Objective: To investigate the oncologic and surgical safety of the fused fascia method for immediate breast reconstruction with implants. Methods: The clinical data of 343 patients with immediate breast reconstruction with implants in Tianjin Medical University Cancer Hospital from 2014-2017 were retrospectively analyzed to compare the 5-year local recurrence-free survival, 5-year disease-free survival and 5-year overall survival of patients with breast reconstruction by fusion fascia and other methods, and to analyze the complication incidences of implant removal between different implant groups. Results: Of the 343 patients with breast reconstruction, 95 were in the fused fascia group (fascia group) and 248 were in the non-fascia group (25 in the bovine pericardial patch group and 223 in the muscle flap group). At a median follow-up of 49 months, the differences in 5-year local recurrence-free survival (90.1% and 94.9%, respectively), 5-year disease-free survival (89.2% and 87.6%, respectively), and 5-year overall survival (95.2% and 95.1%, respectively) between patients in the fascial and non-fascial groups were not statistically significant (P>0.05). The complication incidence of implant removal was 24.0% (6/25) in the patch group and 2.1% (2/95) and 2.2% (5/223) in the fascia and muscle flap groups, respectively. Conclusion: Immediate breast reconstruction with fused fascial combined with implant is safe and feasible, less invasive than muscle flaps, more economical and with fewer complications than patches.
Humans ; Animals ; Cattle ; Female ; Mastectomy/methods* ; Retrospective Studies ; Breast Implants/adverse effects* ; Feasibility Studies ; Mammaplasty/methods* ; Breast Neoplasms/complications* ; Treatment Outcome ; Postoperative Complications/surgery*

OBJECTIVETo analyze the effect of acellular dermal matrix (ADM) on complications of breast reconstruction using tissue expander/implant, and to offer preliminary evidences for ADM clinical application.

METHODSArticles published from Jan. 2010 to Oct. 2012 were searched in Pubmed, EMbase, Science Direct and CNKI database. Literatures were filtrated according to inclusive criteria. Values were extracted from included literatures; factors regarding complications were collected. Meta-analysis was performed with Stata 12. 0.

RESULTS10 researches were included. Comparing to control group, the pooled odds ratio (OR) of overall complications, infections, hematomas/seromas, explantations are 1.51(P=0.038), 1.91(P=0.032), 1.80(P=0.005) and 2.37 (P=0.138) in ADM group In breast reconstruction using tissue expander/implant, ADM increases the respectively.

CONCLUSIONSoccurrence of hematomas/sarcomas as well as risks of infections and overall complications.

Acellular Dermis ; Breast Implants ; adverse effects ; Female ; Humans ; Mammaplasty ; adverse effects ; methods ; Postoperative Complications ; etiology ; Tissue Expansion Devices ; adverse effects

OBJECTIVETo evaluate the complication of nipple retractor in correcting inverted nipples.

METHODS51 patients (95 inverted nipples) who wore nipple retractor in our hospital were included. All the complications they suffered were evaluated.

RESULTSThe total complication rate was 32.63% (31/95 nipples), include areolar depigmentation (21.05%, 20/95), areolar pressure ulcer (5.26%, 5/29), wire dislocation (4.21%, 4/95), nipple necrosis (2.11%, 2/95).

CONCLUSIONSImproper operation technique and insufficient post operation medical care are related with high complication rate of nipple retractor. The most common complication is areolar depigmentation, which will not result in nipple deformity or dysfunction. The nipple retractor could avoid additional scars and ductal injury, which is less traumatic than other techniques.

Adult ; Breast Diseases ; surgery ; Female ; Humans ; Mammaplasty ; adverse effects ; instrumentation ; methods ; Orthotic Devices ; Treatment Outcome ; Young Adult

OBJECTIVETo compare the clinical effect and complications of subfascial breast augmentation and submammary breast augmentation.

METHODFrom Sept. 2009 to May 2012 , 25 patients with subfascial breast augmentation and 31 patients with submammary breast augmentation were observed. The postoperative results including visible implant edge or ripple, upper pole of the implant and long-term implant ptosis were compared respectively. The complications including hematoma, infection and capsular contraction were also recorded.

RESULTS56 cases were followed up for 2 months to 26 months. The incidence rate of visible implant edge or ripple was 4.0% (1/25 ) in the subfascial group and 29.0% (9/31) in the submammary group, showing a significant difference between them ( PC 0.05). The incidence rate of convex upper pole of the implant was 8.0% (2/25) in the subfascial group and 35.5% (11/31) in the submammary group, showing a significant difference between them ( P < 0.05). Long-term implant ptosis was not found in the two groups. The incidence rate of hematoma was 4.0% (1/25) in the subfascial group and 6.5% (2/31) in the submammary group, infection was not found. The incidence rate of capsular contraction was 8.0% (2/25) in the subfascial group and 12.9% (4/31) in the submammary group, showing no statistical difference between them ( P > 0.05 ).

CONCLUSIONSSubfascial breast augmentation has more clinical advantages compared with submammary breast augmentation, but no evident difference was found in the common complication rate, such as capsular contraction.

Adult ; Female ; Humans ; Mammaplasty ; adverse effects ; methods ; Middle Aged ; Postoperative Complications ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the combined treatment with areola approach for capsular contracture after breast augmentation with implants.

METHODSFrom Feb. 2005 to Jun. 2011, 94 cases (168 sides) with Baker III and IV capsular contracture after breast augmentation with implants were treated with areola approach. The implants cavity was recreated, with or without removal of capsule. The implants were reimplanted behind pectoralis major or breast at the second stage in some patients.

RESULTS46 cases were followed up by clinic visit and the others were followed up by telephone for 6-37 months, with an average of 9.9 months. The capsular contracture was relapsed in 2 cases as Baker III and 1 case as Baker IV. All the other breasts got a good appearance with good soft texture and feeling. No hematoma, infection, implants rupture, breast ptosis or implant displacement happened.

CONCLUSIONSCombined treatment with areola approach has a good therapeutic effect for capsular contracture after breast augmentation with implants. The breast appearance is satisfactory with low occurrence of capsular contracture.

Adult ; Breast Implantation ; adverse effects ; Contracture ; etiology ; surgery ; Female ; Humans ; Mammaplasty ; methods ; Postoperative Complications ; surgery

PURPOSE: Recently, several clinicians have reported the advantages of simplicity and cosmetic satisfaction of absorbable mesh insertion. However, there is insufficient evidence regardint its long-term outcomes. We have investigated the surgical complications and postoperative examination from the oncologic viewpoint. MATERIALS AND METHODS: From February 2008 to March 2009, 34 breast cancer patients underwent curative surgery with absorbable mesh insertion in Samsung Medical Center. Patient characteristics and follow up results including complications, clinical and radiological findings were retrospectively investigated. RESULTS: The mean age of the study population was 50.1+/-8.9 years old (range 31-82) with a mean tumor size of 3+/-1.8 cm (range 0.8-10.5), and the excised breast tissue showed a mean volume of 156.1+/-99.8 mL (range 27-550). Over the median follow-up period of 18+/-4.6 months (range 3-25), mesh associated complications, including severe pain or discomfort, edema, and recurrent fluid collection, occurred in nine patients (26.5%). In three cases (8.8%), recurrent mastitis resulted in mesh removal or surgical intervention. In the postoperative radiologic survey, the most common finding was fluid collection, which occurred in five patients (16.1%), including one case with organizing hematoma. Fat necrosis and microcalcifications were found in three patients (9.7%). CONCLUSION: Absorbable mesh insertion has been established as a technically feasible, time-saving procedure after breast excision. However, the follow-up results showed some noticeable side effects and the oncologic safety of the procedure is unconfirmed. Therefore, we suggest that mesh insertion should be considered only in select cases and should be followed-up carefully.
Adult ; Aged ; Aged, 80 and over ; Edema/etiology ; Female ; Follow-Up Studies ; Granuloma, Foreign-Body/etiology/ultrasonography ; Humans ; Mammaplasty/adverse effects/methods ; Mastectomy, Segmental/adverse effects/*methods ; Mastitis/etiology ; Middle Aged ; Pain/etiology ; Postoperative Complications/etiology ; Retrospective Studies ; *Surgical Mesh/adverse effects

INTRODUCTIONThis study aims to evaluate the outcome and safety of the deep inferior epigastric perforator (DIEP) flap for breast reconstruction in a group of Southeast Asian women treated in our unit and to identify risk factors for breast reconstruction using the DIEP flap in this population.

MATERIALS AND METHODSThis is a prospective study on 50 consecutive DIEP flap breast reconstructions by a single surgeon in an academic institution between July 1999 and July 2006. Data on patient demographics, diagnosis, procedure type, adjuvant and neoadjuvant treatments, risk factors and complications were prospectively collected and registered in a clinical database. Outcome variables include total flap loss, partial flap loss, fat necrosis and minor complications related to the donor site or flap. Known risk factors are analysed to determine if they affect outcome in terms of complication rate in this group of patients.

RESULTSTotal flap loss, partial flap loss and fat necrosis complication rates were 6%, 4% and 10%, respectively. Flap complication rates were comparable to those quoted by previous studies done worldwide. Obesity (BMI >27) is a statistically significant factor associated with development of DIEP flap complications in our population.

CONCLUSIONBreast reconstruction with DIEP flap is a safe and reliable method when used in Southeast Asian women, offering optimal results with less donor -site morbidity. Obesity increases the incidence of flap complication in this group of patients.

Abdomen ; surgery ; Adult ; Asian Continental Ancestry Group ; Breast ; surgery ; Databases, Factual ; Female ; Humans ; Mammaplasty ; adverse effects ; methods ; Microsurgery ; Middle Aged ; Multivariate Analysis ; Obesity ; Postoperative Complications ; Prospective Studies ; Rectus Abdominis ; surgery ; Risk Factors ; Surgical Flaps ; adverse effects ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the relationship between mammaplasty and results after polyacrylamide hydrophilic gel (PAHG) removal from breast.

METHODSFrom Feb. 2003 to Aug. 2009, 130 patients with bilateral breast augmentation by PAHG injection were treated. Preoperative ultrasound examination and MRI were performed to know the distribution of PAHG and infiltration at the surrounding tissue. According to the conditions after removal, the patients were received implant augmentation immediately, or at the second stage, or no implant.

RESULTSThe patients were followed up for 3 months at the most with a very satisfactory rate of 63.84% (83/120), a satisfactory rate of 31.53% (41/120) and a unsatisfactory rate of 4.63% (6/120). Slight capsular contracture (Baker I) occurred in 5 cases with 6 breasts in satisfactory group. All the patients in unsatisfactory groups who selected unsuitable implants by themselves were re-operated to take out the implants. 3 cases with much residue PAHG insisted to receive breast implants. Among them, 2 cases achieved acceptable results even the surface of the breasts were not smooth. No other complication happened.

CONCLUSIONSThe breast reaugmentation after PAHG removal should be performed based on the deformity and condition of breast. Both cosmetic result and psychological relief could be obtained after mammaplasty.

Acrylic Resins ; adverse effects ; Adult ; Breast Implants ; adverse effects ; Device Removal ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; methods ; Middle Aged

OBJECTIVETo study the postoperative complications and its risk factors in patients underwent breast reconstruction with abdominal flaps.

METHODSThe clinical data of 115 cases underwent breast reconstructions with abdominal flaps from May 2001 to October 2008 was reviewed. The postoperative complications included total flap necrosis, partial flap necrosis, fat necrosis, hernia, bulge, fat liquefaction and infection. The risk factors of complication rates were also evaluated.

RESULTSThe total postoperative complications rate was 17.4% (20/115). No severe complications was found, such as total flap necrosis, hernia and bulge. The most common complications of flap was fat necrosis which occurred in 6 cases (5.2%), partial flap necrosis in 5 cases (4.3%) and infection in 1 case (0.9%). The donor-site complications included fat liquefaction which occurred in 8 cases (7.0%) and infection in 3 cases (2.6%). No significant relation was found between patient's age, body mass index (BMI), timing of surgery and the postoperative complication rate. The postoperative complications occurred more frequently in active smokers, patients with radiotherapy history, or reconstructions with pedicled transverse rectus abdominis myocutaneous (TRAM) flaps. But no significant difference was found in those factors.

CONCLUSIONSFewer complications happens in patients with a reconstruction with deep inferior epigastric perforator (DIEP) flap. Abdominal flap should be performed with more consideration in active smokers or patients with a radiotherapy history. Age and obesity should not be contraindications to breast reconstruction with abdominal flaps.

Abdomen ; surgery ; Adult ; Breast Neoplasms ; surgery ; Female ; Humans ; Mammaplasty ; adverse effects ; methods ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Risk Factors ; Surgical Flaps ; adverse effects

OBJECTIVETo evaluate the incidence of capsular contracture in breast augmentation with textured versus smooth mammary Implants.

METHODSRandomized controlled trials (RCTs) and clinical controlled trials (CCTs) were collected from Medline, Embase from May 1966 to May 2006, cochrane library (Issue 2, 2005), and CBM disc from May 1979 to May 2006. We handsearched Chinese Journal of Plastic Surgery (from establishment to May 2006) and Journal of Plastic and Reconstructive Surgery of America (from establishment to May 2006). RCTs were included. Data were extracted by two reviewers with designed extraction form RevMan. 4.2.8 software was used for data analysis.

RESULTSSix RCTs were included. The combined results of meta analysis showed that patients with textured implants had a lower tendency to develop capsules contracture than those with smooth implants either at one year or ten years after the breast augmentation.

CONCLUSIONSCompared with smooth mammary implants, textured surface implants significantly reduce the incidence of capsular contracture after breast augmentation.

Breast Implants ; adverse effects ; Contracture ; etiology ; Evidence-Based Medicine ; Female ; Humans ; Mammaplasty ; adverse effects ; methods ; Postoperative Complications ; Randomized Controlled Trials as Topic