, Middle Aged, Paracentesis methods, Seroma therapy, Ultrasonography, Mammary, Breast Implants adverse effects, Seroma diagnostic imaging, Seroma etiology
- Published
- 2016
- Full Text
- View/download PDF
19. An Analysis of Complication Risk Factors in 641 Nipple Reconstructions.
- Author
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Satteson ES, Reynolds MF, Bond AM, and Pestana IA
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Breast Implantation adverse effects, Breast Implantation methods, Breast Implants, Breast Neoplasms surgery, Breast Neoplasms therapy, Comorbidity, Female, Humans, Mammaplasty statistics & numerical data, Middle Aged, Obesity complications, Obesity epidemiology, Postoperative Complications epidemiology, Retrospective Studies, Risk Factors, Smoking adverse effects, Smoking epidemiology, Surgical Flaps, Young Adult, Mammaplasty adverse effects, Mammaplasty methods, Nipples surgery, Postoperative Complications etiology
- Abstract
Nipple-areola reconstruction represents the completion of the breast restorative process and is associated with significant positive psychological implications. While factors such as medical comorbidities, smoking status, and radiation therapy have been shown to be associated with an increase in complications following breast reconstruction, their impact on nipple reconstruction remains largely unaddressed in the literature. An IRB-approved, retrospective review of 472 patients who underwent nipple reconstruction at Wake Forest University over a 15-year period was completed. Demographic and surgical characteristics were assessed including age, body mass index, medical comorbidities, smoking status, need for radiation, breast reconstruction type, and nipple flap used. Four hundred and seventy-two patients with 641 nipple reconstructions were included with an average follow-up of 56.5 months. Radiation prior to nipple reconstruction was required in 146 breasts (22.8%). Overall, postoperative nipple projection problems occurred in 7.6% of reconstructions with a 4.1% rate of other complications, including nipple necrosis, tip loss, wound infection and wound breakdown. Implant-based reconstruction and radiation were associated with significantly more nipple projection problems (p = 0.009 and 0.05, respectively). Higher rates of complications and nipple projection problems were seen with skate flap reconstruction compared to a star flap (p = 0.046 and 0.001, respectively). Implant-based breast reconstruction and radiotherapy are associated with higher rates of nipple reconstruction problems. Identification of patient and surgical variables associated with increased risk of poor outcomes preoperatively could help in patient counseling and selection of the most appropriate method of breast and nipple reconstruction., (© 2016 Wiley Periodicals, Inc.)
- Published
- 2016
- Full Text
- View/download PDF
20. Postoperative Expansion is not a Primary Cause of Infection in Immediate Breast Reconstruction with Tissue Expanders.
- Author
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Avraham T, Weichman KE, Wilson S, Weinstein A, Haddock NT, Szpalski C, Choi M, and Karp NS
- Subjects
- Adult, Biocompatible Materials administration & dosage, Breast Implantation adverse effects, Female, Humans, Mastectomy methods, Middle Aged, Postoperative Complications, Plastic Surgery Procedures methods, Retrospective Studies, Surgical Wound Infection prevention & control, Tissue Expansion methods, Biocompatible Materials adverse effects, Breast Neoplasms therapy, Mastectomy adverse effects, Plastic Surgery Procedures adverse effects, Surgical Wound Infection etiology, Tissue Expansion adverse effects
- Abstract
Perioperative infection is the most common and dreaded complication associated with tissue expander (TE) breast reconstruction. Historically, the expansion period was thought to be the time of greatest hazard to the implant. However, recent institutional observations suggest infectious complications occur prior to expansion. This investigation, therefore, was conducted to determine the timing of infectious complications associated with two-stage TE breast reconstructions. Following IRB approval, a retrospective review of all consecutive two-stage immediate TE breast reconstructions at a single institution from November 2007 to November 2011 was conducted. Reconstructions were then divided into two cohorts: those suffering infectious complications and those that did not. Infectious complications including minor cellulitis, major cellulitis, abscess drainage, and explantation were identified. Various operative and patient variables were evaluated in comparison. Eight hundred ninety immediate two-stage TE breast reconstructions met inclusion criteria. Patients suffering infection were older (55.4 years versus 49.3 years; p < 0.001), and more likely to have therapeutic mastectomy (94% versus 61%; p < 0.0001), the use of acellular dermal matrix (ADM; 72.5% versus 54.9%; p = 0.001), and greater initial TE fill (448.6 mL versus 404.7 mL; p = 0.0078). The average time to developing of infectious symptoms was 29.6 days (range 9-142 days), with 94.6% (n = 87) of infections prior to the start of expansion. Perioperative infections in immediate two-stage TE to implant breast reconstructions are significant and occur mostly prior to the start of expansion. Thus, challenging the conventional wisdom that instrumentation during expander filling as the primary cause of implant infections. Possible etiologic factors include greater age, therapeutic mastectomy versus prophylactic mastectomy, larger initial TE fill, and the use of ADM., (© 2015 Wiley Periodicals, Inc.)
- Published
- 2015
- Full Text
- View/download PDF
21. The Effect of Radiation on Complication Rates and Patient Satisfaction in Breast Reconstruction using Temporary Tissue Expanders and Permanent Implants.
- Author
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Anker CJ, Hymas RV, Ahluwalia R, Kokeny KE, Avizonis V, Boucher KM, Neumayer LA, and Agarwal JP
- Subjects
- Adult, Aged, Aged, 80 and over, Breast Implantation adverse effects, Breast Implants, Dose Fractionation, Radiation, Female, Humans, Mammaplasty methods, Mastectomy, Middle Aged, Retrospective Studies, Tissue Expansion methods, Tissue Expansion Devices, Breast Implantation methods, Breast Neoplasms radiotherapy, Breast Neoplasms surgery, Mammaplasty adverse effects, Patient Satisfaction
- Abstract
The optimal method of reconstruction following mastectomy for breast cancer patients receiving radiation therapy (RT) is controversial. This study evaluated patient satisfaction and complication rates among patients who received implant-based breast reconstruction. The specific treatment algorithm analyzed included patients receiving mastectomy and immediate temporary tissue expander (TE), followed by placement of a permanent breast implant (PI). If indicated, RT was delivered to the fully expanded TE. Records of 218 consecutive patients with 222 invasive (85%) or in situ (15%) breast lesions from the Salt Lake City region treated between 1998 and 2009 were retrospectively reviewed, 28% of whom received RT. Median RT dose was 50.4 Gy, and 41% received a scar boost at a median dose of 10 Gy. Kaplan-Meier analyses were performed to evaluate the cumulative incidence of surgical complications, including permanent PI removal. Risk factors associated with surgical events were analyzed. To evaluate cosmetic results and patient satisfaction, an anonymous survey was administered. Mean follow-up was 44 months (range 6-144). Actuarial 5-year PI removal rates for non-RT and RT patients were 4% and 22%, respectively. On multivariate analysis (MVA), the only factor associated with PI removal was RT (p = 0.009). Surveys were returned describing the outcomes of 149 breasts. For the non-RT and RT groups, those who rated their breast appearance as good or better were 63% versus 62%, respectively. Under 1/3 of each group was dissatisfied with their reconstruction. RT did not significantly affect patient satisfaction scores, but on MVA RT was the only factor associated with increased PI removal. This reconstruction technique may be considered an acceptable option even if RT is needed, but the increased complication risk with RT must be recognized., (© 2015 Wiley Periodicals, Inc.)
- Published
- 2015
- Full Text
- View/download PDF
22. How should we investigate breast implant rupture?
- Author
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Hold PM, Alam S, Pilbrow WJ, Kelly JF, Everitt EM, Dhital SK, and Juma A
- Subjects
- Cohort Studies, Female, Humans, Postoperative Complications diagnostic imaging, Prospective Studies, Retrospective Studies, Breast Implantation adverse effects, Breast Implants adverse effects, Magnetic Resonance Imaging economics, Postoperative Complications diagnosis, Prosthesis Failure, Ultrasonography, Mammary economics
- Abstract
We aimed to examine a cohort of patients presenting with breast implant complications to establish the sensitivity and specificity of clinical examination, Ultrasound Scanning (US) and Magnetic Resonance Imaging (MRI) in the diagnosis of implant rupture, and to examine the correlation between US and MRI. We performed a 26-month retrospective review. Patients underwent US and MRI to exclude rupture. Results of US and MRI were compared prospectively for concordance, then retrospectively to clinical findings and surgical diagnosis. Thirty-four patients with 60 implants were reviewed. The sensitivities of clinical diagnosis, US, and MRI for rupture was 42%, 50%, and 83%, respectively, while the specificities were 50%, 90%, and 90%. The concordance between US and MRI was 87%. MRI is the investigation of choice for implant rupture. US is a valuable alternative with good concordance with MRI. When US is positive for implant rupture an MRI is not necessary to confirm the diagnosis. Knowledge of the sensitivity and specificity as well as the concordance between the two investigations is useful to ensure the appropriate use of available resources., (© 2012 Wiley Periodicals, Inc.)
- Published
- 2012
- Full Text
- View/download PDF
23. Radiotherapy and immediate expander/implant breast reconstruction: should reconstruction be delayed?
- Author
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Drucker-Zertuche M, Bargallo-Rocha E, and Zamora-Del RR
- Subjects
- Adult, Aged, Breast Neoplasms surgery, Combined Modality Therapy, Female, Humans, Middle Aged, Time Factors, Breast Implantation adverse effects, Breast Neoplasms radiotherapy
- Abstract
Chest wall irradiation is very common for mastectomy patients that have opted for immediate breast reconstruction. We reviewed a 6 year experience with tissue expander implant reconstruction with and without radiotherapy in 97 patients. All patients were evaluated with respect to aesthetic outcome, infection, implant exposure, capsular contracture, displacement and failure of the reconstruction; more than 50% of our irradiated patients resulted in a complication. The findings of this study demonstrate that the rate of complications and the rate of patients requiring corrective surgeries in irradiated patients is significant in early follow up., (© 2011 Wiley Periodicals, Inc.)
- Published
- 2011
- Full Text
- View/download PDF
24. Comparative study of breast implant rupture using mammography, sonography, and magnetic resonance imaging: correlation with surgical findings.
- Author
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Di Benedetto G, Cecchini S, Grassetti L, Baldassarre S, Valeri G, Leva L, Giuseppetti GM, and Bertani A
- Subjects
- Diagnosis, Differential, Female, Humans, Magnetic Resonance Imaging, Mammography, Rupture diagnosis, Rupture diagnostic imaging, Silicones adverse effects, Ultrasonography, Breast Implantation adverse effects, Prostheses and Implants adverse effects, Rupture surgery
- Abstract
Purpose of this study was to evaluate the accuracy of mammography, ultrasonography, and magnetic resonance imaging (MRI), in the detection of breast implant rupture and to make a correlation with findings at explantation. The study population consisted of 63 women with 82 implants, undergoing surgical explantation. Implant rupture status was blindly determined obtaining diagnosis of rupture, possible rupture, or intact implant. Strictly predetermined rupture criteria were applied and compared with findings at surgery, which were considered the gold standard. False-positives and false-negatives were retrospectively evaluated to identify pitfalls in the investigation. All associations between imaging signs and surgical findings were evaluated by using chi-square test. The respective sensitivity and specificity of investigations are reported. Our experience suggests that MRI is the more accurate method for identification of breast implant rupture, even if it should be performed following the diagnostic algorithm proposed.
- Published
- 2008
- Full Text
- View/download PDF
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