Breast reconstruction using a “free flap” from the patient’s abdomen is a safe procedure with a high success rate in older women opting for reconstruction after mastectomy, reports a study in the December issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).
Although the risk of some complications is higher, free-flap reconstruction has “generally good outcomes” in women aged 65 or older, according to the report by ASPS Member Surgeon Oren Tessler, MD, MBA, and colleagues of Louisiana State University Health Sciences Center, New Orleans.
“Older women desire breast reconstruction after mastectomy, and should be offered all reconstruction options available,” Tessler comments, in a media release from ASPS.
Women choose to get breast implants either for breast reconstruction after mastectomy or for cosmetic reasons. The American Society of Plastic Surgeons reported 400,000 breast implant procedures took place in 2017, up nearly 40 percent since 2000.
It’s taken several years to gather data but the FDA now believes that textured breast implants may be more likely to cause ALCL, although it says smooth implants are also linked to an increased risk. The trouble is that there’s no organized effort to put together data from people who have implants and those who have developed ALCL.
Use of the synthetic and fully resorbable TIGR Matrix surgical mesh helped improve the outcome in breast cancer patients undergoing immediate reconstruction, according to a study published in the Journal of Plastic Surgery and Hand Surgery.
The TIGR Matrix and other surgical meshes aim to support, and hold in place, breast implants to improve the aesthetic result with decreased risk of capsule formation. However, traditional meshes, such as the biological acellular dermal matrices, have been linked to severe complications including seroma, necrosis, and the loss of implants.
In the study, lead author Hakan Hallberg and colleagues investigated the use of the TIGR Matrix in a prospective series of 49 consecutive patients undergoing immediate breast reconstruction with a tissue expander or permanent implant. All patients were non-obese, current non-smoker, and not scheduled for postoperative radiotherapy, explains a media release from Novus Scientific.
The TIGR Matrix—produced by Novus Scientific AB, headquartered in Uppsala, Sweden—resulted in a low incidence of complications. The rate of implant-loss was similar as reported with other matrices. Furthermore, TIGR Matrix showed a 3.1% incidence rate of seroma and a 1.5% risk of infections. For comparison, the reported incidences of seroma and infection with other matrices are up to 15% and 30%, respectively.
Immediate breast reconstruction with a tissue expander and TIGR Matrix surgical mesh has a low complication rate, concluded the investigators of the Sahlgrenska University Hospital in Gothenburg, Sweden, per the release.
[Source(s): Novus Scientific, PR Newswire]
Hani Sbitany, MD, is one of a handful of surgeons who are pioneering and studying the outcomes of a new approach that is less invasive, has a less painful recovery, and results in more natural-looking breasts.
The procedure is called a prepectoral reconstruction, and involves placing the implants on top of the pectoralis muscle, just under the skin where breast tissue naturally resides.
“Whether it’s loss of strength, whether its chronic pain or whether animation deformity – there are drawbacks to putting these implants under the muscle,” says Hani Sbitany, MD, a plastic and reconstructive surgeon at UCSF Health.
KCI announces that recently published data stemming from two studies demonstrate that closed incision negative pressure therapy (ciNPT) with the PREVENA Incision Management System reduced postsurgical wound complication potential in patients recovering from oncological breast surgery and breast reconstruction, respectively.
One study titled, “The Impact of Closed Incision Negative Pressure Therapy on Postoperative Breast Reconstruction Outcomes,” showed that patients who received ciNPT with the PREVENA System had significantly lower rates of overall complications and returns to the operating room compared to those in the standard of care (SOC) for incision management after breast reconstruction post-mastectomy group. In addition, patients in the PREVENA Therapy group overall had a shorter mean time to complete removal of all drains than the SOC group, averaging 9.9 days versus 13.1, respectively.
In a separate study titled, “Closed Incision Negative Pressure Therapy in Oncological Breast Surgery: Comparison with Standard Care Dressings,” researchers found that patients in the PREVENA Therapy group showed significantly lower postsurgical complication rates, demonstrating 4 percent in the PREVENA Therapy group versus 45 percent in the SOC group.
“Minimizing the risk of complications for the patients in my care is of the utmost importance to me as a practicing plastic surgeon, and this recent data adds to the established body of evidence that demonstrates the ability of PREVENA Therapy to help preserve outcomes for breast reconstruction patients,” said Ron Silverman, MD, FACS, Chief Medical Officer, KCI, an Acelity Company. “Further, this data has implications for lowering healthcare costs and improving quality and the patient experience as post-operative complications create a tremendous burden impacting patients, surgeons and payers. At KCI, we are dedicated to bringing to market innovations that address these needs supported by proven-real world results that improve patients’ lives.”
“The Impact of Closed Incision Negative Pressure Therapy on Postoperative Breast Reconstruction Outcomes”:
- A single site, retrospective review of records for 356 adult female patients who underwent breast reconstruction post-mastectomy was conducted. Records were divided into two groups for comparative analysis: patients who received SOC versus patients who received ciNPT with the PREVENA Incision Management System for closed incision management post breast reconstruction.
“Closed Incision Negative Pressure Therapy in Oncological Breast Surgery: Comparison with Standard Care Dressings”:
- In a study of 37 patients undergoing oncological breast surgery, 17 patients (25 surgeries) received ciNPT with the PREVENA Incision Management System and the remaining 20 patients (20 surgeries) had SOC.
Both studies were published in Plastic and Reconstructive Surgery – Global Open.
[Source(s): Acelity, Business Wire]
If you choose breast implants for reconstruction, it’s important to know that they don’t always last forever. The time may come when you need to consider replacement or maintenance of your implants.
While implant reconstruction offers a safe, straightforward and effective way to restore breast contour after mastectomy, it’s possible to have trouble with your implants years later.
In 2012, Somers had an experimental stem cell fat grafting procedure to reconstruct her breast.
Now, roughly six years since that procedure, Somers still loves to talk about her breast. She did so, apparently unprompted, in an interview with Us Magazine, in which she said, “This is a regrown breast. This is really mine.”
Wearing a bra, or not, was the last thing on my mind when I underwent a preventive double mastectomy three years ago. But when I woke up from that first surgery, and the three reconstructive surgeries that followed, I was wearing a bra. It was pale pink, closing in front with a strip of hook and loop fasteners, and had two rings hanging from the sides to keep my surgical drains from dangling.
I hated this bra. For eight weeks after my mastectomy I needed to wear it, stuffed with soft gauze to protect my sensitive skin.
Immediate breast reconstruction (IBR) after mastectomy doesn’t negatively affect patient outcomes, according to a new study by researchers at Loma Linda University Health.
The finding could help ease the concerns of patients and physicians, many of whom have been unsure about the combined procedure compared to other options. At issue is a slight delay needed to coordinate schedules of both surgeons — one to perform the mastectomy, the other to perform the reconstruction. Doing so can extend the time from diagnosis to the initial surgery.
Researchers, however, found that a delay of less than 120 days for women under 60 did not have a substantial negative effect on patient survival rates. The average delay, they found, was two weeks.
Doing a Google search of the terms “mastectomy” or “breast reconstruction,” will likely lead you to a plethora of images of these procedures on white breasts, while black bodies are almost non-existent in the results.
And even if you try being more specific by entering the phrase “mastectomy on black woman,” a few more photos will pop up, but it’s still clear that there are not nearly enough resources for black people fighting the disease.