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IMCAS Asia 2024
Program

FOCUS ON 113

Contributed Talks - Breast, body and genital surgery

Room: Room 5
Date: Sunday 23 June 2024 at 15:00 to 16:00
Format: CONTRIBUTED TALKS > session made up of abstract submissions that were carefully reviewed and selected by the Scientific Board

Chairs

Dr Jonas Daniel BICO

Plastic Surgeon

Philippines

Dr Hanna LUZE

Plastic Surgeon

Austria

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
15:00	Dr Jeffrey Celso Mari RAFAEL	A RARE ENCOUNTER: BREAST IMPLANT CAPSULAR CONTRACTURE IMMEDIATELY PRECEDED BY HERPES ZOSTER, A CASE REPORT	View	138335
15:12	Dr Kaito KUZUSHIMA	Asians buttocks contouring: without fat injection	View	138336
15:24	Dr Brian ANG	The Autoderm Flap Revisited: A Tried and Tested Technique in Aesthetic Breast Reconstruction	View	138337
15:36	Dr Bahareh ARBABI	V wedge De-Epithelialization technique for labial reduction: more effective, less complications	View	138338
15:48		Q&A		138670

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Breast cancer & reconstruction

Body contouring (surgical)

Buttocks (non-surgical)

Buttocks (surgical)

Threads

Dr Jeffrey Celso Mari RAFAEL

Plastic Surgeon

Philippines

Other author(s) : Lionico Federico Marquez, MD, DPBS, Karlo Marco Capellan, MD, FPAPRAS, * Alexandria Monica Tan-Gayos, MD, FPAPRAS

A RARE ENCOUNTER: BREAST IMPLANT CAPSULAR CONTRACTURE IMMEDIATELY PRECEDED BY HERPES ZOSTER, A CASE REPORT

Objectives: This paper aims to contribute to the limited publications regarding these two disease entities (herpes zoster and breast implant capsular contracture) and to make an avenue for further studies regarding any possible link between them. This paper also aims to enforce proper patient education regarding vaccination efforts and early recognition of signs and symptoms in order to achieve early intervention with antivirals and prevention of long-term complications in susceptible individuals both young and old.

Introduction: This case report in a public tertiary hospital in the Philippines documents a rare occurrence of a patient presenting with a grade IV breast implant capsular contracture, left, which is preceded by a herpes zoster infection affecting the post-operative site at the T4 dermatome on the ipsilateral side. Shortly after the patient had noted a breast implant capsular contracture on the left, this prompted her to consult at the institution for which a surgical intervention was warranted after assessing the current condition of the patient.

Materials / method: We present an 80-year-old female, with no known co-morbids, initially diagnosed with varicella during her teenager years, who was complaining of pain from both the postherpetic neuralgia and the breast implant contracture. The patient then underwent laboratory work-up and diagnostics. Cardiopulmonary clearances were requested where the patient was cleared as low-risk for the procedure.
The patient underwent breast implant explantation with partial capsulectomy, left. Specimens were sent for gram stain, culture studies and for histopathologic assessment to rule out infection and malignancy.

Results: Microbiological analysis of explanted tissues and fluids revealed no bacterial growth thereby ruling out ongoing infection. Histopathological examination confirmed benign findings with no evidence of malignancy thereby ruling out breast implant-associated anaplastic large cell lymphoma. The patient's post-operative course was uneventful with no subjective complains and was discharged on post-operative day three. At follow-up visits, patient reported complete resolution of pain associated with both capsular contracture and postherpetic neuralgia and a fully epithelialized post-operative site.

Conclusion: The patient was managed accordingly and promptly by removal of the breast implant and capsule to rule out ongoing infection and the possibility of an implant associated malignancy. Patient’s main concern of pain, caused by the implant and as a sequela of the herpes zoster, was addressed and resolved as well according to the patient. This case report stresses the attention on this rare occurrence between herpes zoster infection and breast implant capsular contracture as management requires early diagnosis and prompt treatment.

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 Kaito KUZUSHIMA

Plastic Surgeon

Japan

Other author(s) :

Asians buttocks contouring: without fat injection

Objectives: Although there are many buttock plastic surgery procedures, Asians do not like fat injection in the buttocks.
There is a need to make your buttocks look refreshed without sagging.
However, the fat around the buttocks and thighs is suctioned, the buttocks will sag.
I would like to report on a method to lift up the buttocks without injecting buttock fat.

Introduction: The overall goal of buttoplasty is to achieve a more youthful appearance and contour.
How much fat to suction and how much fat to put in, how much to lift depends on the individual's anatomy.
The presentation emphasizes the importance of individualized approaches in buttocks contouring.

Materials / method: I observed changes in the buttocks in three cases：
cases where only buttock thread lift was performed,
cases where buttock thread lift was performed for a person who had undergone buttocks liposuction in the past and the buttocks were sagging,
cases where buttock liposuction and buttock thread lift were performed at the same time.

Results: All patients who had buttocks thread lifts were able to lift their buttocks, and to create a more youthful appearance and contour.
These findings underscore the importance of considering three-dimensional aspects and individual variations in achieving aesthetic goals in buttocks contouring.

Conclusion: It is best to discuss this carefully with the patient and decide which method to use to shape the buttocks.
I reported this because I expected demand for buttocks contouring to increase without fat injection.
Among Asians, a combination treatment of buttocks liposuction and thread lift is recommended.
As the number of combination treatment is expected to increase, future issues will include considering the number of threads, the angle at which they should be inserted, and the amount of suction.

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 Brian ANG

Plastic Surgeon

Philippines

Other author(s) :

The Autoderm Flap Revisited: A Tried and Tested Technique in Aesthetic Breast Reconstruction

Objectives: To describe the autoderm flap as an important technique in implant-based immediate breast reconstruction.
To describe the benefits and advantages of this technique in the absence of allograft use in breast reconstruction.

Introduction: The incidence of breast cancer is still on the rise today, with as many as one out of eight women afflicted with this disease. Over the last several decades, there has been refinements in the surgical management of breast cancer, with the advent of breast conservation surgery and oncoplastic surgery. For those opting for mastectomy, there are also areas of improvement in breast reconstruction. One of these is the use of the autoderm flap in implant-based breast reconstruction.

Materials / method: In patients with large, ptotic breasts, the autoderm flap is an ideal technique in implant-based breast reconstruction. The inferior portion of the mastectomy flap is used for additional coverage of the implant. The skin here is de-epithelialized and the dermal flap is remained attached inferiorly along the inframammary fold. This serves as additional coverage for the implant or expander, especially if there are no available allografts or dermal substitutes to cover the inferior and lateral poles. The implant is placed subpectorally, and the autoderm flap is sutured to inferior pectoralis.

Results: The autoderm flap is an inferiorly based dermal pedicle used in immediate breast reconstruction after a mastectomy. It has been shown to be very useful and reliable, especially in the absence of allografts and dermal skin substitutes for implant coverage. In large, ptotic breasts with excess skin, this technique can be used, with good results and satisfied outcomes. A contralateral breast lift or reduction can also be offered to achieve better symmetry, and this can be performed during the time of mastectomy, or in another setting.

Conclusion: The autoderm flap technique in implant-based immediate breast reconstruction is a tried and tested technique, especially for breast cancer patients with large, ptotic breasts who opt for mastectomy. The procedure is described and revisited here in detail, and the benefits, advantages, disadvantages, and risks are discussed thoroughly.

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 Bahareh ARBABI

Gynecologist

Iran

Other author(s) : Dr Bahareh Arbabi

V wedge De-Epithelialization technique for labial reduction: more effective, less complications

Objectives: Enlarged labium minus can be annoying for functional, aesthetic or social reasons. In the past, labia reduction was performed by amputation of the protuberant segment and over sewing the edge. However, this technique removes the natural shape and color of the edge of the labium minus. The V wedge De-Epithelialization was presented in year 2000 with better aesthetic results and less side effects. This study was aimed to investigate the side effects and results of the V wedge de-epithelialization technique with unique cultural and social characteristics of our context.

Introduction: Enlarged labium minus can be annoying for functional, aesthetic or social reasons. In the past, labia reduction was performed by amputation of the protuberant segment and over sewing the edge. However, this technique removes the natural shape and color of the edge of the labium minus. The V wedge De-Epithelialization was presented in year 2000 with better aesthetic results and less side effects. This study was aimed to investigate the side effects and results of the V wedge de-epithelialization technique with unique cultural and social characteristics of our context.

Materials / method: Method: This quasi-experimental study was conducted on 40 married female candidates for labial reduction between July to March 2022. These participants were chosen by convenience sampling method. This group of females treated by V wedge de-epithelialization technique and followed up one month after the surgery. Side effects scale, female sexual function (FSFI) and genital appearance satisfaction (GAS) scales were employed for data collection in this research. Data were analyzed using SPSS v.22 software.

Results: Results: More than two third of samples were between 35 to 40 years of old and 68 % were employed. About 24 % had an academic education degree and most of participants had a diploma degree. Wound dehiscence was seen in less than 10 % samples after one month follow up. The new method showed a significant FSFI improvement scores compared with pre operation scores(p<0/05).statistical significant differences was seen in GAS scores before and after the operation and one month’s follow up too.

Conclusion: Conclusion: In terms of aesthetic aspect, the V wedge de-dpithelialization technique for labial reduction has better results in sexual function and general appearance satisfaction with fewer side effects and risk compared with older lobectomy techniques.

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 Asia 2024 Program

FOCUS ON 113

Contributed Talks - Breast, body and genital surgery

Chairs

Lectures of the session

Recommended sessions

IMCAS Asia 2024
Program