1000 - Breast Beauty - c.ymcdn.com ?· • Utilize ADMs • Fat grafting • Breast lifts • Breast…

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  • 1

    1 BetterUnderstandSomeIssuesFacedbyWomenWhoBattledBreastCancer

    2 IdentifyBreastRelatedIssuesThatMaybeSuccessfullyAddressedThroughPS

    3 AdvancesinPS,incl.FatTransfer,StemCells,SpyTech,Biologics,3Dtattoos

    4 BasicUnderstandingofFedLawthatAffordsWomenOpportunitiestoRestoreBreastBeauty

    NoDisclosures

    Learningobjectives:

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    Essentially2basiccomponentsofeverything:

    PlasticSurgery=Cosmetic+Aesthetic

    Plastic [Greek:plastikos]:toshape/fashion/moldFORM&FUNCTION

    PlasticSurgery=Reconstructive

    Ganz,PatriciaA,M.D.(2008)PsychologicalandSocialAspectsofBreastCancer,OncologyJournal

    shock disbelief

    fearanxiety

    grief

    sadness

    anger

    uncertainty

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    SelfTalk

    ManoraWoman?

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    VenusdeMilostatue

    AllStagesofBreastreconstruction Prostheses Nipplereconstruction Nippleareolatattooing

    Surgeryofotherbreasttoproducesymmetricalappearance BreastReduction BreastLift BreastAugmentation

    HealthInsurersMandatedtoCover:

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    BreastCancerPatientEducationAct(BCPEA)

    SignedbyPresidentObamainDecember2015

    ImplementedinOctober2016toinformbreastcancerpatientsabouttheavailabilityandcoverageofbreastreconstructionandprostheses.

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    DuringourLifetime,1in8womenwillbediagnosedwithbreastcancer

    Knowyouroptions Mastectomy

    NipplesparingmastectomySkinSparingmastectomy

    Lumpectomy(OncoplasticSurgery) Breastreduction Breastlift BreastTissueRearrangement

    Imagefrom:Maxwell,G.Patrick,Whitworth,P.,Gabriel,A.NippleSparingMastectomy,PlasticSurgeryKey.

    NippleSparingMastectomyIncisions

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    NippleSparingMastectomy

    NippleSparingMastectomy

    2.38%locoregionalrecurrence

    Criteria:Peripherallylocatedtumors2cmawayfromnipplemarginSmallerthan5cmindiameterHumanepidermalgrowthfactornegative(Her2neu)

    Headon,H.etal.ArchPlast Surg.2016Jul;43(4):328338.

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    SkinSparingMastectomy

    SkinSparingMastectomy

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    Lumpectomy+RadiationNORECONSTRUCTION

    POSTLUMPECTOMYDEFECTS

    OncoplasticBreastReconstruction

    postrightlumpectomywithimmediatebreastreductionreconstruction

    postneoadjuvantchemotherapy

    BeforerightlumpectomyRightLumpectomywithbreastreductionforsymmetry

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    ImmediateBreastReconstruction

    Tissueexpander/Implantreconstruction

    AutologousFlaps LatissimusDorsiFlap+/Expander

    AbdominalFlaps GlutealFlaps Thighflaps(TUG)

    BreastreconstructionOptions

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    Tissueexpander

    Miller,MichaelJ,M.D.(2011)SiliconeGelBreastImplants,SurgeryoftheBreast,3rd Ed

    U.S.InstituteofMedicine(2000),TheSafetyofSiliconeBreastImplants

    Noels,ECetal(2015)BreastImplantsandtheriskofbreastcancer:ametaanalysisofcohortstudies,AestheticSurgeryJournal

    MedicalGradeSiliconefoundin breastimplants heartcatheters heartvalves cardiacpacemakers implantableinfusionpumps. Mostmedicaldevicesimplantedinsofttissuearecoatedwithsiliconeatthe

    materialtissueinterface

    BreastImplantsSalineorSilicone

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    BreastImplantAssociatedAnaplasticLargeCellLymphoma(BIAALCL)

    359MedicalDeviceReports(MDR) 231reportsincludedimplant

    information(203texturedand28smooth,312includedimplantfill(186siliconeand126saline)

    AveryraretypeofnonHodgkinsLymphoma

    NOTABREASTCANCER

    FDAdoesnotrecommendwomenwithBreastimplantshavethemremovedMarch2017.

    AbdominalFlaps

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    LatissimusDorsiFlap

    TechnologyandTechniques

    ScarTherapyHyperbaricO2Therapy

    FatProcessingSystem

    Negativepressuretherapy

    AcellularDermalMatrix

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    IndocyanineGreenAngiography

    Fatgraftingbenefits=Bodycontouring

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    Strategicallydesigningaestheticincisions

    Scarmassage

    SiliconeSheeting/tape

    MinimizingScars

    MastectomyScars

    PlasticsurgeryAwardwinning3DRealismArtist LifetimeStudent

    3DNippleAreolaTattooing

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    NippleReconstruction Nippleprojectionwithlocaltissueflap(CVFlap)

    SkingraftForAreola 3DNippletattoos Combinationofabove

    3Dtattoo CVflap,skingraft,3Dtattoo

    CVflap,Skingraft

    Replaceimplants/Changesize Releasescartissue UtilizeADMs Fatgrafting Breastlifts Breastreduction Nipplereconstruction/3Dtattoo Usuallyacombinationoftheabove

    Revisionofreconstructedbreasts

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    Revisionofreconstructedbreasts

    Whyshouldwomenbeginannualmammographyatage40?

    www.endtheconfusion.org

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    Questions