Preliminary Outcomes of Hypochlorous Acid as an Adjunct for Pocket Irrigation in Revision Aesthetic Breast Surgery

2020 ◽  
Author(s):  
Samir Hasan ◽  
Mirza Mujadzic ◽  
Sumesh Kaswan ◽  
Joshua Halpern ◽  
Bruce Van Natta ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Breast Augmentation ◽  
Hypochlorous Acid ◽  
Breast Surgery ◽  
Capsular Contracture ◽  
Retrospective Chart Review ◽  
Allergic Reactions ◽  
Level Of Evidence ◽  
Aesthetic Breast ◽  
Grade Iii

Abstract Background Capsular contracture is a challenging problem for plastic surgeons despite advances in surgical technique. Breast pocket irrigation decreases bacterial bioburden. Studies have shown that hypochlorous acid (HOCl; PhaseOne Health, Nashville, TN) effectively penetrates and disrupts biofilms; however, there are limited clinical data regarding this irrigation in breast augmentation. Objectives The aim of this study was to investigate the effects of HOCl pocket irrigation in revision breast augmentation by evaluating rates of capsular contracture recurrence, infection, and allergic reactions. Methods We performed an institutional review board–approved retrospective chart review of revision breast augmentation cases for Baker grade III/IV capsular contractures in which pockets were irrigated with HOCl. Data were obtained from 3 board-certified plastic surgeons. Results The study included 135 breasts in 71 patients, who ranged in age from 27 to 77 years (mean, 53.7 years). Follow-up ranged from 12 to 41 months (mean, 20.2 months). Postoperatively, there were 2 unilateral Baker grade III/IV recurrences at 13 months and 1 bilateral Baker grade II recurrence at 3 months. There were no infections or allergic reactions. The overall Baker grade III/IV capsular contracture recurrence rate was 0% at 12 months and 1.5% at 15 months. Conclusions Breast pocket irrigation decreases bioburden, which may influence capsular contracture recurrence. We evaluated 3 varied applications of HOCl in revision aesthetic breast surgery and found a low capsular contracture recurrence rate and no adverse reactions. We plan to report our findings with HOCl in primary breast augmentation in the future, and other studies are being conducted on the efficacy of HOCl in aesthetic surgery. Level of Evidence: 4

Popcorn Capsulorrhaphy in Revision Aesthetic Breast Surgery

2018 ◽  
Vol 40 (1) ◽  
pp. 63-74 ◽  
Author(s):  
M Bradley Calobrace ◽  
Chet Mays ◽  
Ryan Wilson ◽  
Ryan Wermeling
Keyword(s):  
Breast Surgery ◽  
Retrospective Chart Review ◽  
Size Change ◽  
Level Of Evidence ◽  
Breast Ptosis ◽  
Operative Revision ◽  
Average Patient ◽  
Implant Size ◽  
Average Size ◽  
Aesthetic Breast

Abstract Background Control of the pocket in revisional breast surgery can be technically challenging and unpredictable. A capsulorrhaphy technique has been utilized in altering capsules in secondary aesthetic breast surgery. Objectives The authors sought to determine the effectiveness of popcorn capsulorrhaphy in revisional breast surgery. Methods A retrospective chart review of revisional breast cases utilizing popcorn capsulorrhaphy was conducted between September 2015 and August 2017. Only aesthetic breast cases were included. Data were collected for 149 patients. Results One hundred forty-nine patients representing 266 breasts were operated on. The average patient age was 42 years and the mean body mass index was 24.2 kg/m2. The average time from their original surgery to the popcorn capsulorrhaphy secondary procedure was 9.3 years. Indications for capsulorrhaphy included malposition in 163 breasts (61.3%), implant positioning for breast ptosis in 34 breasts (12.8%), pocket adjustment for implant size change in 49 breasts (18.4%), and postexplantation pocket reduction in 20 breasts (7.5%). Of the 266 implants, 145 (54.5%) were smooth, 101 (38%) textured, and 20 (7.5%) were explanted. The average original implant size was 405 cc and the average size placed at the time of capsulorrhaphy was 422 cc. Two hundred thirty-six (88.7%) were in a submuscular pocket and 30 (11.3%) were subglandular. The total number of complications was 39 (14.7%), and 16 (6%) required some type of operative revision. Conclusions Popcorn capsulorrhaphy can provide pocket control and stability with low complication and revision rates. The addition of a mesh or biologic at the time of popcorn capsulorrhaphy can further lower the complication and revision rates. Level of Evidence: 4

Capsulectomy, Implant Exchange, and Placement of Acellular Dermal Matrix Is Effective in Treating Capsular Contracture in Breast Augmentation Patients

2019 ◽  
Author(s):  
Douglas S Wagner ◽  
Shayda J Mirhaidari
Keyword(s):  
Recurrence Rate ◽  
Complication Rate ◽  
Breast Augmentation ◽  
Capsular Contracture ◽  
Acellular Dermal Matrix ◽  
Implant Removal ◽  
Common Complication ◽  
Level Of Evidence ◽  
Dermal Matrix ◽  
Acellular Dermal

Abstract Background Capsular contracture is a common complication of breast augmentation surgery and many techniques to prevent and treat it have been suggested with inconsistent or variably effective results. Objectives The aim of this paper was to describe a protocol for treating established capsular contracture after breast augmentation with a low recurrence rate. Methods From January 2009 to December 2012, 79 previous bilateral breast augmentation patients presented for treatment of established capsular contracture. There were 135 breasts with capsular contracture: 56 were bilateral and 23 were unilateral. Ten patients opted for no treatment; 2 patients opted for implant removal. Twenty-four were treated with the ICES (implant exchange, capsulectomy, and possible exchange of site) protocol and 43 were treated with the SPICES (Strattice placement in the reconstructive position, implant exchange, capsulectomy, and possible exchange of site) protocol. Results The 24 patients treated with the ICES protocol had a recurrent capsular contracture rate of 15%. The 43 patients treated with the SPICES protocol had a 2.7% recurrent capsular contracture incidence and an 2.7% complication rate. Conclusions Capsular contracture after breast augmentation, whether primary or recurrent, can be successfully treated with the SPICES protocol. Level of Evidence: 4

scholarly journals Superficial thrombophlebitis (Mondor′s Disease) after breast augmentation surgery

2008 ◽  
Vol 41 (02) ◽  
pp. 219-221
Author(s):  
P. Viana Giovanni Andre ◽  
M. Okano Fabrlcio
Keyword(s):  
Chest Wall ◽  
Breast Augmentation ◽  
Breast Surgery ◽  
Clinical Aspects ◽  
Surgical Trauma ◽  
Superficial Thrombophlebitis ◽  
Therapeutic Measures ◽  
Aesthetic Breast

ABSTRACTAlthough the aetiology of Mondor′s disease remains unclear, the most commonly cited cause is trauma of some sort. Although surgical trauma has frequently been quoted, reports that specifically implicate aesthetic breast surgery are unusual in the literature. In this article, the authors report a case of superficial thrombophlebitis of the anterolateral chest wall secondary to breast augmentation surgery in a woman, five months after the procedure. The authors performed an analysis of the disease′s main etiologic components and preponderant clinical aspects, and determined all appropriate therapeutic measures.

scholarly journals Back to Basics: Could the Preoperative Skin Antiseptic Agent Help Prevent Biofilm-Related Capsular Contracture?

2018 ◽  
Vol 39 (8) ◽  
pp. 848-859 ◽  
Author(s):  
Jenny Carvajal ◽  
Melissa Carvajal ◽  
Gilma Hernández
Keyword(s):  
Breast Augmentation ◽  
Capsular Contracture ◽  
Bacterial Biofilm ◽  
Skin Microbiome ◽  
Level Of Evidence ◽  
Clinical Safety ◽  
Skin Preparation ◽  
Significant Difference ◽  
Chi Squared ◽  
Healthcare Epidemiology

AbstractBackgroundCapsular contracture (CC) has remained an unresolved issue throughout history. Strong evidence focuses on bacterial biofilm as its main source. A literature review revealed that more than 90% of bacteria found in capsules and implants removed from patients with Baker grade III-IV CC belong to the resident skin microbiome (Staphylococcus epidermidis, predominant microorganism). The use of an adequate preoperative skin antiseptic may be a critical step to minimize implant contamination and help prevent biofilm-related CC.ObjectivesThe authors sought to compare the effect of 2 different antiseptic skin preparations: povidone-iodine (PVP-I) vs chlorhexidine gluconate (CHG) on CC proportions after primary breast augmentation through a periareolar approach.MethodsIn June of 2014, The Society for Healthcare Epidemiology of America proposed to use CHG for preoperative skin preparation in the absence of alcohol-containing antiseptic agents as strategy to prevent surgical site infection. The clinical safety committee of a surgical center in Colombia decided to change PVP-I to CHG for surgical site preparation thereafter. The medical records of 63 patients who underwent to primary breast augmentation through a periareolar approach during 2014 were reviewed. In the first 6 months PVP-I was used in 32 patients, and later CHG was employed in 31 patients.ResultsPearson’s chi-squared test to compare CC proportions between subgroups showed a statistically significant difference. The CC proportion was higher for patients who had antisepsis with PVP-I. CC was absent when CHG was employed.ConclusionsCHG as preoperative skin antiseptic for primary breast augmentation surgery was more effective than PVP-I to help prevent biofilm-related CC.Level of Evidence: 3

Aesthetic Breast Surgery: What Do the Measurements Reveal?

2019 ◽  
Vol 40 (7) ◽  
pp. 742-752
Author(s):  
Elisa Bolletta ◽  
Ciara Mcgoldrick ◽  
Elizabeth Hall-Findlay
Keyword(s):  
Breast Reduction ◽  
Breast Surgery ◽  
Suprasternal Notch ◽  
Level Of Evidence ◽  
Aesthetic Results ◽  
Measuring Tape ◽  
Nipple Position ◽  
The Right ◽  
Aesthetic Breast

Abstract Background Do plastic surgeons really know what happens to the breast after surgery? We often think that we do, but we have very few measurements to show whether we are on the right track. Objectives Only when the surgeon can predict the changes can she or he achieve consistent outcomes. Measurements lead to understanding; understanding what the measurements show allows us to refine our approach. Methods Consecutive patients in 4 categories were analyzed: breast reduction, mastopexy, augmentation, and mastopexy-augmentation. All procedures were performed by a single surgeon and all measurements were performed by the same surgeon. A standard measuring tape was utilized, and data were collected immediately preoperatively and at each follow-up visit. Only those patients with preoperative and complete 1-year postoperative measurements were included in this review. The parameters measured were clavicle to upper breast border (UBB), UBB to nipple, suprasternal notch (SSN) to nipple, SSN to inframammary fold (IMF), and chest midline to nipple. Results The changes were consistent. The borders of the breast footprint were expanded with the addition of an implant (UBB and IMF) and reduced with the removal of parenchyma (IMF). The existing SSN to nipple position was stretched when volume was added to the breast mound and it remained unchanged from the preoperatively marked position in a breast reduction. Conclusions Although measurements are not necessary to achieve good aesthetic results in breast surgery, surgeons should understand what the measurements show and what happens to the different breast parameters. Level of Evidence: 3

Autologous Costal Cartilage Harvest for Rhinoplasty with Simultaneous Breast Surgery: A Safe and Efficient Technique

2020 ◽  
Vol 40 (9) ◽  
pp. NP480-NP490 ◽  
Author(s):  
Jay W Calvert ◽  
Millicent O Rovelo ◽  
Marc V Orlando ◽  
Edwin Kwon
Keyword(s):  
Breast Surgery ◽  
Capsular Contracture ◽  
Costal Cartilage ◽  
Donor Site ◽  
Level Of Evidence ◽  
Perioperative Morbidity ◽  
Patient Demographics ◽  
Included Patient ◽  
Additional Surgery ◽  
A New Technique

Abstract Background Autologous costal cartilage is frequently required for revision rhinoplasties and for challenging primary rhinoplasties. Patients undergoing a concomitant breast surgery can have costal cartilage harvested through their breast surgery incisions, thereby obviating an additional rib harvest scar. The safety and efficacy of this approach has yet to be described. Objectives The aim of this study was to evaluate the outcomes, safety, and results of a new technique, described here, for harvesting costal cartilage during a concomitant breast operation. Specifically, the rates of capsular contracture and rhinoplasty revisions were of great interest. Methods A retrospective review was performed evaluating the senior author’s experience with this technique. Data collected included patient demographics, operations performed, operative time, perioperative morbidity, and postoperative complications. Rates of capsular contracture and rhinoplasty revisions were compared with national averages. Results A total of 31 female patients were included. Ten (32.3%) breast complications occurred. There were 6 (19.4%) rhinoplasty complications, comprising 1 infection and 5 revisions. The capsular contracture rate was 6% and the rhinoplasty revision rate was 16%. Both of these rates are comparable to independent breast surgeries and rhinoplasties. There were no cases of perioperative mortality or major morbidity. Conclusions Combining breast surgery and rhinoplasty surgery allows for autologous rib harvest through the breast surgery incisions. This is a safe technique that results in outcomes similar to either procedure performed alone. In addition, the patient is spared an additional surgery and donor site scar. Level of Evidence: 4

scholarly journals Association between the Desire for Breast Augmentation and Instagram Engagement: A Cross-Sectional Survey among Young Polish Women

2021 ◽  
Vol 18 (19) ◽  
pp. 10317
Author(s):  
Tomasz Skrzypczak ◽  
Klaudia Błachnio ◽  
Tomasz Górnicki ◽  
Justyna Kmieć ◽  
Agnieszka Ciąder ◽  
...  
Keyword(s):  
Breast Augmentation ◽  
Online Survey ◽  
Breast Surgery ◽  
Negative Feeling ◽  
Inclusion Criteria ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Level Of Activity ◽  
The Impact ◽  
Aesthetic Breast

The impact of social media on the eagerness to undergo aesthetic breast surgery is unknown. We aimed to evaluate the association between Instagram engagement and the willingness to undergo breast augmentation. Women aged between 19–34 years old participated in an online survey. Of the 1560 respondents, 1226 (78.59%) met the inclusion criteria. BMI, bra type, bra cup size, education, and level of activity on Instagram increased the willingness to undergo breast augmentation (OR = 1.520, p = 0.020). Moreover, concurrent Snapchat use (OR = 1.348, p = 0.024) and the number of published posts on a respondent’s Instagram accounts (reference, n > 26; 0 < n ≤ 26; OR = 0.708, p = 0.009; lack of posts (n = 0): OR = 0.702, p = 0.155) were significant drivers of the respondents’ willingness. Fashion (OR = 0.730, p = 0.021), design/architecture (OR = 0.730, p = 0.022), and models (OR = 0.623, p = 0.004) were the searched content categories that increased the desire for breast augmentation. Positive and negative feeling scores that were triggered by Instagram content were correlated with BREAST-Q scores. We concluded that Instagram is a commonly used social network service among young women, and it may drive a desire for breast augmentation. Further analyses of Instagram preferences may help assess the willingness to undergo breast surgery, and in turn assist in tailoring marketing campaigns.

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