BOOK
Complications in Breast Reduction, An Issue of Clinics in Plastic Surgery, E-Book
(2016)
Additional Information
Book Details
Abstract
This issue of Clinics in Plastic Surgery, devoted to Complications in Breast Reduction, is guest edited by Dr. Dennis C. Hammond. Articles in this issue include: Assessing Risk and Avoiding Complications in Breast Reduction; Management of Shape Distortion After Vertical Breast Reduction; Management of Shape Distortion After Wise Pattern Breast Reduction; Management of Shape Distortion After SPAIR Mammaplasty; Management of the Ischemic NAC After Breast Reduction; Nipple Reconstruction After NAC Necrosis Following Breast Reduction; Management of Recurrent Macromastia; Management of Occult Cancer After Breast Reduction; Mammographic Management of the Post-reduction Breast; Management of Asymmetry After Breast Reduction; Management of the High Riding Nipple After Breast Reduction; Breast Reduction in the Burned Breast; Avoiding Complications in Gigantomastia; and Avoiding Medicolegal Risk in Breast Reduction.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Complications in Breast Reduction\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | v | ||
| Preface: Complications in Plastic Surgery\r | v | ||
| Assessing Risk and Avoiding Complications in Breast Reduction\r | v | ||
| Reduction Mammaplasty and Breast Cancer Screening\r | v | ||
| The Management of Breast Cancer Detected by Reduction Mammaplasty\r | v | ||
| Avoiding the Unfavorable Outcome with Wise Pattern Breast Reduction\r | v | ||
| Managing Complications in Vertical Mammaplasty\r | vi | ||
| The Short Scar Periareolar Inferior Pedicle Reduction Mammaplasty: Management of Complications\r | vi | ||
| Management of Asymmetry After Breast Reduction\r | vi | ||
| Management of Recurrent or Persistent Macromastia\r | vi | ||
| Management of the High-Riding Nipple After Breast Reduction\r | vii | ||
| Management of the Ischemic Nipple–Areola Complex After Breast Reduction\r | vii | ||
| Managing Necrosis of the Nipple Areolar Complex Following Reduction Mammaplasty and Mastopexy\r | vii | ||
| Breast Reduction in the Burned Breast\r | vii | ||
| Avoiding Complications in Gigantomastia\r | viii | ||
| Medicolegal Issues in Breast Reduction\r | viii | ||
| CLINICS IN PLASTIC SURGERY\r | ix | ||
| FORTHCOMING ISSUES | ix | ||
| July 2016 | ix | ||
| October 2016 | ix | ||
| January 2017 | ix | ||
| RECENT ISSUES | ix | ||
| January 2016 | ix | ||
| October 2015 | ix | ||
| July 2015 | ix | ||
| Preface:Complications in \rPlastic Surgery | xi | ||
| Assessing Risk and Avoiding Complications in Breast Reduction | 323 | ||
| Key points | 323 | ||
| INTRODUCTION | 323 | ||
| ASSESSMENT OF RISK HISTORY | 325 | ||
| ASSESSMENT OF RISK: PHYSICAL EXAMINATION | 326 | ||
| AVOIDANCE OF COMPLICATIONS: GENERAL CONSIDERATIONS | 327 | ||
| AVOIDANCE OF COMPLICATIONS: TECHNIQUE SELECTION | 327 | ||
| AVOIDANCE OF HEMATOMA | 327 | ||
| AVOIDANCE OF SKIN ISCHEMIA, SKIN LOSS, AND WOUND SEPARATION | 328 | ||
| AVOIDANCE OF NIPPLE–AREOLA COMPLEX ISCHEMIA | 328 | ||
| AVOIDANCE OF UNATTRACTIVE SCARS | 328 | ||
| AVOIDANCE OF VOLUME AND NIPPLE–AREOLA COMPLEX ASYMMETRY | 329 | ||
| AVOIDANCE OF NIPPLE–AREOLA COMPLEX MALPOSITION | 329 | ||
| AVOIDANCE OF NIPPLE RETRACTION | 329 | ||
| SUMMARY | 329 | ||
| REFERENCES | 330 | ||
| Reduction Mammaplasty and Breast Cancer Screening | 333 | ||
| Key points | 333 | ||
| INTRODUCTION | 333 | ||
| Preoperative Screening Recommendations | 334 | ||
| IMAGING FINDINGS POSTREDUCTION MAMMAPLASTY | 334 | ||
| MAMMOGRAPHY | 334 | ||
| ULTRASOUND AND MRI | 336 | ||
| FOLLOWING ONCOPLASTIC BREAST REDUCTION | 337 | ||
| SUMMARY | 339 | ||
| REFERENCES | 339 | ||
| The Management of Breast Cancer Detected by Reduction Mammaplasty | 341 | ||
| Key points | 341 | ||
| INTRODUCTION | 341 | ||
| FACTORS INFLUENCING THE INCIDENCE OF OCCULT BREAST CANCER FOUND AFTER REDUCTION MAMMAPLASTY | 341 | ||
| Age | 341 | ||
| Family History of Cancer | 341 | ||
| Previous Breast Biopsy Showing High-Risk Pathology | 342 | ||
| Personal History of Breast Cancer | 342 | ||
| Thoroughness of Preoperative Examination: Imaging | 343 | ||
| Thoroughness of Postoperative Examination: Pathology | 343 | ||
| MANAGEMENT OF INCIDENTALLY DETECTED BREAST CANCER | 343 | ||
| SUMMARY | 344 | ||
| REDUCTION MAMMAPLASTY AND THE RISK OF BREAST CANCER | 345 | ||
| SCREENING FOR BREAST CANCER AFTER REDUCTION MAMMAPLASTY | 346 | ||
| REFERENCES | 346 | ||
| Avoiding the Unfavorable Outcome with Wise Pattern Breast Reduction | 349 | ||
| Key points | 349 | ||
| INTRODUCTION | 349 | ||
| HISTORICAL CONSIDERATIONS | 350 | ||
| DESIGNING SKIN FLAPS TO MINIMIZE SHAPE DISTORTION | 352 | ||
| CREATING THE PEDICLE TO MINIMIZE SHAPE DISTORTION | 353 | ||
| CLOSURE | 353 | ||
| NIPPLE POSITION | 356 | ||
| MANAGING SCARS TO OPTIMIZE OUTCOMES | 357 | ||
| POSTOPERATIVE REVISION | 357 | ||
| SUMMARY POINTS FOR AVOIDING THE UNFAVORABLE OUTCOME WITH WISE PATTERN BREAST REDUCTION | 357 | ||
| REFERENCES | 358 | ||
| Managing Complications in Vertical Mammaplasty | 359 | ||
| Key points | 359 | ||
| INTRODUCTION | 359 | ||
| PATIENTS AND TECHNIQUE SELECTION | 359 | ||
| THE MODIFIED LEJOUR TECHNIQUE | 359 | ||
| TECHNIQUE, MATERIALS, AND METHODS | 360 | ||
| COMPLICATIONS | 360 | ||
| Minor Complications | 360 | ||
| Major Complications | 362 | ||
| SUMMARY | 362 | ||
| REFERENCES | 362 | ||
| The Short Scar Periareolar Inferior Pedicle Reduction Mammaplasty | 365 | ||
| Key points | 365 | ||
| INTRODUCTION | 365 | ||
| TECHNIQUE | 365 | ||
| COMPLICATIONS | 366 | ||
| Standard Operative Complications | 366 | ||
| Delayed wound healing | 366 | ||
| Fat necrosis | 367 | ||
| Late seroma scar contracture | 367 | ||
| Shape distortion | 367 | ||
| Asymmetry | 368 | ||
| Nipple-areolar complex distortion | 368 | ||
| Areolar herniation | 369 | ||
| Infected Teflon suture | 371 | ||
| Rehypertrophy | 371 | ||
| SUMMARY | 371 | ||
| REFERENCES | 372 | ||
| Management of Asymmetry After Breast Reduction | 373 | ||
| Key points | 373 | ||
| INTRODUCTION | 373 | ||
| ASYMMETRY OF THE NIPPLE-AREOLA COMPLEX | 374 | ||
| ASYMMETRIES OF BREAST MOUND VOLUME AND SHAPE | 377 | ||
| DISCUSSION | 380 | ||
| REFERENCES | 381 | ||
| Management of Recurrent or Persistent Macromastia | 383 | ||
| Key points | 383 | ||
| INTRODUCTION | 383 | ||
| BACKGROUND | 383 | ||
| ETIOLOGY | 385 | ||
| Inadequate Primary Volume Reduction | 385 | ||
| Inadequate Breast Shape | 385 | ||
| Breast Tissue Hypertrophy | 386 | ||
| PREOPERATIVE CONSIDERATIONS | 386 | ||
| History and Physical Examination | 386 | ||
| Previous Operative Records | 387 | ||
| Informed Consent | 387 | ||
| TIMING OF REPEATED BREAST REDUCTION | 387 | ||
| OPERATIVE TECHNIQUE | 388 | ||
| Understanding the Blood Supply of the Nipple-Areola Complex | 388 | ||
| Skin Marking and Pedicle Selection | 388 | ||
| Infiltration | 389 | ||
| De-epithelialization | 390 | ||
| Excision of Breast Tissue | 390 | ||
| Liposuction | 391 | ||
| Closure | 391 | ||
| SUMMARY | 391 | ||
| REFERENCES | 392 | ||
| Management of the High-Riding Nipple After Breast Reduction | 395 | ||
| Key points | 395 | ||
| INTRODUCTION | 395 | ||
| SUMMARY/DISCUSSION | 396 | ||
| INDIRECT CORRECTION OF THE NIPPLE-AREOLA COMPLEX POSITION | 398 | ||
| INFERIOR BREAST PARENCHYMA RESECTION | 398 | ||
| SUPERIOR BREAST VOLUME ADDITION | 398 | ||
| DIRECT CORRECTION OF THE NIPPLE-AREOLA COMPLEX POSITION | 399 | ||
| V-Y INFERIOR NIPPLE REPOSITIONING | 400 | ||
| RECIPROCAL TRANSPOSITION FLAPS | 400 | ||
| REFERENCES | 401 | ||
| Management of the Ischemic Nipple–Areola Complex After Breast Reduction | 403 | ||
| Key points | 403 | ||
| INTRODUCTION | 403 | ||
| ANATOMIC CONSIDERATIONS | 403 | ||
| Vascular Nutrition of the Breast | 404 | ||
| RISK FACTORS CONTRIBUTING TO NIPPLE–AREOLA COMPLEX NECROSIS | 404 | ||
| Be Alert to | 404 | ||
| ASSOCIATED RISK FACTORS | 405 | ||
| PREOPERATIVE CONTROL | 405 | ||
| INTRAOPERATIVE EVALUATION | 406 | ||
| Vitality of the Nipple–Areola Complex During Closure Is an Important Factor to Be Checked in Every Mammaplasty Procedure | 406 | ||
| INTRAOPERATIVE NIPPLE–AREOLA COMPLEX PERFUSION EVALUATION | 407 | ||
| INTRAOPERATIVE NIPPLE–AREOLA COMPLEX REPERFUSION MANEUVERS | 407 | ||
| POOR NIPPLE VASCULARITY | 407 | ||
| FREE NIPPLE–AREOLA COMPLEX GRAFT INDICATIONS | 408 | ||
| WHEN TO THINK ABOUT A FREE NIPPLE–AREOLA COMPLEX GRAFT | 408 | ||
| COMPLICATIONS OF FREE NIPPLE GRAFTING | 408 | ||
| POSTOPERATIVE CONTROL: HYPOTHERMIA AND PAIN | 408 | ||
| NECROTIC WOUND MANAGEMENT | 408 | ||
| Initial Treatment | 410 | ||
| First 30 days | 410 | ||
| After Debridement of All Necrotic Tissue | 410 | ||
| After 30 days | 410 | ||
| CAN WE PREDICT NIPPLE–AREOLA COMPLEX VIABILITY? | 410 | ||
| INTRAOPERATIVE PROCEDURE TO CHECK TISSUE PERFUSION WITH INDOCYANINE GREEN | 410 | ||
| TREATMENT OF SEQUELAE | 411 | ||
| Different Available Options | 411 | ||
| SUMMARY | 411 | ||
| SUPPLEMENTARY DATA | 413 | ||
| REFERENCES | 413 | ||
| Managing Necrosis of the Nipple Areolar Complex Following Reduction Mammaplasty and Mastopexy | 415 | ||
| Key points | 415 | ||
| INTRODUCTION | 415 | ||
| PREVENTING ISCHEMIA OF THE NIPPLE AREOLAR COMPLEX | 416 | ||
| MANAGING ISCHEMIA OF THE NIPPLE AREOLAR COMPLEX | 417 | ||
| RECONSTRUCTION OF THE NECROTIC NIPPLE AND AREOLA | 420 | ||
| REFERENCES | 423 | ||
| Breast Reduction in the Burned Breast | 425 | ||
| Key points | 425 | ||
| INTRODUCTION | 425 | ||
| RISKS OF OPERATING ON BURNED BREASTS | 425 | ||
| EVALUATION OF THE HYPERTROPHIC BURNED BREAST | 426 | ||
| PRINCIPLES FOR REDUCING THE BURNED BREAST | 426 | ||
| Improve Breast Contour by Releasing Scar Contractures | 426 | ||
| Delay Until Grafts Are Sufficiently Healed and Breasts Are Fully Developed | 426 | ||
| Be Conservative When Designing the Resection Pattern | 426 | ||
| Consider Balancing Procedures at the Same Time | 426 | ||
| TECHNICAL CONSIDERATIONS | 427 | ||
| Inferior Pedicle Mammaplasty | 427 | ||
| Avoiding Complications in Gigantomastia | 429 | ||
| Key points | 429 | ||
| INTRODUCTION | 429 | ||
| DEFINITION | 429 | ||
| CAUSES | 430 | ||
| ANATOMY | 430 | ||
| EVALUATION | 430 | ||
| Treatment Options | 431 | ||
| Preoperative Counseling | 431 | ||
| Other Preoperative Considerations | 432 | ||
| Surgical Management | 432 | ||
| Complications | 434 | ||
| Nipple-Areola Complex Necrosis | 435 | ||
| Hematoma | 435 | ||
| Seroma | 436 | ||
| Wound Dehiscence | 436 | ||
| Wound Infection | 436 | ||
| Nipple-Areola Complex Sensation Disturbances | 436 | ||
| SUMMARY | 436 | ||
| REFERENCES | 438 | ||
| Medicolegal Issues in Breast Reduction | 441 | ||
| Key points | 441 | ||
| GENERAL RISKS | 441 | ||
| SPECIFIC RISKS | 441 | ||
| SIZE AND SHAPE ARE ALWAYS AN ISSUE FOR THE PATIENT SEEKING BREAST REDUCTION | 442 | ||
| SYMMETRY | 442 | ||
| PATHOLOGY OF THE BREAST SPECIMEN | 443 | ||
| REVISION POLICY–FINANCIAL POLICY | 443 | ||
| PHOTOGRAPHS AND PATIENT PRIVACY | 443 | ||
| INFORMED CONSENT | 444 | ||
| REFERENCES | 444 | ||
| FURTHER READINGS | 444 | ||
| Index | 445 |