Objectives: Transumbilical breast augmentation by silicone implant is unique technique for less scar.

Introduction: Transumbilical breast augmentation (TUBA)
with saline implants has been considered a safe and efficient
technique for decades. However, because silicone
implants are more popular than saline ones, TUBA with
saline implants is not widely performed. In 2014, we
published a report on transumbilical breast augmentation
using silicone cohesive gel implants. As we have performed
transumbilical silicone breast augmentation
(TUSBA) for 15 years with slight modifications, this study
aimed to describe this novel technique and present
accompanying patient outcomes over 7 years.

Materials / method: We enrolled patients desiring breast augmentation
at a single center. The preoperative design was initially
determined with the patients in standing positions before
they underwent surgery under general anesthesia in a
supine position

Results: Between January 2018 and December 2022, 69
women and one man underwent TUSBA at a single center.
All patients underwent cohesive gel silicone implantation
in the subpectoral pocket. The implant size varied from 225
to 300 mL (average 272 mL) because two patients underwent
surgery with implants of different sizes due to breast
asymmetry. All patients were satisfied with the surgery
outcome except one who was dissatisfied because of
abdominal bulging.

Conclusion: TUSBA offers advantages such as minimal
scarring and unrestricted arm movement; thus, it can be an
alternative option for patients seeking breast augmentation.

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Objectives: To decide what plane is best for breast augmentation surgery

Objectives: This study investigates the potential of TNF-a-treated human ADSCs on silicone implants to alleviate RICC, hypothesizing to enhance suppressive effects on radiation-induced capsular contracture(RICC) by modulating inflammatory responses in a radiation-exposed environment.

Introduction: Post-mastectomy radiotherapy plays a crucial role in breast cancer treatment but can lead to an inflammatory response causing soft tissue damage, particularly radiation-induced capsular contracture (RICC), impacting breast reconstruction outcomes. Adipose-derived stem cells (ADSCs), known for their regenerative potential via paracrine capacity, exhibit inherent radiotolerance. The influence of tumor necrosis factor-alpha (TNF-a) on ADSCs has been reported to enhance the paracrine effect of ADSCs, promoting wound healing by modulating inflammatory responses.

Materials / method: In vitro, T-hASCs were cultured on various surfaces to assess viability after exposure to radiation up to 20 Gy. In vivo, T-hASC and non-TNF-a-treated hASC (C-hASCs)-coated membranes werevimplanted in mice before radiation exposure, and an evaluation of the RICC mitigation took place 4 and 8 weeks after implantation. In addition, the growth factors released from T-hASCs were assessed.

Results: In vitro, hASCs displayed significant radiotolerance, maintaining consistent viability after exposure to 10 Gy. TNF-a treatment further enhanced radiation tolerance, as evidenced by significantly higher viability than C-hASCs at 20 Gy. In vivo, T-hASC-coated implants effectively suppressed RICC, reducing capsule thickness. T-hASCs exhibited remarkable modulation of the inflammatory response, suppressing M1 macrophage polarization while enhancing M2 polarization. The elevated secretion of vascular endothelial growth factor from T-hASCs is believed to induce macrophage polarization.

Conclusion: This study establishes T-hASCs as a promising strategy for ameliorating the adverse effects experienced by breast reconstruction patients after mastectomy and radiation therapy. The observed radiotolerance, anti-fibrotic effects, and immune modulation suggest the possibility of enhancing patient outcomes and quality of life. Further research and clinical trials are warranted for broader clinical uses.