An overview of animation deformity in prosthetic breast reconstruction

Fracol, Megan; Feld, Lauren N.; Chiu, Wen Kuan; Kim, John Y.S.

doi:10.21037/gs.2018.09.09

Cited by 24 publications

(24 citation statements)

References 18 publications

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“…Several methods have been proposed to assess BAD [3,7,10, 20,21]. Most recently, Fracol et al [21] suggested using Kim’s quantitative grading scale to standardize the grading of BAD by nipple displacement in centimeters and the percentage of skin area affected by rippling [21]. Within the last 2 years, Cheffe et al [20] developed an objectively measurable scale to address the severity of BAD in women undergoing dual-plane augmentation.…”

Section: Discussionmentioning

confidence: 99%

A simple clinical assessment of breast animation deformity following direct-to-implant breast reconstruction

et al. 2019

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Background A high incidence of breast animation deformity (BAD) has been reported following immediate breast reconstruction with subpectorally placed implants. The aim of this study was to assess and compare the incidence of BAD in women who underwent either subpectoral or prepectoral immediate breast reconstruction. Therefore, we developed a grading tool and tested its reproducibility in a clinical setting. Methods Video recordings of 37 women who had undergone unilateral or bilateral immediate breast reconstruction were evaluated by two consultant plastic surgeons. The degree of BAD was assessed by our grading tool, named the Nipple, Surrounding Skin, Entire Breast (NSE) grading scale, which evaluates the degree of tissue distortion in three areas of the breast. Blinded assessments were performed twice by each observer. Results Eighteen patients were reconstructed with subpectoral implant placement and 19 with prepectoral implant placement. Using the NSE grading scale, we found a significant difference in the degree of BAD between the groups, in favor of patients who underwent prepectoral immediate breast reconstruction (0.2 vs. 4, P = 0.000). Inter-and intraobserver agreement was moderate (74%) to strong (88%). Conclusions The incidence and severity of BAD was significantly lower in women reconstructed with a prepectorally placed implant than in those who underwent subpectoral immediate breast reconstruction. All patients reconstructed using the subpectoral technique had some degree of BAD. The inter-and intraobserver agreements were high when using the NSE grading scale, suggesting it is an easy-to-use, reproducible scale for assessing BAD in women who undergo immediate breast reconstruction.

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Section: Discussionmentioning

confidence: 99%

A simple clinical assessment of breast animation deformity following direct-to-implant breast reconstruction

et al. 2019

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“…Despite appealing esthetic results, animation deformity, muscle spasm, and postoperative pain remain potential consequences of subpectoral placement that can significantly affect the quality of life. 59 , 60 Furthermore, the implant in the subpectoral plane may only be partially covered. To complete the pocket and fully protect the implant, an acellular dermal matrix is often used, thereby a naturally appearing breast without compromising the mastectomy flaps can be created.…”

Section: Discussionmentioning

confidence: 99%

Quality of Life After Bilateral Risk-Reducing Mastectomy and Simultaneous Reconstruction Using Pre-Pectoral Silicone Implants

Spindler¹,

Ebel²,

Briest³

et al. 2021

PPA

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Purpose Bilateral risk-reducing mastectomy (BRRM) can reduce the risk of developing breast cancer by up to 95% in women with increased exposure. Although survival is increased, mastectomies can adversely affect a patient physically, psychologically, and psychosexually. High health-related quality of life (HRQoL) is often achieved after simultaneous breast reconstruction (BR) following BRRM; however, data on the pre- and postoperative results of HRQoL are lacking. Therefore, we investigated the quality of life, esthetic outcome, and patient well-being after BRRM and simultaneous implant-based BR. Patients and Methods Of the 35 patients who underwent skin-sparing or nipple-sparing mastectomy between May 2012 and December 2017 at a university hospital, only 22 completed the evaluation. Baseline data and data on previous operations and operation techniques were retrieved from the patient’s charts. BREAST-Q and short form-36 health survey (SF-36) questionnaires were used to evaluate patient satisfaction and HRQoL. Results SF-36 analysis showed a significantly higher score for pain (p=0.043) in our population than in the general female population. Comparing the pre- and postoperative BREAST-Q results, a significant decrease in the physical well-being of the chest (p=0.0179) and a slight improvement in breast satisfaction were observed (p=0.3266). All patients were well-satisfied with the postoperative outcome, reconstruction, and perioperative surgeon care. Conclusion Bilateral mastectomy with simultaneous BR using pre-pectoral implants is associated with an HRQoL similar to that of the healthy population. Although bilateral mastectomy may have an immense effect on the psychological, physical, and social aspects, immediate BR preserves the outer appearance and improves self-esteem.

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“…Animation deformity can be observed in patients undergoing subpectoral implant-based breast reconstruction. It is usually corrected by a pocket change to the subcutaneous position or selective nerve ablation with botox injections [66].…”

Section: Breast Implant Complicationsmentioning

confidence: 99%

Oncoplastic and Reconstructive Breast Surgery: A Comprehensive Review

Çıtgez¹,

Yiğit²,

Baş³

2022

Cureus

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Most of the approaches that were valid until recently in breast cancer surgery have undergone significant changes with rising awareness, increasing number of patients, and knowledge. It is important to repair the damage caused by surgical treatment performed in accordance with oncological principles and to obtain good cosmetic results. The quality-of-life indexes increase and body image is positively affected by the development of oncoplastic surgery and reconstruction techniques.The oncoplastic techniques are commonly used for the closure of glandular defects. Surgeons must pay attention to the breast volume, tumor location, the amount of breast tissue that would be removed, and the oncoplastic technique that may be required. Oncoplastic breast surgery allows wide local excision of the mass with good cosmetic results. In addition, a contralateral breast lift, breast augmentation or breast reduction may be required to accommodate the conceptually reconstructed breast. The use of oncoplastic breast surgery techniques results in lower mastectomy rates with equivalent local and long-term survival rates as compared with mastectomy and offers women the option of plastic and reconstructive interventions performed at the time of initial surgery. Mastectomy may be needed for large tumors, as breast-conserving surgery may not be possible or may not produce satisfactory cosmetic results. Breast reconstruction methods after mastectomy include autologous or implant-based breast reconstructions, which can be performed at the same time as the breast cancer surgery (immediate reconstruction) or at a later time (delayed reconstruction).Oncoplastic and reconstructive breast surgery minimizes the impact of breast cancer surgery and yields equivalent survival outcomes without psychological morbidity. With advanced techniques, better breast image than before can also be achieved. In this review, the technical details of oncoplastic breast surgery, surgical margin positivity management, reconstruction methods, radiation therapy given after reconstruction surgery, radiologic imaging modalities, and management of complications are discussed.

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An overview of animation deformity in prosthetic breast reconstruction

Cited by 24 publications

References 18 publications

A simple clinical assessment of breast animation deformity following direct-to-implant breast reconstruction

A simple clinical assessment of breast animation deformity following direct-to-implant breast reconstruction

Quality of Life After Bilateral Risk-Reducing Mastectomy and Simultaneous Reconstruction Using Pre-Pectoral Silicone Implants

Oncoplastic and Reconstructive Breast Surgery: A Comprehensive Review

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