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Book Details
Abstract
With breast augmentation and tumor removal the #1 procedures in cosmetic surgery and reconstructive surgery, respectively, according to latest ASPS information, this issue on breast augmentation presents discussion of procedures for cosmetic enhancement and for breast reconstruction. The first section includes topics such as: Evolution and Future Development of Breast Implants; Standardization of the Bra Cup; Process of Breast Augmentation with Special Focus on Patient Education, Patient Selection and Implant Selection; Etiology & Prevention of Capsular Contracture; 3-D Imaging and Simulation in Breast Augmentation: What is the Current State of the Art?; Fresh Look at the Anatomy of the Chest Wall with Special Attention to the Pectoralis Major and Infra-Mammary Fold with Implications to Breast Surgery; Differences between Saline & Silicone Implants that Most Plastic Surgeons Don't Know; Shapes, Sizes, Shells and Surface and the Selection Process of Breast Implants; Shapes, Proportions and Variations in Breast Aesthetic Ideals - definition of breast beauty: analysis and surgical practice. The next section presents surgical approaches and techniques for breast implant surgery: Teaching Breast Augmentation What are the Critical Intra Operative Steps & Decision Making: Maximizing Results and Minimizing Revisions; Mastering the Nuances of Highly Cohesive Shaped Breast Implants; Strategies, Challenges and Solutions in Augmentation Mastopexy Patients: The Most Difficult Primary Breast Procedure; Use of Scaffold Support of the Breast in Primary Augmentation Mastopexy; Considerations and Improvement of Breast Asymmetry in Primary Augmentation; Surgical Strategies in the Correction of the Tuberous Breast; Subfascial Apprach to Breast Augmentation with Lipofilling of the Breast; Surgical Approaches to Breast Augmentation: Surgical Options for Incisions & Planes; Fat Grafting / Fat Transfer to the Breast; Use of Barbed Sutures in Primary Augmentation and Mastopexy. The final section presents special situations in surgical procedures: High Resolution Ultrasound and the Detection of Breast Implant Shell Failure; Breast Implant Associated ALCL.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Breast Augmentation | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | v | ||
| Preface: Breast Augmentation\r | v | ||
| The Evolution of Breast Implants\r | v | ||
| The Standardization of Bra Cup Measurements: Redefining Bra Sizing Language\r | v | ||
| The Process of Breast Augmentation with Special Focus on Patient Education, Patient Selection and Implant Selection\r | v | ||
| Understanding the Etiology and Prevention of Capsular Contracture: Translating Science into Practice\r | v | ||
| Three-dimensional Imaging and Simulation in Breast Augmentation: What Is the Current State of the Art?\r | vi | ||
| Shapes, Proportions, and Variations in Breast Aesthetic Ideals: The Definition of\rBreast Beauty, Analysis, and Surgical Practice\r | vi | ||
| The Laminated Nature of the Pectoralis Major Muscle and the Redefinition of the Inframammary Fold: Clinical Implications in ... | vi | ||
| Weight Measurement and Volumetric Displacement of Breast Implants and Tissue Expanders: Why Port and Shell Volumes Matter i ... | vi | ||
| Teaching Breast Augmentation: A Focus on Critical Intraoperative Techniques and Decision Making to Maximize Results and Min ... | vii | ||
| Strategies and Challenges in Simultaneous Augmentation Mastopexy\r | vii | ||
| The Etiologies of Chest Wall and Breast Asymmetry and Improvement in Breast Augmentation\r | vii | ||
| Surgical Strategies in the Correction of the Tuberous Breast\r | viii | ||
| The Subfascial Approach to Primary and Secondary Breast Augmentation with Autologous Fat Grafting and Form-Stable Implants\x0B | viii | ||
| Transaxillary Subfascial Augmentation Mammaplasty with Anatomic Form-Stable Silicone Implants\r | viii | ||
| Surgical Approaches to Breast Augmentation: The Transaxillary Approach\r | viii | ||
| Clinical Applications of Barbed Suture in Aesthetic Breast Surgery\r | ix | ||
| Coming of Age: Breast Implant–Associated Anaplastic Large Cell Lymphoma After 18 Years of Investigation\r | ix | ||
| CLINICS IN PLASTIC SURGERY\r | x | ||
| FORTHCOMING ISSUES | x | ||
| January 2016 | x | ||
| April 2016 | x | ||
| July 2016 | x | ||
| RECENT ISSUES | x | ||
| July 2015 | x | ||
| April 2015 | x | ||
| January 2015 | x | ||
| Preface: Breast Augmentation\r | xi | ||
| The Evolution of Breast Implants | 399 | ||
| Key points | 399 | ||
| INTRODUCTION | 399 | ||
| EVOLUTION OF SALINE IMPLANTS | 400 | ||
| EVOLUTION OF SILICONE IMPLANTS | 400 | ||
| SURFACE | 400 | ||
| FILLER | 401 | ||
| SHELL | 402 | ||
| IMPLANT SHAPE | 402 | ||
| DISCUSSION | 402 | ||
| SUMMARY | 402 | ||
| REFERENCES | 403 | ||
| The Standardization of Bra Cup Measurements | 405 | ||
| Key points | 405 | ||
| OVERVIEW | 405 | ||
| METHODS | 406 | ||
| RESULTS | 406 | ||
| DISCUSSION | 407 | ||
| SUMMARY | 410 | ||
| ACKNOWLEDGMENTS | 410 | ||
| REFERENCES | 410 | ||
| The Process of Breast Augmentation with Special Focus on Patient Education, Patient Selection and Implant Selection | 413 | ||
| Key points | 413 | ||
| INTRODUCTION | 413 | ||
| PATIENT EDUCATION AND INFORMED CONSENT | 414 | ||
| Team Approach to Education | 414 | ||
| Determine Patient Knowledge/Patient Desires | 414 | ||
| IMPLANT CHARACTERISTICS/SURGICAL APPROACH | 416 | ||
| Shaped Versus Round | 416 | ||
| Smooth Versus Textured | 417 | ||
| Saline Versus Silicone | 417 | ||
| Pocket Plane | 417 | ||
| Incision Selection | 417 | ||
| Limitations Patients Should Understand | 418 | ||
| PREOPERATIVE ASSESSMENT/CONSULT KEY POINTS | 418 | ||
| Patient History | 418 | ||
| Physical Examination/Measurements Key Points | 418 | ||
| Breast base width | 419 | ||
| Skin stretch | 419 | ||
| Nipple-inframammary fold on stretch | 419 | ||
| Breast type (implant-specific planning) | 419 | ||
| Photography | 419 | ||
| IMPLANT SELECTION: TISSUE-BASED CLINICAL ANALYSIS AND PLANNING | 419 | ||
| Bra/Sizers Limitations | 420 | ||
| High-5 System | 421 | ||
| Three-Dimensional Analyses | 422 | ||
| SUMMARY | 425 | ||
| REFERENCES | 426 | ||
| Understanding the Etiology and Prevention of Capsular Contracture | 427 | ||
| Key points | 427 | ||
| INTRODUCTION | 427 | ||
| FACTORS INFLUENCING CAPSULAR CONTRACTURE FORMATION | 428 | ||
| Bacteria and Subclinical Infection (Strong Potentiator) | 428 | ||
| Implant Texturing (Both Suppressor and Strong Potentiator) | 429 | ||
| Silicone Foreign Body Reaction (Potentiator) | 430 | ||
| Incision Choice | 430 | ||
| Submuscular Pocket (Suppressor) Versus Subglandular Pocket (Potentiator) | 430 | ||
| Implant Exposure Time (Potentiator) | 430 | ||
| Induction Intravenous Antibiotics (Suppressor) | 430 | ||
| Pocket Irrigation (Suppressor) | 431 | ||
| Nipple Coverage (Suppressor) | 431 | ||
| Introduction Sleeves (Suppressor) | 431 | ||
| Topical Antibiotics (Suppressor) | 431 | ||
| Hematoma (Potentiator) and Use of Surgical Drains (Potentiator) | 432 | ||
| FUTURE DEVELOPMENTS | 432 | ||
| SUMMARY | 432 | ||
| REFERENCES | 433 | ||
| Three-dimensional Imaging and Simulation in Breast Augmentation | 437 | ||
| Key points | 437 | ||
| INTRODUCTION | 437 | ||
| COMPUTERIZED STEREOSCOPIC IMAGING | 438 | ||
| CAMERA CALIBRATION | 438 | ||
| THE THREE-DIMENSIONAL SURFACE | 439 | ||
| CREATING A USABLE THREE-DIMENSIONAL SURFACE | 440 | ||
| COMPUTER SIMULATION | 440 | ||
| SIMULATION OF BREAST AUGMENTATION | 440 | ||
| MASTOPEXY: AUGMENTATION | 442 | ||
| IS THIS THREE-DIMENSIONAL? | 442 | ||
| CREATING A TRUE THREE-DIMENSIONAL IMAGE | 442 | ||
| ANALYSIS OF SURFACE DATA | 444 | ||
| THREE-DIMENSIONAL IMAGE CAPTURE, COMPUTER SIMULATION, AND BREAST AUGMENTATION | 445 | ||
| HOW THE AUTHOR INTEGRATES THIS TECHNOLOGY INTO HIS PATIENT WORK FLOW (EPSTEIN) | 445 | ||
| IMPLEMENTING THE TECHNOLOGY INTO YOUR CONSULTATION WORKFLOW | 445 | ||
| HOW THE AUTHOR INTEGRATES THIS TECHNOLOGY INTO HIS PATIENT WORK FLOW (SCHEFLAN) | 447 | ||
| SUMMARY | 449 | ||
| ACKNOWLEDGMENTS | 449 | ||
| REFERENCES | 449 | ||
| Shapes, Proportions, and Variations in Breast Aesthetic Ideals | 451 | ||
| Key points | 451 | ||
| INTRODUCTION | 451 | ||
| ANALYSIS OF BREAST BEAUTY | 452 | ||
| POPULATION ANALYSIS | 452 | ||
| AESTHETIC TEMPLATE | 455 | ||
| TREATMENT GOALS AND SURGICAL PLANNING | 457 | ||
| MEASUREMENT PRINCIPLES | 459 | ||
| THE ICE FORMULA | 459 | ||
| ANALYSIS OF THE ICE PRINCIPLE | 460 | ||
| RESULTS | 461 | ||
| DISCUSSION | 463 | ||
| SUMMARY | 464 | ||
| REFERENCES | 464 | ||
| The Laminated Nature of the Pectoralis Major Muscle and the Redefinition of the Inframammary Fold | 465 | ||
| Key points | 465 | ||
| INTRODUCTION | 465 | ||
| REVIEW OF THE LITERATURE | 466 | ||
| LAMINATED NATURE OF PECTORALIS | 468 | ||
| Crescent-Shaped Origin of Muscle | 468 | ||
| Dual Layer of Pectoralis | 468 | ||
| Relationship to Inframammary Fold | 469 | ||
| Medial inflection point | 469 | ||
| Lateral inflection point | 471 | ||
| Central inflection point | 471 | ||
| CURRENT CONCEPT OF PECTORALIS ANATOMY AND ITS IMPLICATIONS | 472 | ||
| Right Angle Insertion of Inferior Origin to Vertical Sternal Origin | 472 | ||
| Consequences with Augmentation | 472 | ||
| Lateral misidentification | 472 | ||
| Underdissection | 473 | ||
| Overdissection medially | 474 | ||
| Overdissection inferiorly | 474 | ||
| Consequences with Implant-Based Reconstruction | 474 | ||
| Complete submuscular reconstruction | 474 | ||
| Acellular dermis matrix-based reconstruction | 474 | ||
| Failure to resecure the deep layer | 476 | ||
| Clinical Applications to Mastopexy and Reduction | 477 | ||
| DISCUSSION | 477 | ||
| REFERENCES | 479 | ||
| Weight Measurement and Volumetric Displacement of Breast Implants and Tissue Expanders | 481 | ||
| Key points | 481 | ||
| INTRODUCTION AND BACKGROUND | 481 | ||
| METHODS | 483 | ||
| Computational Methodology | 483 | ||
| RESULTS | 484 | ||
| DISCUSSION | 485 | ||
| DISCLOSURE | 490 | ||
| ACKNOWLEDGMENTS | 490 | ||
| REFERENCES | 490 | ||
| Teaching Breast Augmentation | 493 | ||
| Key points | 493 | ||
| INTRODUCTION | 493 | ||
| PREOPERATIVE PLANNING | 493 | ||
| PATIENT POSITIONING | 494 | ||
| INFILTRATION OF LOCAL ANESTHETIC | 494 | ||
| SURGICAL PREPARATION AND STERILE DRAPING | 494 | ||
| INCISION | 495 | ||
| Inframammary Fold Positioning | 495 | ||
| Inframammary Incision | 497 | ||
| Periareolar Incision | 497 | ||
| IMPLANT POCKET | 497 | ||
| Pocket Decision | 497 | ||
| Pocket Control | 498 | ||
| Dual-Plane Pocket | 498 | ||
| IMPLANT PLACEMENT | 499 | ||
| CLOSURE | 500 | ||
| POSTOPERATIVE MANAGEMENT | 501 | ||
| SUMMARY | 502 | ||
| SUPPLEMENTARY DATA | 502 | ||
| REFERENCES | 502 | ||
| Strategies and Challenges in Simultaneous Augmentation Mastopexy | 505 | ||
| Key points | 505 | ||
| INTRODUCTION | 505 | ||
| BREAST VASCULAR ANATOMY | 505 | ||
| INDICATIONS FOR AUGMENTATION MASTOPEXY | 506 | ||
| PREOPERATIVE PREPARATION | 507 | ||
| OPERATIVE STRATEGY | 509 | ||
| Borderline Ptosis | 509 | ||
| Deflated Ptosis Grades 2 and 3 | 509 | ||
| Grade 4 Ptosis (Pseudoptosis) | 511 | ||
| Constricted or Tuberous Breast | 512 | ||
| Native Breast Asymmetry | 512 | ||
| COMPLICATIONS | 512 | ||
| Hematoma | 512 | ||
| Infection | 512 | ||
| Skin and Nipple Necrosis | 513 | ||
| Implant Visibility or Rippling | 513 | ||
| Pocket Asymmetry or Implant Malposition | 513 | ||
| Symmastia | 513 | ||
| Subpectoral Implant Movement | 513 | ||
| Pseudoptosis: “Bottoming Out” | 513 | ||
| Capsular Contracture | 513 | ||
| Malposition and Shape of the Nipple-Areola Complex | 514 | ||
| Double Bubbles | 514 | ||
| Nipple Sensation and Lactation | 514 | ||
| Implant-Related Complications | 515 | ||
| Tissue-Related Complications | 515 | ||
| POSTOPERATIVE CARE | 515 | ||
| OUTCOMES | 515 | ||
| SUMMARY | 515 | ||
| DISCLOSURES | 516 | ||
| REFERENCES | 516 | ||
| The Etiologies of Chest Wall and Breast Asymmetry and Improvement in Breast Augmentation | 519 | ||
| Key points | 519 | ||
| OVERVIEW | 519 | ||
| EMBRYOLOGY OF CHEST WALL AND BREAST DEVELOPMENT | 520 | ||
| HISTORICAL MANAGEMENT | 520 | ||
| ACQUIRED CHEST WALL DEFORMITIES | 521 | ||
| PSYCHOSOCIAL IMPLICATIONS | 522 | ||
| PATIENT ASSESSMENT AND PREOPERATIVE PLANNING | 522 | ||
| CORRECTION OF CHEST WALL AND BREAST ASYMMETRIES WITH SHAPED HIGHLY COHESIVE GEL IMPLANTS | 522 | ||
| Tissue-Based Planning | 523 | ||
| Techniques for Correction | 523 | ||
| ISOLATED BREAST ASYMMETRIES | 525 | ||
| CORRECTION OF BREAST AND CHEST WALL ASYMMETRY WITH IMPLANTS AND FAT | 526 | ||
| SUMMARY | 529 | ||
| REFERENCES | 529 | ||
| Surgical Strategies in the Correction of the Tuberous Breast | 531 | ||
| Key points | 531 | ||
| INTRODUCTION | 531 | ||
| ANATOMY AND HISTOPATHOLOGY | 532 | ||
| CLASSIFICATION | 533 | ||
| TREATMENT GOALS AND PLANNED OUTCOMES | 533 | ||
| Principles of Treatment | 533 | ||
| The Constricted Base | 535 | ||
| Volume Correction | 535 | ||
| BREAST IMPLANTS AND THE TUBEROUS BREAST | 537 | ||
| Incision Selection | 539 | ||
| Pocket Selection | 540 | ||
| Preoperative Markings and Determining the New Inframammary Fold | 541 | ||
| Skin Excision | 541 | ||
| Patient Positioning and Rapid Recovery Process | 542 | ||
| Procedural Approach | 543 | ||
| POTENTIAL COMPLICATIONS AND MANAGEMENT | 545 | ||
| OUTCOMES | 547 | ||
| Case 1 | 547 | ||
| Case 2 | 547 | ||
| Case 3 | 548 | ||
| Case 4 | 548 | ||
| REFERENCES | 548 | ||
| The Subfascial Approach to Primary and Secondary Breast Augmentation with Autologous Fat Grafting and Form-Stable Implants | 551 | ||
| Key points | 551 | ||
| INTRODUCTION | 552 | ||
| THE SUBFASCIAL APPROACH | 552 | ||
| FORM-STABLE IMPLANTS | 553 | ||
| AUTOLOGOUS FAT GRAFTING | 555 | ||
| SURGICAL PLANNING/TECHNIQUE | 556 | ||
| Patient Selection | 556 | ||
| Primary augmentation | 556 | ||
| Secondary augmentation | 557 | ||
| Preoperative Evaluation/Implant Selection | 557 | ||
| Surgical Technique | 558 | ||
| Subfascial dissection | 558 | ||
| Autologous fat grafting | 558 | ||
| Postoperative Care | 561 | ||
| Results | 561 | ||
| SUMMARY | 561 | ||
| REFERENCES | 562 | ||
| Transaxillary Subfascial Augmentation Mammaplasty with Anatomic Form-Stable Silicone Implants | 565 | ||
| Key points | 565 | ||
| INTRODUCTION | 566 | ||
| AXILLARY APPROACH | 566 | ||
| THE SUBFASCIAL TECHNIQUE | 570 | ||
| FORM-STABLE IMPLANTS | 572 | ||
| SURGICAL PLANNING/TECHNIQUE | 573 | ||
| Patient Selection | 573 | ||
| Primary augmentation | 573 | ||
| Preoperative Evaluation/Implant Selection | 573 | ||
| Surgical Technique | 575 | ||
| Subfascial transaxillary approach for breast augmentation dissection | 575 | ||
| Postoperative Care | 578 | ||
| Results | 579 | ||
| SUMMARY | 580 | ||
| REFERENCES | 583 | ||
| Surgical Approaches to Breast Augmentation | 585 | ||
| Key points | 585 | ||
| PREOPERATIVE PLANNING | 586 | ||
| PATIENT POSITIONING AND SETUP | 586 | ||
| PROCEDURE | 587 | ||
| Incision and Initial Dissection | 587 | ||
| Creation of the Optical Cavity | 588 | ||
| Pectoralis Major Muscle Release | 588 | ||
| Device Placement | 589 | ||
| Clinical Results | 590 | ||
| SUPPLEMENTARY DATA | 592 | ||
| REFERENCES | 592 | ||
| Clinical Applications of Barbed Suture in Aesthetic Breast Surgery | 595 | ||
| Key points | 595 | ||
| BACKGROUND | 595 | ||
| CLINICAL APPLICATIONS | 597 | ||
| TWO-LAYER BREAST AUGMENTATION CLOSURE | 597 | ||
| BREAST REDUCTION AND MASTOPEXY CLOSURE | 599 | ||
| ADDITIONAL BREAST APPLICATIONS | 600 | ||
| Review of the Literature | 600 | ||
| SUPPLEMENTARY DATA | 604 | ||
| REFERENCES | 604 | ||
| Coming of Age | 605 | ||
| Key points | 605 | ||
| INTRODUCTION | 605 | ||
| LYMPHOMA BACKGROUND | 606 | ||
| BREAST IMPLANT–ASSOCIATED ANAPLASTIC LARGE CELL LYMPHOMA: A NOVEL VARIANT | 606 | ||
| EPIDEMIOLOGY | 607 | ||
| DIAGNOSIS AND TREATMENT | 607 | ||
| CLINICAL CHARACTERISTICS AND OUTCOMES | 608 | ||
| SETTING RESEARCH PRIORITIES | 610 | ||
| MEDICAL-LEGAL CONSIDERATIONS | 610 | ||
| REPORTING OF CASES | 610 | ||
| SUMMARY | 610 | ||
| REFERENCES | 611 | ||
| Index | 615 |