Navegando por Palavras-chave "Mammaplasty"

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    Anthropometry of the Breast Region: How to Measure?
    (Springer, 2014-04-01) Espírito Santo, Paulo Rogério Quieregatto do [UNIFESP]; Hochman, Bernardo [UNIFESP]; Ferrara, Soraia F. [UNIFESP]; Furtado, Fabianne [UNIFESP]; Liebano, Richard E. [UNIFESP]; Sabino Neto, Miguel [UNIFESP]; Ferreira, Lydia M. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Breast region measurements are important for research, but they may also become significant in the legal field as a quantitative tool for preoperative and postoperative evaluation. Direct anthropometric measurements can be taken in clinical practice. the aim of this study was to compare direct breast anthropometric measurements taken with a tape measure and a compass.Forty women, aged 18-60 years, were evaluated. They had 14 anatomical landmarks marked on the breast region and arms. the union of these points formed eight linear segments and one angle for each side of the body. the volunteers were evaluated by direct anthropometry in a standardized way, using a tape measure and a compass.Differences were found between the tape measure and the compass measurements for all segments analyzed (p > 0.05).Measurements obtained by tape measure and compass are not identical. Therefore, once the measurement tool is chosen, it should be used for the pre- and postoperative measurements in a standardized way.This journal requires that authors assign a level of evidence to each article. for a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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    Antibiotic prophylaxis in reduction mammaplasty: study protocol for a randomized controlled trial
    (Biomed Central Ltd, 2016) Garcia, Edgard Silva [UNIFESP]; Veiga, Daniela Francescato [UNIFESP]; Veiga-Filho, Joel; Cabral, Isaias Vieira; Larcher Pinto, Natylia Lana; Novo, Neil Ferreira [UNIFESP]; Sabino Neto, Miguel [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]
    Background: The role of antibiotics in surgical procedures where the risk of surgical site infection (SSI) is low remains uncertain. There is, to date, no evidence to justify the routine use of antibiotics in postoperative reduction mammaplasty. The aim of this study is to evaluate the effect of postoperative antibiotic treatment on the occurrence of SSI after breast reduction surgery. Methods: This is a double-blind randomized clinical trial with 124 breast hypertrophy patients allocated to two treatment groups: antibiotic (n = 62) and placebo (n = 62). All patients will undergo reduction mammoplasty, performed by the same surgical team. The surgeons will raise the nipple-areola complex by the superomedial pedicle technique. The patients will receive antibiotics intravenously during anesthetic induction and every 6 hours thereafter during their 24-hour hospital stay. During discharge from the hospital, each patient will receive a numbered package containing either cephalexin or placebo capsules and will be directed to take one capsule every 6 hours for 7 days. Neither the surgery team nor the patients will know the contents of the capsules. Patients will be monitored for the occurrence of SSI once weekly during the first 30 days following hospital discharge by a single surgeon who is blinded to their treatment group. SSI will be evaluated based on the definition adopted by the Centers for Disease Control and Prevention. Discussion: Due to the variety of risk factors for SSI and limited case studies, conclusions regarding the effect of antibiotics on the occurrence of SSIs following reduction mammaplasty are potentially biased. In recent studies, perioperative antibiotic prophylaxis was effective in preventing infection and is therefore recommended in clinical practice. However, antibiotic use in the postoperative period still remains controversial.
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    Aumento mamário por meio da incisão da abdominoplastia: estudo prospectivo de 100 casos
    (Sociedade Brasileira de Cirurgia Plástica, 2013-03-01) Dini, Gal Moreira [UNIFESP]; Milani, Jean [UNIFESP]; Albuquerque, Luciana Gianini; Oliveira, Mario Farinazzo de [UNIFESP]; Santos Filho, Ivan Dunshee de Abranches Oliveira [UNIFESP]; Iurk, Lauren Klas [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Cidade de São Paulo
    INTRODUCTION: Pregnancy and obesity cause distension of the abdominal wall and produce changes in the shape and size of the breasts. Thus, the need of aesthetic improvement of the abdominal area is not uncommon, coinciding with the desire for breast augmentation. Performing mammoplasty via the abdominoplasty incision approach was first described in 1976. Because of the lack of prospective studies using this approach, we performed a series of dermolipectomy procedures using the abdominal incision to insert a pair of silicone gel breast implants. METHODS: In total, 100 consecutive patients were selected, with a mean age of 33 ± 2 years. Classic abdominoplasty was performed, and 2 tunnels were then made in the right and left hypochondria. After implant placement, the mammary fold was reconstructed using simple sutures with absorbable threads to attach the subcutaneous tissue to the aponeurosis. RESULTS: None of the following complications were observed: deep-vein thrombosis, cardiorespiratory or anesthetic complications, skin necrosis, visible bleeding, hematoma, or clinically detectable infection. The volume of the implants ranged from 280 to 450 mL (median, 350 mL). The mean operation time was 116 minutes. Reoperation was not necessary in any of the cases. The monitoring period ranged from 9 to 84 months (mean, 36 months). CONCLUSIONS: Breast augmentation via the abdominoplasty incision approach was demonstrated to be a reliable and simple technique, providing a new, scar-free alternative to mammary surgical procedures.
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    Dispositivo de simetrização de cicatriz mamária em mamoplastias
    (Universidade Federal de São Paulo (UNIFESP), 2017-06-30) Giometti, Maria Claudia Sanchez [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Sobral, Christiane Steponavicius [UNIFESP]; http://lattes.cnpq.br/7996290670653478; http://lattes.cnpq.br/1619822351741819; http://lattes.cnpq.br/9274257878506103; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Dissatisfaction with the symmetrization of scars after mammoplasty is one of the main causes of postoperative complaints. Purpose: To develop a device to symmetrize breast scars. Methods: Search of anteriority of devices described for symmetrization of mammary scars post mammoplasties and comparison with the design of the new device. Description of the main features and functions of the developed instrument. Results: The search of anteriority in the bases of the INPI, EPO, USPTO, WIPO, SIPO and JPO, Google Patents and Scholar resulted in the 11 patents described in the international patent classification. But none with the bilateral symmetrization characteristics of the breasts. In the analysis of the device under study the patents of the existing devices were compared with the following criteria: design and applicability. The composition, function, measurements and mode of use of the device have been described. Conclusion: A device to symmetrize mammary scars has been developed.
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    The Impact of Surgical Treatment on the Self-Esteem of Patients with Breast Hypertrophy, Hypomastia, or Breast Asymmetry
    (Springer, 2012-02-01) Sabino Neto, Miguel [UNIFESP]; Felipe Abla, Luiz Eduardo [UNIFESP]; Lemos, Ana Lucia [UNIFESP]; Garcia, Elvio Bueno [UNIFESP]; Reis Enout, Mariana Junqueira [UNIFESP]; Cabral, Nadia Canale [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background Currently, the concept of health includes not only the absence of disease but also a complete state of physical, psychological, and social well-being with increased emphasis on the importance of self-esteem. This study aimed to evaluate the impact of surgical treatment on the self-esteem of patients with breast asymmetry, breast hypertrophy, or hypomastia.Methods the Rosenberg Self-Esteem UNIFESP-EPM Scale was administered preoperatively and in the early and late postoperative periods to assess self-esteem. the sample comprised three groups of patients: the breast asymmetry group (n = 35), the breast hypertrophy group (n = 50), and the hypomastia group (n = 40).Results Surgical treatment had a positive and similar impact on the self-esteem of the patients in the three study groups.Conclusions Correction of breast asymmetry, breast hypertrophy, and hypomastia improved the patient's self-esteem. All three groups reported a similar increase in self-esteem (decrease in total scores) after breast reconstruction.
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    Impacto da hipertrofia mamária e da mamoplastia redutora na imagem corporal
    (Universidade Federal de São Paulo (UNIFESP), 2017-06-01) Fonseca, Cristiane Costa [UNIFESP]; Veiga, Daniela Francescato [UNIFESP]; Rocha, Maria José Azevedo de Brito [UNIFESP]; http://lattes.cnpq.br/3846281522105441; http://lattes.cnpq.br/1695706360514926; http://lattes.cnpq.br/4866360247611152; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Body image dissatisfaction is the main component that motivates the seek for plastic surgery; however, there are few studies that associate it with reduction mammaplasty. Objective: To evaluate the impact of breast hypertrophy and breast reduction on women´s body image. Methods: Women with breast hypertrophy scheduled for breast reduction from June 2013 to December 2015 were prospectively evaluated (mammaplasty group), as well as women with normal sized breasts (normal size breast group). The Body Dysmorfic Disorder Examination (BDDE), the Body Investment Scale (BIS) and the Breast Evaluation Questionnaire (BEQ55) were applied by interview at baseline and after six months. For the analysis it was applied ANOVA with repeated measures, for intergroup and intragroup comparisons between time points. Results: A total of 103 women in each group were enrolled. In the intergroup comparison, after the operation, women who underwent mammaplasty presented less negative body image symptoms (BDDE, p≤0.001) and were more satisfied with the body and breasts (BIS, p=0.157) than normal volume breasts women, besides to invest more in appearance (BEQ55, p≤0.001). Conclusion: The reduction mammaplasty improved body image of women with breast hypertrophy.
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    Keyhole pattern for preoperative marking for reduction mammaplasty
    (Pulsus Group Inc, 2010-12-01) Jardini Barbosa, Marcus Vinicius [UNIFESP]; Nahas, Fabio Xerfan [UNIFESP]; Sabia Neto, Miguel Angelo; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Reg Hosp Franca
    BACKGROUND: There are many techniques used for reduction mammaplasty; however, the most frequently performed procedures result in an inverted T scar. Preoperative marking is an important step for the success of the procedure, especially for surgeons at the initial learning stage. However, there is no consensus regarding the best method. In 1981, Strombeck designed a pattern for preoperative marking for reduction mammaplasty. This pattern provides stable parameters that promotes an acceptable symmetry marking.OBJECTIVE: To evaluate the use of the Strombeck pattern for preoperative marking for reduction mammaplasty. Methods: Fifty-seven patients who underwent reduction mammaplasty between April 2006 and April 2007 were prospectively evaluated. Patient ages ranged from 17 to 61 years; the mean body mass index was 22.2 kg/m(2). After defining the standard landmarks of the breast, preoperative markings were made using the Strombeck pattern. Breast reduction surgery was performed under local anesthesia with sedation. Postoperative results were evaluated according to a numerical visual analogue scale, at the seven-, 15- and 30-day follow-up periods. The Student's t test and the Kruskal-Wallis test were used for statistical analysis (P<0.05).RESULTS: The mean weight of resected breast tissue was 317.5 g for the right breast and 305.8 g for the left breast (P=0.17). Scores obtained using a visual analogue scale showed a progressive increase in the scores during the postoperative follow-up period (P<0.0001).CONCLUSION: The use of the Strombeck pattern enabled surgeons to perform reduction mammaplasty with good postoperative results as seen in the follow-up periods.
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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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    Nível de atividade física em mulheres mastectomizadas e submetidas a reconstrução mamária
    (Sociedade Brasileira de Cirurgia Plástica, 2012-12-01) Sabino Neto, Miguel [UNIFESP]; Moreira, João Ricardo [UNIFESP]; Resende, Vanessa; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Sociedade Brasileira de Cirurgia Plástica
    BACKGROUND: Regular physical activity has been recommended for the prevention and treatment of coronary heart disease, diabetes mellitus, and hypertension. Besides being a protective factor against breast cancer, physical activity following the diagnosis of breast cancer has been associated with an improved quality of life and survival. The aim of this study was to assess levels of physical activity in women who had undergone mastectomy without breast reconstruction and in women who had undergone breast reconstruction after breast cancer treatment. METHODS: Two groups, each with 18 patients, comprised the patient series. One group comprised women who had undergone mastectomy without breast reconstruction, and the other group comprised women who had undergone mastectomy and breast reconstruction. All patients were aged between 18 and 60 years. The exclusion criteria were physical disability; illiteracy; ongoing chemotherapy, radiation therapy, or psychiatric therapy; and surgery performed within the previous 12 months. Study participants completed the International Physical Activity Questionnaire. Statistical analysis was performed by applying the chi-square and Student's t tests, adopting a significance level of P < 0.05. RESULTS: In the group of women who had undergone mastectomy without breast reconstruction, 16.7% were very active, 61.1% were active, and 22.2% were insufficiently active. In the group of women who had undergone mastectomy with breast reconstruction, 55.6% were very active, 33.3% were active, and 11.1% were insufficiently active. The difference between the groups was statistically significant (P < 0.0001). CONCLUSIONS: In this study, the level of physical activity among women who underwent breast reconstruction was higher than that among women who underwent mastectomy without breast reconstruction.
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    Relação do tamoxifeno e tromboembolismo venoso profundo na intervenção cirúrgica de reconstrução de mama - revisão de literatura
    (Universidade Federal de São Paulo, 2022-02-10) Malagutti, Anna Carolina [UNIFESP]; Crozatti, Márcia Terezinha Lonardoni [UNIFESP]; http://lattes.cnpq.br/7164068307075233
    O câncer de mama se tornou o mais diagnosticado no mundo nas mulheres, sendo mais prevalente o que expressa receptor de hormônio. Como consequência um maior número de mulheres passou a usar o tamoxifeno como terapia adjuvante. Entretanto, alguns estudos apontam aumento de probabilidade de eventos tromboembólicos na vigência deste tratamento. A reconstrução de mama é uma cirurgia frequentemente realizada em pacientes com essa condição, e as complicações do uso de tamoxifeno nessa cirurgia podem levar a trombose, isquemia até necrose e possibilidade de perda parcial ou total do retalho. É importante estudar a relação do tamoxifeno com o tromboembolismo venoso profundo na intervenção cirúrgica de reconstrução de mama de modo a subsidiar a construção de um possível algoritmo e assim melhorar o desfecho cirúrgico. Esta relação foi estudada através de revisão da literatura. A metodologia se baseou na técnica “P.I.C.O” para formulação da estratégia de busca, utilizando a base de dados Pubmed. Foram selecionados 6 artigos, dentre os quais apenas um mostra a relação do tamoxifeno com o tromboembolismo na reconstrução de mama. Porém, os artigos apontam a necessidade de estudos mais robustos sobre o assunto, com maior amostragem, melhor capacidade de relacionar o tipo de reconstrução com o tromboembolismo e sugerem a necessidade de realizar a pausa do medicamento antes e após a cirurgia de reconstrução de mama.
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    Tempo de permanência do curativo após mamoplastia redutora: influência na colonização, na infecção da ferida operatória e na opinião das pacientes
    (Universidade Federal de São Paulo (UNIFESP), 2010-08-25) Veiga Filho, Joel [UNIFESP]; Sabino Neto, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: There is controversy in the literature regarding the treatment of surgical wounds, which includes different approaches to wound management, such as “not to dress the wound” to “leave the dressing in place for 24-48 hours” or “until sutures are removed”. Objective: To evaluate the effect of the length of time the dressings were left in place after reduction mammaplasty on skin colonization, surgical site infection, and patient opinion. Methods: Seventy patients undergoing reduction mammaplasty were randomly divided into two groups: group PO1 (dressing was removed on the first postoperative day) and group PO6 (dressing was removed on the sixth postoperative day). Skin colonization was detected by culture of samples collected at predefined time points. Surgical site infections were classified according to the guidelines of the Centers for Disease Control and Prevention (CDC). Patient satisfaction was assessed on postoperative day 13. Results: A larger number of colony-forming units were measured in group PO1 on postoperative day 6. Nine (12.9%) patients had surgical site infection (seven from group PO1, and two from group PO2). In group PO1, 66% of the patients chose to keep the dressing for one day, while 83% of the patients in group PO6 chose to keep the dressing for six days. Conclusions: Higher colonization levels were observed in group PO1 on the sixth postoperative day. There was no difference in surgical site infection between groups. Most of the patients chose to keep the dressing in place for six days postoperatively, and felt it was safer.
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    Use of the BREAST-Q (TM) Survey in the Prospective Evaluation of Reduction Mammaplasty Outcomes
    (Springer, 2018) Cabral, Isaias Vieira; Garcia, Edgard da Silva; Neponucena Sobrinho, Rebecca; Pinto, Natalia Lana Larcher; Juliano, Yara [UNIFESP]; Veiga-Filho, Joel; Ferreira, Lydia Masako [UNIFESP]; Veiga, Daniela Francescato [UNIFESP]
    BREAST-Q (TM) is a patient-reported outcomes survey instrument with a specific module that evaluates breast reduction surgery. It allows assessment of patient's satisfaction with received treatment and evaluates the impact of surgery on different aspects of the patient's quality of life. This article aims to assess the satisfaction and quality of life of patients who underwent reduction mammaplasty. Women aged between 18 and 60 years, with a body mass index ranging from 19 to 30 kg/m(2), who were already scheduled for reduction mammaplasty, were included in the study. The Brazilian version of the BREAST-Q (TM) Reduction/Mastopexy Module (preoperative 1.0 and postoperative 1.0 versions) was self-applied preoperatively and 1 and 6 months after the operation. One hundred and seven patients were included in the study and completed the 6-month follow-up. The median age was 33 years, and the median preoperative body mass index was 25 kg/m(2). The superomedial pedicle was used in 96.3% of the cases, and the total median weight of the resected breast was 1115 g. There was a significant improvement in the scores of the scales: Psychosocial well-being, Sexual well-being, Physical well-being, and Satisfaction with the breasts compared to the preoperative assessment (p < 0.0001). The scales Satisfaction with the NAC and Satisfaction with the outcome, available only in the postoperative version, demonstrated high satisfaction rates at the two postoperative periods evaluated. Reduction mammaplasty improved the quality of life and provided high levels of patient satisfaction with outcomes 1 and 6 months postoperatively. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.