جستجوی مقالات مرتبط با کلیدواژه "reduction mammoplasty" در نشریات گروه "پزشکی"
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Background
Bilateral breast hypertrophy, ranging from mild to severe, can lead to various complications, including pain, ulceration, infection, and psychological distress. Swift surgical intervention is often necessary to address the mechanical and psychological challenges associated with excessive breast weight. While treatment approaches for this condition are debated, recent advancements favor surgical strategies like mastectomies with reconstruction to improve clinical and psychological outcomes. We present a unique case of bilateral breast hypertrophy successfully managed through breast amputation and NAC (nipple-areolar complex) graft using wise patterns incision mammoplasty.
Case PresentationThis report details the case of a 30-year-old female with hypothyroidism and lupus who experienced significant bilateral breast enlargement during her second pregnancy. The patient faced pain, hyperpigmentation, and limited mobility, along with abnormal laboratory findings. Bilateral reduction mammoplasty (breast amputation) was performed, leading to successful outcomes and improved quality of life for both the patient and her newborn. Follow-up assessments showed no recurrence or complications postoperatively.
ConclusionThis case highlights the challenges of managing breast hypertrophy in pregnant patients with autoimmune conditions. Early recognition and multidisciplinary management are crucial in such cases. The positive results of the interventions underscore the importance of timely and comprehensive care for patients facing similar conditions.
Keywords: Pregnancy, Gigantomastia, Reduction Mammoplasty, Breast Hypertrophy -
BACKGROUND
Macromastia in adolescent girls is a distressing condition. There is an increase in the number of patients opting for reduction mammoplasty in the late teens. The semicircular horizontal method of breast reduction, first described by Passot in 1925 has the advantage of being able to do larger reduction, particularly suitable for pendulous breasts and having a hidden scar in the inframammary fold.
METHODSEleven patients of adolescent macromastia were included in this study. It was conducted over a period of 4 years (2013-17) at two teaching institutions in Kolkata and Rishikesh, India. The mean age of the patients was 19.2 years. The Passot technique of reduction mammoplasty was performed in each case and the volume of resected breast tissue recorded by weighing the specimen. The aesthetic outcome was assessed by Lowery scale (volume, contour, placement of the breast mound and inframammary fold). Patient satisfaction was assessed after 6 months of follow up on a scale of 1 to 10, where 1-4 was poor, 5-6 fair, 7-8 good and 9-10 excellent.
RESULTSMean total reduction per breast was 856 gm. Patients reported a mean decrease of cup size by 1.5. The aesthetic outcome was excellent in 6 patients and good in 5 patients. Patient satisfaction was excellent in 9 patients and good in 2 patients.
CONCLUSIONPassot technique is a safe and effective technique of reduction mammoplasty and is especially useful in adolescent macromastia where the absence of visible scar on the breasts is very satisfying for the patients.
Keywords: Reduction mammoplasty, Passot, Unmarried females -
BACKGROUND
Macromastia in adolescent girls is a distressing condition. There is an increase in the number of patients opting for reduction mammoplasty in the late teens. The semicircular horizontal method of breast reduction, first described by Passot in 1925 has the advantage of being able to do larger reduction, particularly suitable for pendulous breasts and having a hidden scar in the inframammary fold.
METHODSEleven patients of adolescent macromastia were included in this study. It was conducted over a period of 4 years (2013-17) at two teaching institutions in Kolkata and Rishikesh, India. The mean age of the patients was 19.2 years. The Passot technique of reduction mammoplasty was performed in each case and the volume of resected breast tissue recorded by weighing the specimen. The aesthetic outcome was assessed by Lowery scale (volume, contour, placement of the breast mound and inframammary fold). Patient satisfaction was assessed after 6 months of follow up on a scale of 1 to 10, where 1-4 was poor, 5-6 fair, 7-8 good and 9-10 excellent.
RESULTSMean total reduction per breast was 856 gm. Patients reported a mean decrease of cup size by 1.5. The aesthetic outcome was excellent in 6 patients and good in 5 patients. Patient satisfaction was excellent in 9 patients and good in 2 patients.
CONCLUSIONPassot technique is a safe and effective technique of reduction mammoplasty and is especially useful in adolescent macromastia where the absence of visible scar on the breasts is very satisfying for the patients.
Keywords: Reduction mammoplasty, Passot, Unmarried females -
BackgroundSurgery for hypertrophied breast represents a challenge for plastic surgeons. The search for a good cosmetic breast has led to the development of many techniques. Objectives for reduction mammoplasty are to achieve elevated, symmetrical breasts, with round shape, good projection, small cicatrices that are not very perceptible, and a lasting result.MethodsThis study was carried out on 60 cases who had done reduction mammoplasty from January 2009 to December 2014. All patients were examined and asked for late post-operative results and overall patient's satisfaction.ResultsLong term projection and contour of the breast were more satisfactory among patients who had superomedial pedicle with a statistical significant difference. No statistical significant difference was observed between patients undergone either types of operations concerning breast symmetry, nipple symmetry and sensation. The mean score of satisfaction was higher among patients undergone superomedial pedicle than inferior pedicle.ConclusionThe superomedial pedicle shows better long term cosmetic result in reduction mammoplasty.Keywords: Patient's satisfaction, Reduction mammoplasty, Inferior pedicle, Superomedial pedicle
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زمینه و هدفماموپلاستی کاهنده (کوچک کردن پستان) یکی از اعمال جراحی شایع جراحی پلاستیک محسوب می شود و یکی از تکنیک های شایع بکار رفته روش پدیکول تحتانی است. افتادگی پل تحتانی پستان (Bottoming out) از عوارض دراز مدت آن محسوب می شود. چندین راهکار تعریف شده اند که نتیجه کاملی نداشته اند. این مطالعه در پی آن است با معرفی روشی بنام ثابت کردن تاشدگی Plication Fixation)) این عارضه را به حداقل برساند.مواد و روش ها66 بیمار کاندید ماموپلاستی با پدیکول تحتانی، با ثبت اطلاعات دموگرافیکی (جمعیت شناختی) به طور تصادفی در 2 گروه پدیکول تحتانی به تنهایی و پدیکول تحتانی با ثابت کردن تاشدگی تحت جراحی قرار گرفتند. شاخص های طول زمان عمل، مقدار نسج برداشته شده، حس بعد عمل، از بین رفتن نیپل و فراوانی افتادگی پل تحتانی پستان اندازه گیری شد و همراه برخی متغیرهای دیگر با روش کای اسکوار و فیشر آنالیز آماری شدند.یافته هامیزان پلیکاسیون در گروه دوم 2/2±10 سانتی متر بود. میزان آسیمتری (غیر قرینگی) قبل عمل هم از 5 به یک مورد کاهش یافت. یک مورد سروما در این گروه دیده شد. میزان افتادگی پل تحتانی پستان در گروه اول به طور معنی داری بیشتر از گروه ثابت کردن تاشدگی بود.نتیجه گیریپدیکول در جراحی پدیکول تحتانی برای حفظ خونرسانی و حس نیپل اهمیت دارد، ولی از ایرادات بالقوه آن افتادگی قسمت تحتانی پستان با گذشت زمان است که با این تکنیک تا زیادی جلو آن گرفته می شود. عوارض ناشی از پدیکول نیز تا حد زیادی برطرف می شوند. به نظر می رسد استفاده از تکنیک ثابت کردن تاشدگی در مورد ماموپلاستی کاهنده با عوارض کم توانسته است نتایج دراز مدت بیشتری در مقایسه با روش معمول پدیکول تحتانی داشته باشد.
کلید واژگان: ماموپلاستی کاهنده, پدیکول تحتانی, پلیکاسیونIntroduction &ObjectiveReductive mammoplasty is one of the most common operations in plastic surgery and inferior pedicle is one of most common techniques. Bottoming out is considered as a long term sequel. Introduced solutions have had satisfactory results. This study wants to present Plication fixation (Pf) as a new technique for minimizing bottoming out.Materials and Methods66 patients who were candidates for inferior pedicle reduction mammoplasty were categorized randomly into simple reduction mammoplasty (as inferior pedicle) and inferior pedicle reduction mammoplasty with plication fixation, and underwent appropriate operation. Parameters like operation time, reduced tissue weight, nipple sense, and frequency of bottoming out, were recorded and analyzed.ResultsIn group 2 (Pf) pedicle lengths was 10±2.2 cm. Asymmetry reduced from 5 to1. Seruma was seen in a patient. In the first group bottoming out was significantly more than in the second group (Pf).ConclusionsPedicle has vital role in inferior pedicle reduction mammoplasty as far as blood supply and sensibility is concerned. One of its potential complications is bottoming out, as Plication fixation can reduce it significantly. So it seems that placation fixation with little complications, can lead to more long term results in inferior pedicle reduction mammoplasty.Keywords: Reduction Mammoplasty, Inferior Pedicle, Plication -
زمینهدر طی دو دهه اخیر از تابش نور لیزر Pulsed – dye laser (PDL) در درمان اسکارهای هیپرتروفیک و کلوئید استفاده شده که با درجات مختلفی از موفقیت همراه بوده است. بعضی از مطالعات، بر درمان زودرس اسکار به وسیله PDL جهت دستیابی به نتیجه بهتر تاکید دارند، لذا محققین از PDL جهت پیشگیری از ایجاد اسکار هیپرتروفیک و کلوئید در محل انسیزیون های جراحی در مراحل اولیه ترمیم زخم استفاده کرده اند. این کارآزمایی بالینی تصادفی شده با گروه کنترل، به منظور بررسی اثر استفاده پروفیلاکتیک (سه هفته بعد از عمل جراحی) از PDL 585 nm در کاهش شدت اسکارهای جراحی در انسیزیون های reduction ماموپلاستی دو طرفه در مراجعه کنندگان به مرکز تحقیقات لیزر پزشکی جهاد دانشگاهی علوم پزشکی تهران طرح ریزی و اجرا شد.روش بررسیدر این طرح 6 بیمار که تحت reduction ماموپلاستی دو طرفه قرار گرفته بودند، مطالعه را به پایان رساندند. در هر بیمار 3 سانتی متر از انتهای مدیال و 3 سانتی متر از انتهای لترال خط انسیزیون به صورت تصادفی به عنوان کنترل انتخاب و قرینه آن در طرف مقابل، تحت تابش با PDL 585nm قرار می گرفت (در مجموع 24 ناحیه اسکار، شامل 12 منطقه کنترل و 12 منطقه لیزر). تابش لیزر به فواصل 1 ماه، در 2 نوبت دیگر با همین پارامترها تکرار شد. ارزیابی اسکارهای بیماران قبل از انجام پروسه و نیز طی زمان های پیگیری یعنی انتهای ماه اول و دوم (قبل از انجام لیزر) و 2 ماه بعد از آخرین جلسه تابش لیزر، توسط پزشک مستقل با استفاده از VSS (Vancouver Scar Scale) صورت گرفت.یافته هادو ماه بعد از سومین جلسه تابش، ضایعات گروه لیزر، بهبودی قابل توجهی را از نظر واسکولاریتی، انعطاف پذیری و ارتفاع نشان می دادند (p value< 0.001). در حالی که در گروه کنترل، میزان بهبود واسکولاریتی (p value=0.14)، انعطاف پذیری (p value=0.13) معنی دار نبود و ارتفاع اسکارها تغییری را نشان نمی داد.نتیجه گیرینتایج این کارآزمایی بالینی تصادفی شده نشان می دهد که استفاده پروفیلاکتیک از سه جلسه تابش لیزر PDL 585 nm با دوز پایین، می تواند به عنوان روشی مناسب و در عین حال ایمن در بهبود واسکولاریتی، انعطاف پذیری و کاهش ارتفاع اسکار ناشی از خط برش reduction ماموپلاستی) با انسیزیون inverted-T (محسوب گردد.
BackgroundPulsed-dye laser (PDL) has been used with variable degrees of success in the treatment of hypertrophic scars and keloids. Some studies show that the newer scars respond better to treatment than the elder ones. Recently few studies have shown the benefits of the 585-nm PDL in improving the quality of surgical scars starting on the day of suture removal. This randomized controlled clinical trial (RCT) was designed to evaluate the effects of 585nm PDL to improve the post reduction mammoplasty surgical scars when used three weeks after surgery.Material And MethodsSix patients with 24 linear post mammoplasty scars completed the trial. In any patient 3cm of the terminal part of the medial and lateral incisional lines were randomly allocated to be treated with PDL and the symmetrical site as control. The laser sites were treated three times on monthly intervals with 585-nm PDL which started 3 weeks after mammoplasty. The scars were evaluated by blinded examiner using the Vancouver Scar Scale (VSS) before laser sessions and 2 months after the last treatment.ResultsTwo months after the last PDL session, there was significant improvement of vascularity, pliability and height of the scars in laser group (p value< 0.001), in contrast to the lesions in control group in which the improvement of vascularity (p value= 0.14), pliability (p value = 0.13) and height of the scars were not significant.ConclusionThe results of this RCT suggest that prophylactic 585-nm PDL irradiation is effective and safe in improving the quality and cosmetic appearance of post reduction mammoplasty incisional lines when used shortly (three weeks) after surgery.Keywords: PDL, Pulsed, dye laser, Reduction mammoplasty, Scar, VSS
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