Annals of plastic surgery
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Annals of plastic surgery · Sep 1998
Prefabrication of a high-density porous polyethylene implant using a vascular induction technique.
Three-dimensional defects have been reconstructed with carved and remodeled frameworks wrapped within vascular carriers and have wide use in ear and nose reconstruction. The main problem with thick coverings is masking of the fine details in the frameworks. Other problems are insufficient blood supply, infection, and exposure of the implant. ⋯ Twenty implants were prefabricated in this procedure, and they were evaluated via histological examination and perfusion scintigraphy. Results revealed that the implants were invaded by fibroneovascular tissue. Blood supply coming from the vascular pedicle was sufficient to maintain the implant as a prefabricated composite flap, which could be transferred as a pedicled flap or a free flap.
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Annals of plastic surgery · Sep 1998
Case ReportsReduction mammaplasty: its role in breast conservation surgery for early-stage breast cancer.
Segmental resection and radiotherapy is an accepted alternative over mastectomy for small, staged breast malignancies. However, women with large, pendulous breasts have been documented to have poorer cosmetic outcomes when undergoing irradiation after breast conservative surgery compared with women with small- or medium-size breasts, thought to be caused by dose inhomogeneity. The purpose of this study was to evaluate the efficacy of combining reduction mammaplasty with breast conservative surgery to facilitate postoperative irradiation. ⋯ Despite equivalent survival outcomes for mastectomy for early-stage breast cancer, certain women are not good candidates for breast conservation and radiation therapy. An alternative for women with large, pendulous breasts that combines breast conservation therapy and concurrent bilateral reduction mammaplasty should be considered. This combination, in selected women, provides good functional and cosmetic results, and at the same time minimizes the potential difficulties of radiation therapy.