PRSonally Speaking

Tuesday, February 18, 2014

Articles of Interest Sneak Peak: A Process for Quantifying Aesthetic and Functional Breast Surgery: II- Applying
At least twice a month, PRSonally Speaking posts full abstracts of interesting or potentially controversial articles from a future issue. This 'sneak preview' of a hot article is meant to give you some food for thought and provide you with topic for conversation among colleagues.
 
When the article is published in print with the March issue, it will be FREE for a period of Two Months, to help the conversation continue in the PRS community and beyond. So read the abstract, join the conversation and spread the word.
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This week we present the introduction to "A Process for Quantifying Aesthetic and Functional Breast Surgery: II- Applying Quantified Dimensions of the Skin Envelope to Design and Preoperative Planning for Mastopexy and Breast Reduction" by Tebbetts et al.
 
Abstract
Background
A previous submission defined methods to objectively define nipple position and vertical and horizontal skin excess in mastopexy and breast reduction1. This paper defines a set of second stage processes for quantified design and operative planning for skin envelope modification.
 
Methods
A skin envelope modification procedure was designed and quantified based on the quantified amount of vertical skin excess. This process was applied in 124 consecutive mastopexy and 122 consecutive breast reduction cases. Average follow up was 4.6 years (range 6-14 years).
 
Results
All cases were assessed, planned, and executed applying the processes in this paper. No patient required nipple repositioning. Complications included excessive lower pole restretch (4%), periareolar scar hypertrophy (0.8%), hematoma (1.2%), areolar shape irregularities (1.6%). Delayed healing at the junction of vertical and horizontal scars occurred in two reduction patients (2/124=1.6%), neither of which required revision. Overall reoperation rate was 6.5% (16/246) for patients in the first 5 years of the study, and decreased to 1.6% for patients from year 6 through year 14.

Conclusions
1)This study defines processes for using objectively defined parameters for skin envelope modification in mastopexy and breast reduction.
2)Quantifying desired skin envelope dimensions enables surgeons to objectively quantify vertical skin excess (VSE) and horizontal skin excess (HSE), select envelope modification design and techniques based on those parameters, and evaluate outcomes based on objective clinical measurements in both mastopexy and breast
reduction.
 
The full article will be published with the March 2014 issue of PRS, and will be free online for non-subscribers. Until then, we hope this "sneak peek" will pique your interests and start a healthy, meaningful conversation.