Navegando por Palavras-chave "Breast Implant"

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    Autoeficácia para a amamentação em mulheres com mamoplastia de aumento e redutora
    (Universidade Federal de São Paulo (UNIFESP), 2019-08-29) Eugenio, Daniella Soares [UNIFESP]; Abrao, Ana Cristina Freitas De Vilhena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Women with breast augmentation and reduction mammoplasty have a lower prevalence of exclusive breastfeeding when compared to those without surgery. Considering self-efficacy for breastfeeding one of the modifiable factors in the prevention of early weaning, it is opportune to know the behavior of this variable in this population. Objectives: To analyze the self-efficacy for breastfeeding in relation to the group of women without breast surgery and with mammoplasty. Method: A cross-sectional study was carried out in a private maternity hospital in the city of São Paulo, with 252 women, 100 of the non-surgical group, 83 of the augmentation mammoplasty group and 69 of the reduction mammoplasty group. Data collection was performed between the 5th and 7th day after delivery through the Breastfeeding Self-Efficacy Scale Short Form Brazilian Version. Results: It was verified that the average of self-efficacy scores for breastfeeding was equal between the group of women without breast surgery and that of women with augmentation mammoplasty and greater in relation to the group of women with reduction mammoplasty and this difference was statistically significant ( p = 0.010). Regarding the mean score of the self-efficacy technique for breastfeeding, this was the same among the group of women without surgery and augmentation mammoplasty and was higher in relation to the group of women with reduction mammoplasty and this difference was statistically significant (p < 0.001). The relationship between self-efficacy and the type of breastfeeding, the volume of breast milk extracted and the associated factors are independent of mammoplasty. In this perspective, it was observed that the relationship between self-efficacy and the practice of AME was statistically significant and that for every 1 point increased in the BSES-SFVB global score there was a 16% increase in the chance of AME. It was also identified that women with reduction mammoplasty are 90% less likely to breastfeed exclusively when compared to women without surgery. The relationship between self-efficacy and volume of breast milk extracted was statistically significant and for each 1 point increased in the BSES-SFVB total score there was an increase of 1.36 ml in the volume of milk extracted. It was also found that women with reductive mammoplasty presented 37.2 ml less than the volume of milked milk when compared to those without surgery. Regarding the associated factors, it was identified that vaginal delivery and the perception of adequate milk production favor higher self-efficacy scores for breastfeeding. Conclusion: Self-efficacy for breastfeeding is affected by reductive mammoplasty.
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    A Mamoplastia De Aumento E A Prática Do Aleitamento Materno
    (Universidade Federal de São Paulo (UNIFESP), 2017-09-28) Marcacine, Karla Oliveira [UNIFESP]; Abrao, Ana Cristina Freitas De Vilhena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Recent research shows that the number of aesthetic plastic surgeries is increasing in Brazil and worldwide and that women undergoing breast augmentation surgery tend to breastfeed for less time, compared to those without surgery. Purpose: To assess the repercussions of breast augmentation during breastfeeding in the first 30 days following delivery. Method: It consisted of a prospective cohort analysis performed at a private hospital in the city of São Paulo, SP in the period 2015-2017, with 240 women, 125 of whom had no surgery, with 115 who had undergone breast augmentation, through three evaluations – the first held between 12 and 72 hours, the second between the 5th and the 7th days, and the third between the 30th and the 32nd days after delivery. Results: The groups were homogeneous. In most women, the surgery had been performed up to 10 years prior, with inframammary incision and pre-pectoral implant placement. The mean prosthesis size was 267 ml. Almost all of the women were told that the surgery would not interfere with breastfeeding and more than half reported concern about breastfeeding. In the first evaluation, the group with breast augmentation presented lower rates of exclusive breastfeeding (EBF) (p=0,016). Regarding aspects related to the surgical characteristics (time elapsed from the surgery, access route, implantation site, and volume implanted), there were no significant differences in the rates of EBF over time, yet there was a significant decrease in percentage, in all groups evaluated. There was no statistical difference between the groups regarding early contact, maternal and child positioning, prehension, and suction. Over time, women who had undergone breast augmentation were less likely to show improvement in their positioning (p=0,0483) and there was a significant worsening of adequate prehension in both groups (p<0,0001). Milk abundance appeared earlier in the breast augmentation group (p=0,038), and there was no significant difference in the incidence of breast engorgement and milk production. Considering the surgical characteristics, appearance of milk, incidence of breast engorgement and milk production were not shown to be associated. The use of Oxytocin Spray was more frequent among women with breast augmentation in the first evaluation (p=0,041), and in both groups, there was a significant decrease in their use during the medical visits (p<0,0001). Over time, the use of galactagogues was more frequent in the breast augmentation group (p=0,049), and in both, there was a significant increase in its use (p<0,0001). According to the surgical characteristics, Oxytocin Spray was more frequently used by women with larger prostheses (p=0,040), while galactagogues was mostly used by those with retro pectoralis implants (p=0,029), both in the second evaluation. During the medical visits, there was a significant decrease in its use in all groups. Over time, galactagogues were more frequently used by women with an inframammary incision (p=0,0127), and there was a significant increase in their use by all groups. Artificial breasts were used mostly among women with breast augmentation at the third visit (p=0,038), as well as during the visits (p=0,0135); over time, in both groups, there was a significant increase of this practice (p<0,0001). There was no statistical difference between the groups regarding pain, pain score, or nipple lesion, and a significant decrease of these three variables was observed over time in both groups (p<0,0001). Considering the surgical aspects, the majority of the women who reported pain had a higher score and nipple lesion rates in the third evaluation, having performed the breast surgery more than 10 years ago (p=0,025, p=0,039, and p=0,021). A higher pain score in the left breast was identified among those with pre-pectoral implants at the second visit (p=0,046). Over time, all groups analyzed for time elapsed from the surgery, access route and volume implanted presented a significant decrease in pain rates and average pain score. On the other hand, the occurrence of nipple lesions showed the same decrease between the groups, followed by access route, implantation site, and size of the implanted prosthesis. Over time, there was a statistically different variation of the nipple lesion rate between the groups, according to the time elapsed from the surgery (p=0,020). Conclusion: Breast augmentation surgery and some of the characteristics interfered with breastfeeding within the first 30 days after delivery.
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    Manual Para Diagnostico, Conduta E Notificação Do Linfoma Anaplasico De Grandes Células Associado Ao Implante Mamário De Silicone Texturizado
    (Universidade Federal de São Paulo (UNIFESP), 2018-10-25) Abelha, Ricardo [UNIFESP]; Garcia, Elvio Bueno [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The increasing number of women with BIA-ALCL is surprising plastic surgeons around the World. Anaplastic Lymphoma of Large Cells Associated to Breast Implants (BIA-ALCL) was recently included in the category of lymphoid neoplasms by the World Health Organization, calling attention to the matter. Brazil ranks second in breast implant surgeries, but less than ten cases of BIA-ALCL were reported in recent years, in contrast to the United States, which confirmed 230 cases only in 2018. Objective: To develop a manual to systematize the conducts referring to the first contact of the plastic surgeon with the suspected cases of Anaplastic Large Cell Lymphoma Associated with the Silicone Breast Implant, unifying the practice of the professionals in the accomplishment of the correct diagnosis and stages following the identification of the disease. Methods: Manual developing studies. It was approved by the CEP of the UNIFESP CAAE: 92274218.4.0000.5505. An anteriority search was carried out and there were an explanatory video on the subject for health professionals and patients, an online and printed informative pamphlet for patients, a pamphlet containing the main questions and answers about the subject, but no materials or documents were found that addressed the subject of this study in the form of a manual. For the development of the content the bibliographic databases and search sites Cochrane, Scielo, LILACS, and Pubmed were consulted, articles were selected in Portuguese and English from 2008 to 2018, with the exception of the first case report of this lymphoma published in 1997. The descriptors in question were: Large Cell Anaplastic Lymphoma, Breast, Breast Implant and Lymphoma. Then the text, illustrations and diagram were elaborated. After its elaboration, the manual was evaluated by specialists by the CVI (Content Validation Index). Results: The completed manual has eighteen pages and nine chapters with the following topics: Introduction, Diagnosis, Staging, Management, Treatment, Notification, Final Considerations, Flowchart and Bibliography. Conclusion: A manual was developed and validated for the diagnosis, management and reporting of Anaplastic Large Cell Lymphoma Associated with Texturized Silicone Breast Implants.