(Press-News.org) July 30, 2015 - Some women with breast cancer can now undergo a "one and done" approach combining nipple-sparing mastectomy with immediate single-stage implant (SSI) breast reconstruction in a single procedure, according to a report in the July issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
In the article, ASPS Member Surgeon Dr. Mark A. Codner of Emory University, Atlanta, shares his approach to single-stage implant (SSI) breast reconstruction after mastectomy for breast cancer. Coauthor Dr. Jose Rodriguez-Feliz comments, "A selected group of patients will now benefit from a simplified reconstructive process with limited office visits for expansions, accelerated return to normal activities, and restoration of a natural breast with preservation of its most important landmark, the nipple areola complex."
'One and Done' Procedure for Breast Cancer Surgery and Reconstruction
The paper analyzes Dr. Codner's experience with 27 SSI reconstructions, with the aim of demonstrating the value of this new approach to immediate reconstruction after breast cancer surgery.
Most of the patients underwent a procedure called nipple-sparing mastectomy. In this technique, the breast cancer surgeon removes the cancerous breast tissue while preserving most of the breast skin as well as the nipple-areola complex (NAC)--the nipple and surrounding tissue.
The plastic surgeon then uses the woman's natural breast skin and NAC for immediate implant-based breast reconstruction. Dr. Codner's technique includes the use of "teardrop"-shaped breast implants and a biomaterial called acellular dermal matrix, which provides a "scaffold" to support the reconstructed breast and promote new tissue growth. In some cases, fat grafting is performed to enhance the cosmetic results.
This combined procedure means that the cancer is removed and the breast reconstructed in a single surgery. The authors believe that this offers important psychological benefits for the patient, including an "immediate return to normal body image."
"Preservation of the NAC and advances in technique have allowed us to achieve aesthetic results that resemble those of cosmetic breast enhancement patients," says Dr. Rodriguez-Feliz. "As a result, we have limited the sense of mutilation that many patients would experience in the past with a two-stage breast reconstruction."
Single-stage implant reconstruction also avoids the stress, discomfort, and inconvenience associated with delayed breast reconstruction--which often includes several weeks of tissue expansion to create new skin for use in reconstruction. While the combined procedure is safe, some women in the experience did experience complications. These included infections requiring intravenous antibiotics and, in some cases, further surgery.
The researchers emphasize that nipple-sparing mastectomy and SSI reconstruction are not appropriate for every woman with breast cancer. Patients must be selected carefully for depending on their overall health, cancer characteristics, and previous treatment. The authors also note that their study is limited by the small number of patients and short-term follow-up.
"Recent advances in oncologic breast surgery have allowed nipple-sparing mastectomy to be accepted as a safe and a viable option for many patients with early-diagnosed breast cancer," says Dr. Rodriguez-Feliz. "As plastic surgeons, our surgical techniques have also evolved in a way that we can now simplify the reconstructive process with a 'one-and-done' procedure."
Drs. Codner and Rodriguez-Feliz encourage other plastic surgeons to "embrace the change" to nipple-sparing mastectomy and SSI in appropriate cases. They conclude, "We hope that by sharing [Dr. Codner's] experience and the most recent literature to support it, we can inspire other plastic surgeons to evolve into what we think will be the future of breast reconstruction."
INFORMATION:
Click here to read "Embrace the Change: Incorporating Single-Stage Implant Breast Reconstruction into Your Practice."
Article: "Embrace the Change: Incorporating Single-Stage Implant Breast Reconstruction into Your Practice" (doi: 10.1097/PRS.0000000000001448)
Plastic and Reconstructive Surgery® is published by Wolters Kluwer.
About Plastic and Reconstructive Surgery
For more than 60 years, Plastic and Reconstructive Surgery® (http://journals.lww.com/plasreconsurg/) has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues.
About ASPS
The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at http://www.plasticsurgery.org or http://www.facebook.com/PlasticSurgeryASPS and http://www.twitter.com/ASPS_news.
About Wolters Kluwer
Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world.
Wolters Kluwer reported 2014 annual revenues of €3.7 billion. The group serves customers in over 170 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on NYSE Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).
Wolters Kluwer Health is a leading global provider of information and point of care solutions for the healthcare industry. For more information about our products and organization, visit http://www.wolterskluwerhealth.com, follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.
July 30, 2015 - More women are expressing interest in plastic surgery to restore a more youthful figure after having children. An update on combined procedures for postpartum body contouring--addressing the abdomen, breasts, and other problem areas--is presented in the August issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
Sometimes called the "mommy makeover," postpartum body contouring combines a "tummy tuck"(abdominoplasty) with breast lift surgery (mastopexy) and other procedures to ...
Some 10-15 percent of combat veterans struggle with wounds invisible to the naked eye: post-traumatic stress. Their lives are ridden with debilitating symptoms: insomnia, flashbacks, depression, anxiety, guilt, and ever-present tension. While there is no cure-all for post-traumatic stress disorder (PTSD), cognitive behavioral therapy -- which actively reprocesses traumatic events to reduce symptoms -- has seen some success.
A new study from researchers at Tel Aviv University, Creighton University in Omaha, Nebraska, and the National Institute of Mental Health suggests ...
On July 30, 2015, researchers from Sichuan University, Sun Yat-sen University, University of California, BGI, etc, reported the latest study on congenitalcataracts. The finding, published on Nature, identifies lanosterol as a key molecule in the prevention of lens protein aggregation and points to a novel strategy for cataract prevention and treatment.
Cataracts are the most common cause of blindness worldwide, accounting for over half of all cases of blindness worldwide. Currently the only treatment is surgical removal of cataractous lenses. High concentrations of crystallin ...
If you have hypertension, it pays to include a pharmacist in a medical care team.
That's the upshot from research by the University of Iowa that found patients with uncontrolled hypertension had better blood pressure control when being cared for by pharmacists working in care teams (with a physician, for example) than patients who relied mostly on a doctor for medication guidance.
The researchers showed pharmacist-included care teams delivered more hands-on and tailored medication regimens to patients, which yielded more effective blood-pressure control results than ...
A new automated data mining system researched and developed at the University of Kent could lead to a dramatic increase in the detection of potentially illegal online sales of elephant ivory through eBay.
Law enforcement agencies and conservationist are expected to make use of the system - developed by researchers from the University's Centre for Cyber Security - in their ongoing battle against illegal ivory sales.
At the moment, identifying illegal elephant ivory being sold online is a laborious, tedious and expensive task, even for experts.
A search for items ...
Teenagers suffering from severe obesity generally feel worse than their peers, but after undergoing gastric bypass nearly all experience improved mental health. One in five, however, still suffers from symptoms of depression - some quite seriously. These are the results of a new study from Lund University in Sweden, published in Obesity.
The study is the largest two-year follow-up in the world regarding mental health in adolescents who have undergone a form of weight-loss surgery known as gastric bypass. It includes 88 Swedish adolescents, 13-18 years old, with an average ...
Philadelphia, PA, July 30, 2015 - Depressed people often find themselves preoccupied with guilty, shameful, or self-defeating thoughts for large parts of their day. These thoughts not only distract from other activities but also fail to resolve the underlying life issues. Further, the ideas that receive focused attention in these depressive ruminations are frequently quite distorted and lead to distress.
The way that depressed people repetitively attend to these negative thoughts in an unproductive manner reflects the reasoning behind use of the term ruminations - because ...
Anyone who has ever watched a group of ants scurrying to carry a large crumb back to their nest has probably wondered how these tiny creatures manage the task. New research at the Weizmann Institute of Science, which appeared today in Nature Communications, explains how a balance of individual direction and conformist behavior enables ants to work together to move their food to in the desired direction.
To lug a large object, a number of ants surround it - the back ones lift, those on the leading edge pull. How do they stay on track, instead of simply pulling all around ...
That is the conclusion of a major new review, written by leading world experts and published in the medical journal, Addiction. The review examined a wide range of measures that healthcare systems in different countries can adopt to help smokers to stop. It reviewed how effective they are and how much they cost, and offers a new tool to help governments and healthcare administrators calculate the cost - and affordability1 - of stop smoking treatments.
The main findings of the review were:
"Cytisine", a medicine currently only found in a few mostly Eastern European ...
New research by scientists at the University of York has given tea and coffee drinkers new information about why their favourite drinks taste as they do.
The study led by Dr Seishi Shimizu, of the York Structural Biology Laboratory in the University's Department of Chemistry, shows that sugar has an important effect in reducing the bitterness of tea and coffee, not just by masking it but by influencing the fundamental chemistry.
The research published in Food and Function reveals new insights into the way in which caffeine, sugar and water interact at the molecular ...
