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Purpose: Obesity and breast density are both associated with an increased risk of breast cancer and are potentially modifiable. Weight loss surgery (WLS) causes a significant reduction in the amount of body fat and a decrease in breast cancer risk. The effect of WLS on breast density and its components has not been documented. Here, we analyze the impact of WLS on volumetric breast density (VBD) and on each of its components (fibroglandular volume and breast volume) by using three-dimensional methods., Materials and Methods: Fibroglandular volume, breast volume, and their ratio, the VBD, were calculated from mammograms before and after WLS by using Volpara™ automated software., Results: For the 80 women included, average body mass index decreased from 46.0 ± 7.22 to 33.7 ± 7.06 kg/m 2 . Mammograms were performed on average 11.6 ± 9.4 months before and 10.1 ± 7 months after WLS. There was a significant reduction in average breast volume (39.4 % decrease) and average fibroglandular volume (15.5 % decrease), and thus, the average VBD increased from 5.15 to 7.87 % (p < 1 × 10 -9 ) after WLS. When stratified by menopausal status and diabetic status, VBD increased significantly in all groups but only perimenopausal and postmenopausal women and non-diabetics experienced a significant reduction in fibroglandular volume., Conclusions: Breast volume and fibroglandular volume decreased, and VBD increased following WLS, with the most significant change observed in postmenopausal women and non-diabetics. Further studies are warranted to determine how physical and biological alterations in breast density components after WLS may impact breast cancer risk.

Objective: Lateral breast defects of various causes can be reconstructed with random patterned local flaps utilizing oncoplastic techniques. These local flaps are used frequently in other areas but are infrequent in breast reconstruction despite affording excellent utility in small lateral defects.We sought to demonstrate this with a case series involving 5 patients who underwent oncoplastic breast surgery with random patterned flap reconstruction. Methods: From 2016 to 2017, 3 different varieties of random flaps were used in 5 women requiring lateral breast defect reconstruction secondary to resection of localized cancer or cutaneous lesion. The local flaps included a rhomboid flap, the bilobed flap, and a rotational flap. Patients were then evaluated in the clinic 10 to 12 months postoperatively for complications, symmetry, and satisfaction of reconstruction. Results: In 4 of 5 patients, the local flap remained fully viable and therewas no incidence of seroma, infection, or further complications. One patient developed a post-operative hematoma requiring evacuation and a second patient experienced distal flap necrosis and delayed wound healing. Patients reported satisfaction with the reconstruction. Conclusions: Several random patterned local flaps exist for a variety of breast defects. They can yield excellent cosmetic results, high patient satisfaction, and bolster a low rate of complications. Our case series emphasizes the utility of random patterned flaps for lateral breast oncoplastic reconstruction. [ABSTRACT FROM AUTHOR]

Purpose: Breast augmentation is the most commonly performed aesthetic operation in the Unites States annually. With the increasing popularity of gel implants, optimal incisional length for specific implant volumes becomes a factor to consider. Our study is the first, to date, to measure optimal incisional length for increasing Mentor smooth, round, moderate plus silicone implant volumes. Method: Three cadaver breasts were dissected in our anatomy laboratory. After dissection of a subpectoral pocket via an inframammary fold incision, time of implant insertion was measured for increasing volumes with the use of increasing incisional site lengths. Results: Values for increased incisions are as follows: 2.5-cm incision facilitated 100-cm3 implant (average time [AvgT] 76 seconds); 3-cm incision 100-cm3 implant (AvgT 32 seconds), 200 cm3 (AvgT 84.33 seconds); 3.5-cm incision 100-cm3 implant (AvgT 13.00 seconds), 200 cm3 (AvgT 22.00 seconds), 300 cm3 (AvgT 33.67 seconds); 4-cm incision 100-cm3 implant (AvgT 5.67 seconds), 200 cm3 (AvgT 11.33 seconds), 300 cm3 (AvgT 21.33 seconds), 400 cm3 (AvgT 26 seconds); 4.5-cm incision 100-cm3 implant (AvgT 5 seconds), 200 cm3 (AvgT 15.17 seconds), 300 cm3 (AvgT 19.67 seconds), 400 cm3 (AvgT 26 seconds), 500 cm3 (AvgT 39.67 seconds), 600 cm3 (AvgT 59.33 seconds), 700 cm3 (AvgT 78.67 seconds); 5-cm incision 100-cm3 implant (AvgT 1 second), 200 cm3 (AvgT 3.67 seconds), 300 cm3 (AvgT 8 seconds), 400 cm3 (AvgT 13 seconds), 500 cm3 (AvgT 19.33 seconds), 600 cm3 (AvgT 23.33 seconds), 700 cm3 (AvgT 28 seconds), 800 cm3 (AvgT 33 seconds). Conclusion: Based on our results, the optimal incision size for increasing Mentor smooth, round, moderate plus volumes is as follows: 2.5 cm for 100-cm3 implant, 3 cm for 200-cm3 implant, 3.5 cm for 300-cm3 implant, 4 cm for 400-cm3 implant, 4.5 cmfor 500- to 700-cm3 implant, and 5 cm for 800-cm3 implant. This guideline can be used to provide the most aesthetic results without tissue compromise. [ABSTRACT FROM AUTHOR]