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Mastopexia de aumento, técnica de quinta generación Augmentation mastopexy, fifth generation technique  [cached]
R. Navarro,L. Torreblanca,A. Enríquez
Cirugía Plástica Ibero-Latinoamericana , 2008,
Abstract: Presentamos una nueva técnica de mastopexia, más sencilla, que evita recidivas además de disminuir el riesgo de carcinoma mamario. El estudio se realiza sobre 25 pacientes femeninas de 25 a 50 a os de edad, con ptosis mamaria. Con las pacientes de pie realizó el marcaje tradicional; si las mamas son peque as se colocan implantes en el plano submuscular, y si son grandes, en retroglandular. Para evitar recidivas se colocaron dos tirantes internos con suturas irreabsorbibles. Si el complejo resultante glándula-implante es grande y pesado, se fija un tirante de mama al periostio hemiclavicular y otro al periostio de la tercera costilla; si es peque o o mediano, únicamente se fija a la costilla. Realizamos controles entre 1 mes y 3 a os tras la intervención. Conseguimos corregir ptosis de entre 5 a 12cm., sin recidiva en ninguno de los controles, ni pseudo-ptosis postoperatoria. El ejercicio físico fue posible a los 15 días de la cirugía con el apoyo de un sujetador elástico. La cicatrización fue altamente satisfactoria. Las únicas complicaciones presentadas fueron dehiscencias parciales en 2 pacientes y sensación de ardor, tirantez y elongación de la areola en pacientes cuya ptosis excedía los 12cm y con areolas grandes. La facilidad de ejecución de la técnica y su seguridad, permiten que la cirugía sea ambulatoria. Proponemos esta técnica, que denominamos de quinta generación, que evita la cicatriz periareolar, la inframamaria, la vertical y la "T" invertida; además, elimina parte de ambos cuadrantes superiores de la mama, lo que disminuye notablemente la posibilidad de desarrollar ulteriores casos de carcinoma mamario y evita recidivas con el uso del tirante clavicular. We present a new mastopexy technique, simpler, which precludes the recidivism and reduces the risk of breast cancer. The study was based on 25 female patients between 25 to 50 years old with breast ptosis. With the patients standing up, was realized the traditional marks. If breasts were small, implants were positioned by submuscular way, and if bigger, the way was retroglandular. For recidivism prevention, it was positioned 2 internal straps; if the gland-implant was bigger and heavier an immobile strap from the breast to the clavicle periostium and to the 3rd rib, was realized; if it would result smaller or median size only were fixed to the third ribs with a dermal flap. Controls were realized between 1 month to 3 years. Ptosis was corrected between 5 to 12cm without any recidivism, neither post surgery pseudo-ptosis. With the support of an elastic brassier, physical exercise is recomm
Mastopexia crescente com implantes de silicone: um estudo longitudinal prospectivo Crescent mastopexy with silicone implants: a longitudinal prospective study  [cached]
Denis Souto Valente,Lauro Aita Carvalho,Rafaela Koehler Zanella
Revista Brasileira de Cirurgia Plástica , 2012,
Abstract: INTRODU O: Mastopexia periareolar crescente com aumento mamário é uma técnica bem descrita para corre o de ptoses mamárias classificadas com graus I e II de Regnault. O objetivo deste estudo é discutir os resultados obtidos utilizando essa técnica, com posicionamento do centro de implantes redondos abaixo do mamilo. MéTODO: Ptoses de grau I foram corrigidas, em pacientes selecionadas, utilizando uma combina o de mastopexia crescente periareolar com aumento mamário utilizando implantes de gel de silicone redondos de perfil alto. As pacientes responderam a um questionário, classificando os resultados obtidos com a mamoplastia como pobres, satisfatórios ou bons. RESULTADOS: Foram estudadas 128 pacientes, que receberam implantes de silicone com volume médio de 308 ml. Foram observadas taxas de reopera o e de complica o de 9,4% e 8,6%, respectivamente. Oitenta e uma (63,3%) pacientes responderam ao questionário, das quais 58% consideraram o resultado bom, 35,8% satisfatório e 6,2% pobre. CONCLUS ES: Este estudo demonstrou que essa combina o de técnicas proporciona bons resultados, com baixo índice de complica es. BACKGROUND: The combination of crescent periareolar mastopexy with breast augmentation is a well-described technique for the cosmetic improvement of breast ptosis classified as grades I and II, according to the Regnault grade scale. The aim of this study is to discuss the results obtained by the authors using a combination technique where the center of the round implants was positioned below the nipple projection. METHODS: Grade I ptosis was corrected in certain patients by a combination of crescent periareolar mastopexy with breast augmentation using round-shaped, high-profile silicone gel implants. Each patient completed a questionnaire and rated the results obtained as poor, satisfactory, or good. RESULTS: Were studied 128 patients who received silicone implants (average volume, 308 mL). The observed reoperations and complications rates were 9.4% and 8.6%, respectively. Eighty-one (63.3%) patients responded to the questionnaire, and 58% considered the result good, 35.8% considered it satisfactory, and 6.2% considered it poor. CONCLUSIONS: This study showed that this combination of techniques yields good results and low complication rates.
Application of mastopexy technique using Klein’s solution. A 40 cases experience. Aplicación de técnicas de Mastopexia con solución de Klein. Experiencia de 40 casos.  [cached]
Heriberto Chávez Sánchez,Liliana Espinosa Chang,Dagmaris Losa Pérez
MediSur , 2009,
Abstract: Background: Breasts has always played an important role in female image. Breast ptosis is a disease which is frequently consulted to plastic surgeons. A correction was performed applying mastopexy in a minor outpatient surgery using modified Klein′s solution in minimal concentrations of lidocaine which avoid bleeding. Objectives: To describe the aesthetic results in the usage of mastopexy with Klein′s solution specifying: behavior of pain, bleeding during the surgery process, presence of complications and the satisfaction exploration in surgical operated patients. Method: A series of cases consisted of 40 patients who came to the plastic surgery consultation at the University Hospital “Dr. Gustavo Aldereguía Lima” in Cienfuegos city with breast ptosis from January 2005 to January 2006, using three mastopexy techniques (pedicle fixation, periareolar fixation, and dermal fixation). Pain was assessed during the operation and after the operation, as well as the satisfaction level of the patients and the aesthetic results obtained. Results: 75 per cent of the studied patients were among 20 and 39 years old. Klein′s solution modified with an anesthetic method was administered. 87.5 per cent stated no not feel pain showing the efficacy of the solution. Complications were minimal, only in two of the patients who presented partial wound dehiscence without any other surgical intervention. Conclusions: It was evidenced the efficacy of the Klein′s solution in the breast ptosis correction. It is recommended the usage of this solution due to the advantages it offers. It is also very economic in its usage. Fundamento: La mama ha tenido un papel importante en la imagen femenina, la ptosis mamaria es una enfermedad por la cual son consultados con frecuencia los cirujanos plásticos. Nos propusimos realizar la corrección aplicando la Mastopexia, en cirugía menor ambulatoria, con solución de Klein modificada, utilizando concentraciones mínimas de lidocaina, que evita sangramientos. Objetivos: Describir los resultados estéticos con la utilización de las técnicas de Mastopexia con solución de Klein precisando: comportamiento del dolor, sangramientos transoperatorio, presencia de complicaciones y exploración de satisfacción en pacientes operadas. Método: Consistió en serie de casos constituida por 40 pacientes, que acudieron a consulta de cirugía plástica en el Hospital Universitario Gustavo Aldereguía Lima, de Cienfuegos, con ptosis mamaria, en el período comprendido de enero del 2005 a enero del 2006, utilizamos tres técnicas de Mastopexia (Fijación de pedículo, Periareolar
Mastopexia y prótesis: Revisión a los 5 a os Mastopexy with and implant: A 5 year follow-up  [cached]
I. Moreno Gallent,M. Ribera Pons
Cirugía Plástica Ibero-Latinoamericana , 2006,
Abstract: Se realiza una revisión de la técnica de Mastopexia y prótesis que realiza el autor. Una de las alteraciones más difíciles de resolver para el cirujano plástico es el de las mamas caídas o muy caídas que presentan un gran exceso de piel, y un escaso volumen de la glándula mamaria. Estos serían los casos adecuados para la realización de esta técnica. Es muy frecuente y se produce tras grandes pérdidas de peso, lactancias repetidas o prolongadas, o después de la involución que se produce en la mujer en el proceso de envejecimiento. Otra indicación para la realización de esta técnica se da en mamoplastias de aumento secundarias en las que hay piel sobrante y un grado de atrofia glandular producido por la compresión del implante durante mucho tiempo. Se presenta la técnica quirúrgica y se discuten las ventajas y complicaciones, así como la evolución en el tiempo. La técnica realizada presenta pocas complicaciones y un buen grado de satisfacción por parte de los pacientes. A revision of Mastopexy with an implant technique is carried out by the author. One of the most difficult disturbances that the surgeon faces is the ptotic breasts, which present a great skin excess and a low volume of mammary gland. These would be the adecuate cases for this technique. It is very frequent and it is produced after big weight losses, repeated or extended lactations, or after involution produced by the aging process. Another indication for carrying out this process would be secundary mammaplasty with skin remaining and atrophy due to the compression of the inmplant for a long time. The technique is presented, and the advantages and complications are discussed, as well as the evolution through time. This technique has few complications and a high level of patient satisfaction.
Mastoplastia de aumento com inclus o de implante de silicone associado a mastopexia com abordagem inicial periareolar (safety pocket) Augmentation mastoplasty with silicone implant associated with mastopexy through an initial periareolar approach (safety pocket)  [cached]
Ataliba Ronan Horta de Almeida,Gnana Keith Marques de Araújo,André Villani Correa Mafra,Pedro Sanglard Pimenta
Revista Brasileira de Cirurgia Plástica , 2012,
Abstract: INTRODU O: A mastopexia com inclus o de implante mamário é uma cirurgia desafiadora e de alta complexidade. No Brasil, observa-se crescente interesse pelo volume mamário maior; entretanto, em certos casos, apenas a inclus o do implante de silicone n o é suficiente para confec o de uma mama c nica e de polo superior cheio. Para obten o desse resultado é necessária a corre o da flacidez cutanea mamária, com retirada do excesso de pele. MéTODO: A abordagem inicial foi realizada com incis o periareolar semicircular inferior, que serviu como acesso à loja mamária em plano subfascial para inclus o do implante. Após o posicionamento do implante, o excedente de pele foi analisado com pontos simples e marca o com azul de metileno previamente à sec o cutanea. Sempre que possível, a marca o em fuso longitudinal foi preferida, mas também foi utilizada a marca o em "L" ou "T" invertido, quando o excesso de pele era maior. RESULTADOS: Foram analisadas 49 pacientes, com idades entre 20 anos e 68 anos, sendo 28 mamas primárias e 21 mamas secundárias. As cirurgias para pexia de mamas com cicatriz resultante em "L" foram realizadas em 23 pacientes, em "T", em 8 casos, e cicatriz vertical, em 18. Foram observadas 6 complica es nesse grupo de pacientes: hematomas (n = 2), retra o cicatricial (n = 2), equimose intensa (n = 1) e esteatonecrose (n = 1). CONCLUS ES: A conduta conservadora da retirada de pele após o implante das próteses, a via de acesso periareolar e a utiliza o do plano subfascial s o pontos diferenciais e relevantes dessa técnica. Essa técnica é considerada também mais segura, pois a única perda da solu o de continuidade do meio com os tecidos se dá pela incis o periareloar. Dessa forma, n o há exposi o da prótese ao ser confeccionada a mastopexia. BACKGROUND: Mastopexy with breast implant surgery is a challenging and highly complex surgical procedure. In Brazil, there is growing interest in larger breast volumes, although in certain cases, the sole addition of silicone implants is not sufficient for constructing a conical breast with a full upper pole. To obtain this result, it is necessary to correct sagging breasts by removing excess skin. METHODS: The initial approach was made with an inferior semicircular periareolar incision, which provided subfascial access to the breast pocket for inclusion of the implant. After implant placement, the excess skin was marked using simple stitches and staining with methylene blue prior to resection. Longitudinal spindle marking was preferred whenever possible. However, "L" or inverted "T" markings were als
Mastopexia tridimensional con anclaje efectivo: Una respuesta a la ptosis, alteraciones de volumen, flacidez y recidiva en las mamoplastias 3D Mastopexy with a dependable anchoring site: A logical response to ptosis, volume alterations, flaccidity and relapse in mammaplasties  [cached]
G. Pe?a Cabús
Cirugía Plástica Ibero-Latinoamericana , 2010,
Abstract: La mastopexia es la técnica quirúrgica común que la Cirugía Plástica realiza en las mamas. En la literatura, se han expuesto múltiples y muy buenas técnicas sin terminar la búsqueda del elemento que sea consistente y que provea la mayor permanencia de resultados. De manera habitual, la atención se ha enfocado hacia la modificación anatómica del polo inferior, tratando de rellenar el polo superior de la mama de manera indirecta, con la confusión generalmente establecida de que, en la mayoría de las técnicas descritas, se considera el sostenimiento como sinónimo de suspensión. De manera descriptiva, exponemos una alternativa de suspensión que resulta tan interesante como sencilla, produciendo los resultados esperados a largo plazo y simplificando la técnica al reducir de manera importante la falta de mantenimiento del relleno del polo superior de la mama, el tiempo operatorio y facilitar la reconstrucción del molde mamario. La detección de un punto anatómico de fusión entre la fascia superficial, que es una continuación de la glándula mamaria y la propia fascia pectoral en la pared torácica, de importancia quirúrgica para el anclaje de la glándula mamaria, y el desarrollo de una técnica simple de suspensión glandular, logran cambiar los conceptos acostumbrados de nuestra práctica. La remodelación de la glándula se vuelve más sencilla y se autonomiza el manejo de la cubierta cutánea, permitiendo reducir la longitud final de las cicatrices. The elusive long term result in mastopexy, reveals the lack of an element that provides with certainty, an alternative that maintains the result surgically obtained. Although myriads of alternatives have been proposed in modern literature, most of them referred to lower pole anatomical molding as an indirect way to modify the upper pole as well, which is in fact the main target expectation for a good and sustained surgically outcome. There is a factor of confusion that has not been currently clarified; sustenance is not necessarily a synonym of suspension, being the latter our main objective that induced to present this technical proposal. The anatomical site of fusion of the superficial fascia which is in continuity with the mammary gland, and the proper pectoralis fascia, means that this structure can be used as a reinforced tissue that becomes as an anchoring site for the breast gland. An easily placement transglandular sutures stablishes the expected real suspension and the technical benefits derived from it, with the advantage of the use of non absorbable suture material that provides the occasion of change for a be
Mastopexia a Longacre modificada
Vieira, Luiz Felipe Duarte Fernandes;Almeida, Carlos Lacerda de Andrade;
Revista Brasileira de Cirurgia Plástica , 2012, DOI: 10.1590/S1983-51752012000100011
Abstract: background: the functional preservation of the breasts should always be a concern for the plastic surgeon. the technique presented in this paper aims to reduce the impact of mammoplasty on breastfeeding by considering the superior vascular pedicle technique with parsimonious gland resection to be the best choice for cases with little breast hypertrophy. methods: we report on 46 patients with mild to moderate breast hypertrophy who underwent mastopexy, with or without breast reduction, using the superior vascular pedicle technique as per the modified technique described by longacre. small gland resections were made so as to preserve the functional and sensory integrity of breasts. results: in the 92 breasts on which we operated, we observed a proper filling of the upper pole through use of a flap, and breast shaping that satisfied the patients' desires. conclusions: the technique presented, in which the lower pole of the breast is used to fill the upper pole, is another technical possibility for mastopexies in patients with a high-positioned nipple-areolar complex.
Implantes mamarios y mastopexía: colgajos mamarios laterales y mediales, una opción técnica Breast Implants and Mastopexy: lateral and Medial Breast Flaps, a Technical Option  [cached]
R. Goulart Jr.,M. Onida Matos
Cirugía Plástica Ibero-Latinoamericana , 2012,
Abstract: La mastopexia asociada al uso de implantes mamarios es actualmente una de las prácticas más desafiantes en Cirugía Plástica; en ella, el cirujano tiene que utilizar al máximo sus capacidades y conocimientos para decidir con exactitud la mejor relación entre el tama o ideal del implante y el exceso de piel a retirar. El objetivo de este artículo es presentar una técnica a base de colgajos mamarios laterales y mediales (CMLM) para cirugía de mastopexia con implantes mamarios en busca de una mejor definición de la mama y de una mayor duración del resultado final. Esta técnica se crea en base a la circulación mamaria y en los excedentes de tejido al final de la cirugía utilizando la marcación en T. Los resultados inmediatos han sido muy satisfactorios en términos de definición de la forma mamaria, de la solidez de la nueva estructura glandular y de la protección del implante mamario. La duración a largo plazo aún debe ser evaluada. Creemos que se trata de una técnica fácil de ejecutar, que permite un resultado estético satisfactorio, proporciona una percepción de mayor seguridad en el posicionamiento del implante, aunque somos conscientes de que su sostenibilidad y duración a largo plazo aún necesitan tiempo para una mejor evaluación. The breast implant associated with mastopexy actually is one of most difficult plastic surgeries. In fact, it is a surgery where the surgeon has to use his higher capabilities and skills in order to decide with precision the best relationship between ideal sizes of the breast implant and skin excess. The purpose in this paper is to present a breast lateral and medial flaps technique for augmentation mastopexy surgery looking for a better breast design and resistance on the final result. The technique was created on breast circulation basis, skin excess and better definition and resistance about the aesthetical breast results in the augmentation mastopexy surgery utilizing the T scar technique. The early results were acceptable in order to get breast definition, breast structure and implant protection. The long term results, especially breast resistance, will need to be evaluated. In our opinion, the technique is easy to execute, it allows a satisfactory aesthetic result giving the perception of high security on the implant position, but its resistance in a long term view needs better evaluation.
Electromyographic study of shoulder and acromioclavicular joint muscles in women who underwent unilateral breast surgery of the types mastectomy and quadrantectomy  [PDF]
Antonia Dalla Pria Bankoff, Sonia Regina Jurado
Health (Health) , 2013, DOI: 10.4236/health.2013.511251
Abstract: We studied 20 women with mean age 57.7 years, being 9 with unilateral quadrantectomy surgery, 1 with surgery type bilateral quadrantectomy and 10 with unilateral mastectomy surgery. The average operative time was 9.8 (nine years and eight months). We studied using surface electromyography the mean deltoid, upper trape-zius and latissimus dorsi muscles in order to check the action potentials of these muscles when performing a sequence of movements of these joints. It was used for the study, an Acquisition Data System ADS1000 containing 12 channels. The electromyography (EMG) results expressed in RMS (Root Mean Square) were analyzed and compared between the surgical and nonsurgical side, among the three repetitions of the sequence of movements and between mastectomy and quadrantectomy for each muscle. For statistical analysis we used analysis of variance (ANOVA) with a double repetition factor (p < 0.05) for the EMG results. The results showed a significant difference (p < 0.05) between the surgical and non-surgical sides to the muscles studied. There was no significant difference between the three repetitions of sequential movements in electromyographic analysis to the muscles studied. There was no significant difference between the types of surgery (mastectomy and quadrantectomy) for the muscles studied.
Breast Surgery with Application of Doughnut Mastopexy Lumpectomy Technique  [PDF]
Kyoichi Matsuzaki
Modern Plastic Surgery (MPS) , 2012, DOI: 10.4236/mps.2012.24022
Abstract: Purpose: Doughnut mastopexy lumpectomy (DML) is a breast resection technique in which a tissue segment is removed and the breast reshaped through a doughnut-shaped de-epithelialized periareolar area. In this study, we attempted to determine whether the DML technique could be useful for other types of breast surgery, in addition to breast cancer lumpectomy. Methods: This study examined a total of 4 patients who underwent the DML technique and were followed up for at least 1 year postoperatively. One patient underwent phyllodes tumor resection, 1 patient underwent removal of a siliconoma, and 2 patients underwent breast reduction mammaplasty. Results: This method enabled en-bloc removal of a large tissue mass or large foreign body that could not be removed through a short periareolar incision. The surgical method of this study enabled the extent of de-epithelialization to be changed according to the size and location of the mass to be excised; good cosmetic results were also obtained. In addition, the surgical method enabled the facile excision of tumors and foreign materials. Conclusions: The DML technique is a useful surgical method that is applicable to other breast surgeries, in addition to breast cancer surgery.
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