Cosmetic Surgery Research Today is a free monthly online journal that collates and summarizes the latest research about Cosmetic Surgery, including details on microsurgery, reconstruction, techniques, risks.

Breast reconstruction: a review and rationale for patient selection.

Nahabedian MY

Department of Plastic Surgery, Georgetown University Hospital, Washington, DC 20007, USA. DrNahabedian@aol.com

SUMMARY: The importance of good patient selection is becoming increasingly appreciated as a predictor of good outcomes following mastectomy and reconstruction. There are many variables that should be considered when making these decisions. Patient variables include breast characteristics, age, body habitus, comorbidities, and expectations. Oncological variables include tumor size, cancer stage, and perioperative radiation. This article is structured to review the variables that are relevant when deciding upon a particular reconstructive option for a particular patient.

Published 1 July 2009 in Plast Reconstr Surg, 124(1): 55-62.
Full-text of this article is available online (may require subscription).

Articles on Cosmetic Surgery published 1 July 2009:

Needlescopic versus laparoscopic cholecystectomy: a meta-analysis.   ANZ J Surg, 79(6): 437-42.

BACKGROUND: To systematically analyse clinical trials on needlescopic (NC) versus laparoscopic cholecystectomy (LC) that evaluated the effectiveness of both procedures for the management of cholelithiasis. METHODS: A systematic review of the literature was undertaken. Clinical trials on NC versus LC were selected according to specific criteria and analyzed to generate summative data expressed in standardized mean difference. RESULTS: Sixteen trials on NC versus LC encompassing 1549 patients ... [Abstract] [Full-text]

A soccer-specific balance training program for hamstring muscle and patellar and achilles tendon injuries: an intervention study in premier league female soccer.   Am J Sports Med, 37(7): 1384-93.

BACKGROUND: A soccer-specific balance training has been shown to decrease injury incidence of the anterior cruciate ligament and ankle sprains in randomized controlled trials. However, hamstring injuries and tendinopathy remain significant issues in soccer. HYPOTHESIS: Proprioceptive training can reduce the incidence of hamstring muscle injuries and tendinopathy in elite soccer. There is a dose-effect relationship between balance training duration and injury incidence. STUDY DESIGN: Cohort ... [Abstract] [Full-text]

Physeal stapling versus 8-plate hemiepiphysiodesis for guided correction of angular deformity about the knee.   J Pediatr Orthop, 29(5): 481-5.

BACKGROUND: Angular deformity in the lower extremities results in cosmetic deformity, gait disturbance, pain, and early joint degeneration. Corrective osteotomy is the gold standard for angular deformity, but is a major surgical intervention with significant incidence of complication. For these reasons, hemiepiphysiodesis is an attractive alternative in the growing child to allow "guided growth" to correct the angular deformity. Physeal stapling has proven success, but hardware ... [Abstract] [Full-text]

Patient-reported aesthetic satisfaction with breast reconstruction during the long-term survivorship Perio.   Plast Reconstr Surg, 124(1): 1-8.

BACKGROUND: Expander/implant and autogenous tissue breast reconstructions have different aging processes, and the time when these processes stabilize is unclear. The authors' goal was to evaluate long-term patient-reported aesthetic satisfaction with expander/implant and autogenous breast reconstruction. METHODS: The authors surveyed a cross-section of University of Michigan women who underwent postmastectomy breast reconstruction (response rate, 73 percent) between 1988 and 2006 [110 ... [Abstract] [Full-text]

The impact of partial breast reconstruction using reduction techniques on postoperative cancer surveillance.   Plast Reconstr Surg, 124(1): 9-17.

BACKGROUND: Partial breast reconstruction using reduction techniques has recently increased in popularity. Some fear that combining breast conservation therapy with partial breast reconstruction alters the architecture and will affect patterns of local recurrence and make postoperative cancer surveillance more difficult. The purpose of this series was to evaluate long-term postoperative cancer surveillance. METHODS: The authors retrospectively reviewed the charts and mammograms of patients (n = ... [Abstract] [Full-text]

Three- and four-dimensional computed tomography angiographic studies of commonly used abdominal flaps in breast reconstruction.   Plast Reconstr Surg, 124(1): 18-27.

BACKGROUND: The innovative technique of three- and four-dimensional computed tomographic angiography allows us to analyze the areas of perfusion in commonly used free abdominal flaps in breast reconstruction, such as pedicled transverse rectus abdominis musculocutaneous (TRAM) flaps, full TRAMs, muscle-sparing TRAMs, and deep inferior epigastric perforator (DIEP) flaps. The authors compared the vascular territories in these flaps. METHODS: A total of 11 lower abdominal flaps were obtained from ... [Abstract] [Full-text]

Shaping the breast in aesthetic and reconstructive breast surgery: an easy three-step principle. Part III--reconstruction following breast conservative treatment.   Plast Reconstr Surg, 124(1): 28-38.

SUMMARY: Of the relatively few studies that exist regarding the cosmetic satisfaction of patients following breast conservation therapy, several indicate significant dissatisfaction in many patients. Breast conservation often results in some of the most challenging and complex reconstructive problems. Indeed, even defining the problem or analyzing the defect can be difficult for the junior surgeon. For the more seasoned reconstructive surgeon, analyzing the problem and applying solutions may be ... [Abstract] [Full-text]

The use of acellular dermal matrix to prevent capsule formation around implants in a primate model.   Plast Reconstr Surg, 124(1): 82-91.

BACKGROUND: Implant-based breast reconstruction is a popular option after mastectomy, but capsular contracture may detract from long-term outcomes. The authors have observed that breast implants covered with acellular dermal matrix (AlloDerm) are less likely to develop a capsule in the area where the implant is in direct contact with the acellular matrix. The authors tested this observation experimentally by comparing capsular formation around implants in the presence and absence of AlloDerm in ... [Abstract] [Full-text]

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