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IMCAS World Congress 2023
Program

FOCUS ON OS S001

Open stage - Scientific lectures - Breast surgery

Room: Open stage - Exhibition hall Level 3
Date: Thursday 26 January 2023 at 10:00 to 11:00
Format: OPEN STAGE TALK > oral presentations taking place on a dedicated stage within the exhibition area and which are video-recorded by our professional AV team

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
10:00	Dr Andra Elena MARTIN	Composite mastopexy combining lipofilling and gland remodeling in postpartum patients	View	120310
10:12	Dr Alessandro INNOCENTI	Tuberous breast - A wide spectrum of features of the same disorder: experience-based classification and reconstructive algorithm	View	120309
10:24	Dr Hanna LUZE	Autologous vs alloplastic breast reconstruction – Differences in complication rates and long-term satisfaction	View	122436
10:36	Dr Rajesh VASU	In search of excellence in major breast reductions - A 23 year experience	View	120308

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Breast reduction

Breast lift (mastopexy)

Breast cancer & reconstruction

Dr Andra Elena MARTIN

Plastic Surgeon

Romania

Other author(s) :

Composite mastopexy combining lipofilling and gland remodeling in postpartum patients

Objectives: The aim of mastopexy is to remodel the breast but in most of the cases breast volume should be also reduced. Combing mastopexy with superior pedicle for nipple vascularization and inferior pedicle for autoaugmentation also with lipofilling offer to patients stable results without the use of an implant. We describe our experience with breast reshaping with composite mammaplasty wiht differrent skin resection patterns(J mammaplasty, wise pattern or circumvertical), only skin excision and autologous fat grafting.

Materials / method: We describe the surgical technique for composite mammaplasty. Photographic documentation was done for every patients. Preoperative bleeding protocol included 1g of tranexamic acid. Postoperative all patients were discharged with kynesiotape to promote wound heeling without tension. Autologus fat grafting was performed under ultrasound control. Postoperative all patients had follow ups at 1,3, respectively 6 months after the surgery with one year ultrasound evaluation.

Results: Fifty patients were included with one year follow up. Mean age of 38 years. All patients had follow up one year after surgery with ultrasound to evaluate fat grafting and gland position after autoaugmentation. Mean skin resection per breast was 15g. Mean autologous fat grafting was 95cc per breast. Superior and medial pedicle was performed in every case. Two cases required free nipple graft. Mean liposuction of the bra roll with radiofrequency assisted liposuction volume was 200cc(100-400cc) with 30 KiloJoules. Two patients had minimal superficial areola necrosis treated conservatively. One p

Conclusion: Combining glandular reshaping , lipofilling and radiofrequency assisted liposuction stable results for postpartum patients may be obtained with high grade of satisfaction among patients and minimal complications.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Alessandro INNOCENTI

Plastic Surgeon

Italy

Other author(s) :

Tuberous breast - A wide spectrum of features of the same disorder: experience-based classification and reconstructive algorithm

Objectives: Tuberous breast (TB) can appear with a wide range of clinical findings poses a challenge to consistency in nomenclature and surgical correction. Due to this polymorphism epidemiological data show a wide discrepancy in the literature. Minor forms are easily confused with normal anatomical breasts. The aim of this article is to focus the peculiar pathologic hallmarks of each type of deformity and to propose a one-step reconstructive algorithm tailored on the distinctive breasts characteristics, through the concept of volume displacement according with the different types of TBs deformity

Introduction: TB deformity is a congenital malformation appearing during puberty, with a wide spectrum of anatomical presentations. The deformity is widely variable among the affected patients, showing very different clinical appearances but despite this, wider intermammary space, breast base constriction, cranialization of the inframammary fold and areola’s disorders are always present as common hallmarks. Due to the multitude of variants in which TB could appear, a reconstructive algorithm could help to assess all features that affects the breast to plann the most appropriate surgical strategy.

Materials / method: From September 2006 to December 2019, 118 patients have been treated for TB deformity in one-step procedure using tailored local flaps according to the preoperatively assessed clinical variant. Minimum follow-up was 12 months. All the procedures were performed under local anesthesia.

Results: A total of 220 TBs (98 hypoplastic and 122 normoplastic) were treated. Patients' mean age was 20.2 years.
Mean follow-up was 36.5 months. Six minor complications (capsular contracture and nipple-areolar-complex
hypoesthesia) and no major complications have been reported. In 9% of cases, minor secondary procedures,
including lipofilling, scar revisions and breast implant substitution, have been performed.

Conclusion: TB correction requires careful identification due to the complexity of its pathological hallmarks, after which
a preoperative planning and a surgical strategy can be assessed. The proposed algorithm, including a
comprehensive classification, preoperative planning and surgical approach derived from authors’ experience,
could help in tailoring the most appropriate surgical approach for each type of tuberous breast deformity.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Hanna LUZE

Plastic Surgeon

Austria

Other author(s) : Sebastian P. Nischwitz, Lars-Peter Kamolz, Thomas Rappl

Autologous vs alloplastic breast reconstruction – Differences in complication rates and long-term satisfaction

Objectives: High oncological safety as well as patient satisfaction regarding the aesthetic-functional result is of utmost importance in modern breast cancer management. For breast reconstruction after mastectomy, alloplastic alternatives with silicone implants are available in addition to various autologous reconstruction options such as free flaps or autologous fat grafting. The present study aimed to generate valuable data to aid in preoperative decision-making and generate the best result for each patient individually.

Introduction: Previous studies have focused on the possible complications of the techniques in detail, but there have been no conclusive comparative studies to date. In addition, existing data from isolated studies on the quality of life, satisfaction, psychosocial and physical well-being of patients who underwent breast reconstruction after breast cancer is inconclusive and not comparable.

Materials / method: In the course of a multicenter retrospective data analysis, complication types and rates as well as several other patient- and surgery related factors were evaluated in free tissue transfer (deep inferior epigastric artery perforator flap, transverse rectus abdominis myocutaneous flap, or latissimus flap), and the use of implants or tissue expanders for breast reconstruction after carcinoma therapy. Standardized Breast-Q questionnaires were used to analyze quality of life, satisfaction, psychosocial and physical well-being in different techniques.

Results: Within the study collective, significant differences regarding the complication types and rates as well as potential risk factors were found and will be discussed together with the results of the current literature. Despite higher complication rates and number of revision surgeries, the long-term satisfaction was shown to be significantly higher in patients who underwent autologous breast reconstruction.

Conclusion: Significant differences in complication types and rates as well as long-term satisfaction were shown in different reconstruction techniques. Findings of these study may aid in preoperative decision-making along with patient-related factors, in order to generate the best result for each patient individually.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Rajesh VASU

Plastic Surgeon

India

Other author(s) : Dr.B.R.N.PADMINI, Dr.ANKITA HARIJEE, Dr.DHARANIPRIYA A

In search of excellence in major breast reductions - A 23 year experience

Objectives: Complication rates in breast reduction surgery can go as high as 40 percent.
Vast surgical experience along with sound surgical principles and technology helped in reducing the complication rates and maintaining stable long term results.

Introduction: Amongst all aesthetic surgical procedures, reduction mammaplasty or breast reduction has the steepest learning curve in terms of understanding and mastering the procedure .the fact that our literature shows a myriad of procedures of breast reduction is a testimony to the fact that no single procedure till date is the best for performing a breast reduction in a given breast. The plastic surgeon not just removes the excess breast tissue to restructure and reshape the breast ,but must understand the dynamics of restoring the structure of the breast by understanding the blood supply to the nipple

Materials / method: A total of 142 female patients requiring breast reduction in excess of 1000gms per side were included in the study.
Patients undergoing minor breast reduction weren't considered for the study. Hall Findlay technique and its modifications was performed in all the 142 patients.

Results: Catastrophic vascular complications in the form of nipple areola necrosis was averted in all patients despite a very long SN- N distance in excess of 40 cms. In such cases, a preliminary delay procedure was performed followed by the definitive procedure a week later.
The early experience of the authors showed a high incidence of wound healing problems like wound dehiscence, delayed wound healing and seromas. These complications were reduced significantly in the author experience by the use of incisional negative pressure wound therapy.

Conclusion: Bottoming out - which is one of the late post operative problems in breast reduction was averted by the use of derma fascial flap, thereby maintaining a stable areola-IMF distance in the long term, preventing the star gaze or a pseudo ptotic appearance of the breast.
Complication rates in breast reduction surgery can go as high as 40 percent. Vast surgical experience along with sound surgical principles and technology helped in reducing the complication rates and maintaining stable long term results.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

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IMCAS World Congress 2023 Program

FOCUS ON OS S001

Open stage - Scientific lectures - Breast surgery

Lectures of the session

Recommended sessions

IMCAS World Congress 2023
Program