The Experts below are selected from a list of 43911 Experts worldwide ranked by ideXlab platform
Mimis Cohen - One of the best experts on this subject based on the ideXlab platform.
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a matched cohort study of superomedial pedicle vertical scar Breast Reduction 100 Breasts and traditional inferior pedicle wise pattern Reduction 100 Breasts an outcomes study over 3 years
Plastic and Reconstructive Surgery, 2013Co-Authors: Anuja K Antony, Sara Yegiyants, Kirstie K Danielson, Steven Wisel, David L Morris, Rudolph F Dolezal, Mimis CohenAbstract:BACKGROUND The superomedial pedicle vertical scar Breast Reduction is gaining popularity for its round, projecting Breast and shorter incision when compared with the traditional Wise-pattern Reduction using an inferior pedicle. However, there is a paucity of large-volume institutional outcomes studies identifying how this technique fares against more traditional methods of Reduction. METHODS A retrospective review of a prospectively maintained database of bilateral Breast Reductions over a 3-year period was performed. One hundred superomedial Breast Reductions (50 patients) were matched to 100 inferior pedicle Breast Reductions (50 patients). Matching was implemented based on age (±3 years) and size of Reduction (±200 g). Patient demographics, size of Reduction, nipple-areola complex sensitivity, minor and major postoperative complications, and symptomatic relief were assessed. Statistical analysis was performed with SAS Version 9.2. RESULTS Two hundred twelve patients underwent 424 bilateral Breast Reductions between January of 2009 and June of 2012 at a single institution. Mean volume of tissue reduced was 815 g per Breast (range, 200 to 2068 g) and 840 g per Breast (range, 250 to 2014 g), respectively. All patients achieved symptomatic relief. No statistical difference in major or minor complications was seen between the two cohorts. No statistical difference in major or minor complications was seen between the two cohorts. No significant difference in complications was seen between small- and large-volume Reductions. CONCLUSION Superomedial pedicle vertical scar Breast Reduction is a novel, alternative mammaplasty technique with excellent functional and aesthetic outcomes which can be used for a wide range of macromastia without a significant difference in complication rates when compared with traditional Wise pattern inferior pedicle Reduction mammaplasty. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III.
Geoffrey L Robb - One of the best experts on this subject based on the ideXlab platform.
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practical guidelines for repair of partial mastectomy defects using the Breast Reduction technique in patients undergoing Breast conservation therapy
Plastic and Reconstructive Surgery, 2008Co-Authors: Steven J Kronowitz, Kelly K Hunt, Henry Mark Kuerer, Eric A Strom, Thomas A Buchholz, Joe Ensor, Cindy Koutz, Geoffrey L RobbAbstract:Background The authors previously compared the local tissue rearrangement, Breast Reduction, and latissimus dorsi flap reconstruction techniques for repairing partial mastectomy defects and showed the benefits of Breast Reduction. Methods In this study, the authors focused solely on factors influencing outcome in 41 patients who underwent repair of a partial mastectomy defect using Breast Reduction. Results Tumor location had a significant effect on the design of the parenchymal pedicle (p = 0.05). Most repairs were performed with an inferior pedicle. Fifty percent of the lower outer and central quadrant tumors required an amputative design with a free nipple graft. The complication rates for immediate and delayed repair were 24 and 50 percent, respectively. The superior pedicle was associated with the highest complication rates. Tumors in the upper outer quadrant of the Breast were associated with the highest complication rate (35 percent). Ninety percent of patients with planned repairs had a viable nipple-areola complex (p = 0.05) and did not require a free nipple graft. More favorable cosmetic outcomes were achieved using an inferior pedicle; less favorable cosmetic outcomes were achieved for tumors in the upper inner quadrant of the Breast. Larger defects did not result in less favorable cosmetic outcomes than smaller defects. Only 7 percent of patients had a positive tumor margin. Five percent of patients developed local Breast cancer recurrence after a mean follow-up of 36 months. Conclusion The authors provide practical guidelines for repairing a partial mastectomy defect using Breast Reduction that should minimize the occurrence of complications and optimize the cosmetic outcome.
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determining the optimal approach to Breast reconstruction after partial mastectomy
Plastic and Reconstructive Surgery, 2006Co-Authors: Steven J Kronowitz, Kelly K Hunt, Henry Mark Kuerer, Cindy Koutz, Jules A Feledy, Adel Youssef, Geoffrey L RobbAbstract:Background: Unfortunately, patients who desire repair of contour deformities after partial mastectomy unually present after radiation therapy, which may increase the risk of complications an result in a poor aesthetic outcome. The authors reviewed their experience with repair of partial mastectomy defects to determine the optimal approach to Breast reconstruction ater partial mastectomy. Methods: Sixty-nine patients who underwent repair of a partial mastectomy defect and received radiation therapy were included in this analysis. The reconstructive techniques were categorized as local tissue rearrangement (LTR), Breast Reduction, or use of a latissimus dorsi myocutaneous flap or thoracoepigastric skin flap (here-after referred to as flap). Results: fifty patients underwent immediate reconstruction before radiation therapy, and 19 underwent delayed rreconstruction after radiation therapy. The reconstructive techniques in patients with immediate reconstruction were local tissue rearrangement in 28 percent, Breast Reduction in 66 percent, and flaps in 6 percent. In patient with delayed reconstruction, 32 percent had local tissue rearrangement, 42 percent had Breast Reduction, and 26 percent had flaps. The complication rates for immediate and delayed reconstruction were 26 percent and 42 percent, respectively. Overall, and in the setting of immediate reconstruction, the flap technique was associated with a higher complication rate than local tissue rearrangement and Breast Reduction. However, in the setting of delayed reconstruction, the flap technique was associated with a lower complication rate than the other two techniques. Fifty-seven percent of the immediate reconstructions performed with the local tissue rearrangement or Breast Reduction technique, but only 33 percent of the immediate reconstructions performed with the flap technique, were associated with an excellent or good aesthetic outcome. Conclusion: Immediate repair of partial mastectomy defects with local tissues results in a lower risk of complications and better aesthetic outcomes than immediate repair of partial mastectomy defects with a latissimus dorsi flap.
Anuja K Antony - One of the best experts on this subject based on the ideXlab platform.
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a matched cohort study of superomedial pedicle vertical scar Breast Reduction 100 Breasts and traditional inferior pedicle wise pattern Reduction 100 Breasts an outcomes study over 3 years
Plastic and Reconstructive Surgery, 2013Co-Authors: Anuja K Antony, Sara Yegiyants, Kirstie K Danielson, Steven Wisel, David L Morris, Rudolph F Dolezal, Mimis CohenAbstract:BACKGROUND The superomedial pedicle vertical scar Breast Reduction is gaining popularity for its round, projecting Breast and shorter incision when compared with the traditional Wise-pattern Reduction using an inferior pedicle. However, there is a paucity of large-volume institutional outcomes studies identifying how this technique fares against more traditional methods of Reduction. METHODS A retrospective review of a prospectively maintained database of bilateral Breast Reductions over a 3-year period was performed. One hundred superomedial Breast Reductions (50 patients) were matched to 100 inferior pedicle Breast Reductions (50 patients). Matching was implemented based on age (±3 years) and size of Reduction (±200 g). Patient demographics, size of Reduction, nipple-areola complex sensitivity, minor and major postoperative complications, and symptomatic relief were assessed. Statistical analysis was performed with SAS Version 9.2. RESULTS Two hundred twelve patients underwent 424 bilateral Breast Reductions between January of 2009 and June of 2012 at a single institution. Mean volume of tissue reduced was 815 g per Breast (range, 200 to 2068 g) and 840 g per Breast (range, 250 to 2014 g), respectively. All patients achieved symptomatic relief. No statistical difference in major or minor complications was seen between the two cohorts. No statistical difference in major or minor complications was seen between the two cohorts. No significant difference in complications was seen between small- and large-volume Reductions. CONCLUSION Superomedial pedicle vertical scar Breast Reduction is a novel, alternative mammaplasty technique with excellent functional and aesthetic outcomes which can be used for a wide range of macromastia without a significant difference in complication rates when compared with traditional Wise pattern inferior pedicle Reduction mammaplasty. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, III.
Steven J Kronowitz - One of the best experts on this subject based on the ideXlab platform.
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practical guidelines for repair of partial mastectomy defects using the Breast Reduction technique in patients undergoing Breast conservation therapy
Plastic and Reconstructive Surgery, 2008Co-Authors: Steven J Kronowitz, Kelly K Hunt, Henry Mark Kuerer, Eric A Strom, Thomas A Buchholz, Joe Ensor, Cindy Koutz, Geoffrey L RobbAbstract:Background The authors previously compared the local tissue rearrangement, Breast Reduction, and latissimus dorsi flap reconstruction techniques for repairing partial mastectomy defects and showed the benefits of Breast Reduction. Methods In this study, the authors focused solely on factors influencing outcome in 41 patients who underwent repair of a partial mastectomy defect using Breast Reduction. Results Tumor location had a significant effect on the design of the parenchymal pedicle (p = 0.05). Most repairs were performed with an inferior pedicle. Fifty percent of the lower outer and central quadrant tumors required an amputative design with a free nipple graft. The complication rates for immediate and delayed repair were 24 and 50 percent, respectively. The superior pedicle was associated with the highest complication rates. Tumors in the upper outer quadrant of the Breast were associated with the highest complication rate (35 percent). Ninety percent of patients with planned repairs had a viable nipple-areola complex (p = 0.05) and did not require a free nipple graft. More favorable cosmetic outcomes were achieved using an inferior pedicle; less favorable cosmetic outcomes were achieved for tumors in the upper inner quadrant of the Breast. Larger defects did not result in less favorable cosmetic outcomes than smaller defects. Only 7 percent of patients had a positive tumor margin. Five percent of patients developed local Breast cancer recurrence after a mean follow-up of 36 months. Conclusion The authors provide practical guidelines for repairing a partial mastectomy defect using Breast Reduction that should minimize the occurrence of complications and optimize the cosmetic outcome.
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determining the optimal approach to Breast reconstruction after partial mastectomy
Plastic and Reconstructive Surgery, 2006Co-Authors: Steven J Kronowitz, Kelly K Hunt, Henry Mark Kuerer, Cindy Koutz, Jules A Feledy, Adel Youssef, Geoffrey L RobbAbstract:Background: Unfortunately, patients who desire repair of contour deformities after partial mastectomy unually present after radiation therapy, which may increase the risk of complications an result in a poor aesthetic outcome. The authors reviewed their experience with repair of partial mastectomy defects to determine the optimal approach to Breast reconstruction ater partial mastectomy. Methods: Sixty-nine patients who underwent repair of a partial mastectomy defect and received radiation therapy were included in this analysis. The reconstructive techniques were categorized as local tissue rearrangement (LTR), Breast Reduction, or use of a latissimus dorsi myocutaneous flap or thoracoepigastric skin flap (here-after referred to as flap). Results: fifty patients underwent immediate reconstruction before radiation therapy, and 19 underwent delayed rreconstruction after radiation therapy. The reconstructive techniques in patients with immediate reconstruction were local tissue rearrangement in 28 percent, Breast Reduction in 66 percent, and flaps in 6 percent. In patient with delayed reconstruction, 32 percent had local tissue rearrangement, 42 percent had Breast Reduction, and 26 percent had flaps. The complication rates for immediate and delayed reconstruction were 26 percent and 42 percent, respectively. Overall, and in the setting of immediate reconstruction, the flap technique was associated with a higher complication rate than local tissue rearrangement and Breast Reduction. However, in the setting of delayed reconstruction, the flap technique was associated with a lower complication rate than the other two techniques. Fifty-seven percent of the immediate reconstructions performed with the local tissue rearrangement or Breast Reduction technique, but only 33 percent of the immediate reconstructions performed with the flap technique, were associated with an excellent or good aesthetic outcome. Conclusion: Immediate repair of partial mastectomy defects with local tissues results in a lower risk of complications and better aesthetic outcomes than immediate repair of partial mastectomy defects with a latissimus dorsi flap.
Eric J Holowaty - One of the best experts on this subject based on the ideXlab platform.
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a cohort study of Breast cancer risk in Breast Reduction patients
Plastic and Reconstructive Surgery, 1999Co-Authors: Mitchell H Brown, Michael J Weinberg, Nelson Chong, Ron Levine, Eric J HolowatyAbstract:Surgical Reduction of the female Breast (Reduction mammaplasty) is very common in plastic surgery. The purpose of this study was to determine whether women who have undergone Breast Reduction surgery are at the same, greater, or lesser risk of developing Breast cancer than women who have not undergone Breast Reduction surgery. This study incorporates a population-based, non-concurrent cohort linkage methodology. The Canadian Institute for Health Information hospital records were used to identify all Ontario women who had undergone Breast Reduction surgery in Ontario between 1979 and 1992. Three computerized probabilistic record linkages were performed. The first linkage was between a file of the 28,042 Ontario women who had undergone bilateral Breast Reduction surgery between April 1, 1979, and December 31, 1992, and a file of incident cancer cases among Ontario women for the calendar period 1979 to 1993. Follow-up of the cohort was undertaken starting from the date of Breast Reduction surgery, and vital status was ascertained as of December 31, 1993, by record linkage with the Ontario Mortality Database maintained at the Ontario Cancer Registry. The incidence of cancer in the Ontario Breast Reduction cohort was compared with the cancer incidence of the general Ontario population after appropriate adjustments for age and calendar time period. The expected number of cancers was calculated using the "PERSON YEARS" computer program. Within the cohort, followed for an average of 6.5 years after bilateral Breast Reduction surgery, 101 Breast cancers were observed and 165.8 were expected, for a standardized incidence ratio of 0.61 (0.50 to 0.74, 95 percent confidence interval). This effect was independent of patient age at Breast Reduction. This study demonstrates that there is no increased risk of Breast cancer after bilateral Breast Reduction surgery and, in fact, a significant decreased risk existed in women followed for an average of 6.5 years.