Background: The introduction of new therapeutic options and advances in the field of breast surgery has put the importance of patient satisfaction and quality of life at par with long-term survival. These essential parameters help physicians and patients decide on the appropriate approach when managing both malignant and benign breast conditions. They have also been used to measure the outcome and success of breast surgery, whether cosmetic or reconstructive, using patients’ perspectives. To date, there is no available questionnaire that is translated, culturally adapted, and validated among Filipino patients to specifically assess their quality of life (QOL) and satisfaction after breast reconstructive surgery. Objective: This study aims to translate a previously validated, internationally accepted, patient-reported outcome (PRO) instrument, the Breast-Q Reconstruction Module, and validate its use among Filipino patients. Methods: This is a tool validation study of a Filipino translation of the Breast-Q Reconstruction Module for the preoperative and postoperative settings. Forward and backward translations were done for the two questionnaires and were finalized after assessment of accuracy and feasibility by language professionals and bilingual patients. We recruited patients referred to the Division of Plastic Surgery of a tertiary government hospital for breast reconstruction to answer the final questionnaires, with 15 re-taking each questionnaire after two weeks. Psychometric properties of the questionnaires, including internal consistency, construct validity, test-retest reliability, and acceptability, were then evaluated. Results: We included 30 patients in this validation study. The internal consistencies of the translated Preoperative and Postoperative Breast-Q Reconstruction Module had high Cronbach’s α coefficients (range: 0.92–0.98 and 0.97–1.00, respectively). Internal consistency was also supported by high mean item-total correlations in all dimensions. The two questionnaires had good test-retest reliability as supported by high intraclass correlation (range for Preoperative: 0.995–1.000 and for Postoperative: 0.95–1.00). Construct validity was supported by inter-scale correlations with low to moderate Spearman’s coefficients (range for Preoperative: 0.22–0.34 and for Postoperative: 0.11–0.27). The sexual well-being dimension had the lowest inter-scale Spearman’s coefficient in both questionnaires and is the only dimension with low acceptability. Conclusion The translated Preoperative and Postoperative Breast-Q Reconstruction Module has high internal consistency, test-retest reliability, acceptability, and low to moderate construct validity among Filipino patients after breast reconstruction surgery. However, the “Satisfaction with the Nipple Reconstruction” subscale is pending since there were no qualified respondents in the sample population. In considering how their relatively conservative culture influences the way Filipino patients tend to view the importance of sexual satisfaction as it relates to their medical management, the sexual well-being domain is suggested to be interpreted separately when assessing the patient’s overall satisfaction with breast reconstruction procedure.
Mammaplasty ; Quality of Life

OBJECTIVE: To present a complicated case of abdominal wall reconstruction after tumor extirpation using an anterolateral thigh free flap.

METHODS: This is a report of a case managed at the Philippine General Hospital last September 2016

RESULTS: A 25-year old male, diagnosed case of recurrent colon adenocarcinoma, underwent wide excision of recurrent abdominal wall tumor with fistula, resulting to 15cm x 30cm full thickness soft tissue abdominal wall defect with exposed bowels. A free anterolateral thigh fasciocutaneous flap was designed and elevated to cover the abdominal wall defect. Recipient vessels (contralateral deep inferior epigastric artery and veins) were anastomosed with donor vessels (descending branch of lateral circumflex femoral artery and veins). The donor site was closed with split thickness skin grafting.

CONCLUSION:The free anterolateral thigh flap allows for coverage of complicated recurrent abdominal wall malignancies, allowing for a single-stage surgery, with little donor site morbidity and shorter hospital stay.

Human ; Male ; Adult ; Free Tissue Flaps ; Thigh ; Abdominal Wall ; Skin Transplantation ; Epigastric Arteries ; Femoral Arter ; Abdominoplasty ; Veins ; Peritoneal Neoplasms ; Fistula ; Adenocarcinoma ; Colon

Objectives: To describe the demographic distribution of patients who had foreign body injections to the breast who were seen by the Division of Plastic Surgery in the past 5 years. To determine the number of cases of patients with foreign body injection to the breast seen by the Division of Plastic Surgery from January 2004- August 2009. To determine the demographic distribution of patients who have had foreign body injections to the breast with regard to age, occupation, and socioeconomic status. To describe the clinical profile of cases. To review the present management procedures for the treatment of foreign body injections to the breast. Methods: This is a retrospective study on patients seen by the Division of Plastic Surgery of the Philippine General Hospital from January 2004 to August 2009 who were seen for complications from foreign body injections to the breast. Cases were identified by querying the electronic patient registry of the Department of Surgery (ISIS). A review of the records was done. The following information was clinical presentation and treatment done in these patients. Results: Thirty six female patients both private and charity were seen by the Division of Plastic Surgery of the Philippine General Hospital from January 2004 to August 2009. The incidence of foreign body injections to the breast was most common in young females 25-35, who were entertainers (72.2%). Forty four breasts presented with changes that were classified under Type II of the Ueno classification (firm induration with or without pain) seen between 6-15 years from the time of injection (58.3%). Majority of the patients (27 patients, 74%) did not know the volume injected. Only 25% of the women had knowledge of the volume injected, 6 patients (16.7%) received injections ranging from 160-300cc, 2 patients (5.6%) received more than 300cc. Twenty four patients were seen and treated as private cases and 12 patients were seen and treated as charity cases. Seventy two breasts were treated mostly with subcutaneous mastectomy with implant or flap reconstruction. Conclusion: Based on the data gathered, most susceptible were young women with occupations wherein an attractive physical appearance would give them an edge or an advantage in their particular career. This is regardless of financial capability. With this, it is important to have a concerned, cooperative effort to stop the practice through public education that can be directed at this population. This will also be a jumpstart point to make large volume foreign body injections to the breast illegal and less accessible in the Philippines. Knowledge of the clinical profile may guide other surgeons to early detection and appropriate treatment. Key words: siliconoma, subcutaneous mastectomy
Human ; Female ; MASTECTOMY, SUBCUTANEOUS ; SURGERY, PLASTIC