Breast Implants Research Articles

Temporal trends in medical device implant procedures in Australia 2008-22: evidence from the Australian Institute of Health and Welfare National Hospital Morbidity database.

ObjectiveExamine the temporal trends in medical device implant procedures in the Australian population.MethodsWe used data from the Australian Institute of Health and Welfare from the financial years 2007-08 to 2021-22 and chose the most frequently performed medical device implant procedures. We estimated the annual change in volume of procedures and age-standardised rates by calculating the compound annual growth rate (CAGR), and used regression with the Newey-West robust variance estimator to examine whether there was a linear trend in the age-standardised rates for each procedure.ResultsFor procedures including cardiac pacemakers, heart valves, hip and knee arthroplasties, and intraocular lenses, the crude CAGR was over 3%. For the age-standardised rates, the CAGR was largest for cardiac pacemaker, followed by heart valve replacement and hip arthroplasty procedures. For some procedures, the growth was more than in the Australian population, including cardiac pacemakers (β=1.00; 95% CI: 0.14-1.86), heart valve replacements (β=0.41; 95% CI: 0.28-0.54), hip arthroplasty (β=3.50; 95% CI: 1.61-5.38), and knee arthroplasty (β=4.31; 95% CI: 0.54-8.09) procedures. The trend of standardised rates of procedures, including incisional hernia with mesh, breast implants, coronary stents, and cardiac defibrillators, grew at the same rate as the population, whereas the rate for gastric banding procedures decreased (β=-3.14; 95% CI: -4.92 to -1.34).ConclusionThe findings from the current study, showing a large increase in medical device implant procedures, will assist in future healthcare planning and efforts in post-market surveillance of safety of medical devices.

Experimental protocol for evaluation of biomaterials in an in-vivo silicone implant coverage.

To describe an experimental surgical model in rats using a dual-plane technique for evaluation of biomaterials in an in-vivo silicone implant coverage. This study was developed following the ISO 10993-6 standard. In this study, 40 male Wistar rats weighing between 250 and 350 g were used, distributed into two groups: experimental, biomaterial superimposed on the minimammary prosthesis (MP); and control, MP without implantation of the biomaterial, with eight animals at each biological point: 1, 2, 4, 12, and 26 weeks. Thus, at the end of biological points (1, 2, 4, 12, and 26 weeks; n = 8 animals per week), the tissue specimens achieved were fixed in buffered formalin and stained with hematoxylin-eosin. Macroscopically, throughout the study, no postoperative complications were apparent. In the histological analysis, it was possible to observe the evolution of the inflammatory response, tissue repair, and fibrous capsule during the biological points. The experimental model described in this study proved to be suitable for evaluating the biomaterial used in the coverage of breast silicone implants.

RELAÇÃO DAS MAMAS FEMININAS COM A ATIVIDADE FÍSICA, EXERCÍCIO E ESPORTE - Parte 1

ABSTRACT Introduction: The women are increasingly seeking to be physically active or even choose sports as their professional activity as in the years, the number of Summer Olympic athletes has equaled that of men. Due to this growing female participation in sports, the study of female and male differences has become increasingly relevant in the involvement of the academic world. Objective: A review on this subject, stimulating more research, and making knowledge reach more women is a major objective of this literature review. We understand that more studies are needed to understand pathophysiology, prevention, and treatment. Methods: The study design was a retrospective narrative review of the relationship between breasts and physical activity, exercise, and sports. Results: Several anthropometric and physiological differences have been established; however, the volume and shape of the female breast is peculiar but still little studied. The specificity of female breasts are conditions that can exert sports performance and contribute to distancing women from physical activity practice. Conclusion: Possible conditions of female breasts in sports are exercise-induced mastalgia, breast injury, nipple injury, pregnancy, and many others. We understand that more studies are needed to understand pathophysiology, prevention, and treatment. Level of Evidence II; Retrospective Narrative Review.

Error assessment of subjective estimates of linear breast dimensions versus the objective method.

The study aimed to investigate the subjective method of estimating linear breast dimensions in comparison to the objective method. The reproducibility and accuracy of the subjective method of estimating linear breast dimensions during a simplified breast shape analysis were examined. Four linear breast dimensions including the distance from the sternal notch to the nipple, distance from the nipple to the inframammary fold, distance from the nipple to the midline and under-breast width were evaluated based on subjective estimates. Images from 100 women with natural breasts and without any history of breast surgery were reviewed by two examiners three times each. The cases were obtained from a large database of breast images captured using the Vectra Camera System (Canfield Scientific Inc., USA). The subjective data were then compared with the objective linear data from the Vectra Camera System in the automated analysis. Statistical evaluation was conducted between the three repeated estimates of each examiner, between the two examiners and between the objective and subjective data. The intra-individual variations of the three subjective estimates were significantly greater in one examiner than in the other. This trend was consistent across all eight parameters in the majority of the comparisons of the standard deviations and variation coefficients, and the differences were significant in 14 out of 16 comparisons (p<0.05). Conversely, in the comparison between the subjective and objective data, the estimates were closer to the measurements in one examiner than the other. In contrast to the reproducibility observed, the assessment of the accuracy revealed that the examiner who previously presented with less reproducibility of the estimated data overall showed better accuracy in comparison to the objective data. The overall differences were inconsistent, with some being positive and others being negative. Regarding the distances from the sternal notch to the nipple and breast width, both examiners underestimated the values. However, the deviations were at different levels, particularly when considering the objective data from the Vectra Camera System as the gold standard data for comparison. Regarding the distance from the nipple to the inframammary fold, one examiner underestimated the distance, while the other overestimated it. An opposite trend was noted for the distance from the nipple to the midline. There were no differences in the estimates between the right and left sides of the breasts. The correlations between the measured and estimated distances were positive: as the objective distances increased, the subjective distances also increased. In all cases, the correlations were significant. However, the correlation for the breast width was notably weaker than that for the other distances. The error assessment of the subjective method reveals that it varies significantly and unsystematically between examiners. This is true when assessing the reproducibility as well as the accuracy of the method in comparison to the objective data obtained with an automated system.

Breast morphology classification method based on generalized neural network

In order to establish a breast shape classification method with general indicators, this paper selects six measurement indicators that can characterize the three-dimensional shape of the breast, such as circumference, length, width, and height. The relevant data of the measurement indicators are used to establish a generalized neural network model, and the generalized neural network is applied to the evaluation of breast shape classification recognition. The MATLAB software toolbox is used, based on training sample data, We have established a generalized neural network (GRNN) model, which involves establishing corresponding functional relationships through training to approximate the training data. After obtaining the function relationship through training, the predicted values were obtained, and the prediction results reflected that the established generalized neural network GRNN model is quite reliable for predicting the category of breast shape. By establishing a mapping relationship between the input quantity of breast feature parameters and the output quantity of categories, training samples can be established. When encountering new test data, these data can also be used as test samples. Based on the established model, appropriate spreads can be adjusted to predict the output quantity, providing relevant personnel with basic and simple basis for judgment and evaluation. It can also provide convenience for customers in various consumption channels Accurate bra size recommendations can help consumers purchase bras that fit well and are comfortable.

Alpelisib Efficacy in Advanced Breast Cancer

Breast cancer is one of the popular problems related to the medical field. Breast cancer become more aggressive, and the incidence rate keeps increasing yearly. The incidence indicates the slow progression of the disease. Yearly, there are more than one million new cases that get worse. Probably the incidence rate will increase significantly in the next years. Breast cancer develops silently without medical attention, and most cases are discovered during a routine clinic visit. While other cases may accidentally discover breast lumps, changes in breast shape or size, and nipple discharge. Breast cancer highly affects women worldwide. Mortality rates of breast cancer are improving, but still, the survival rate in the advanced stage is decreasing. Nowadays, Chemotherapy is considered the gold-standard approach for most cancer types and a modest improvement in both survival rates and toxicity reduction. Therefore, this article aims to focus on the use of one of the modest drugs that treat advanced breast cancer, which is Alpelisib, and highlight the mechanism of action, indication, contraindication, pharmacodynamic, pharmacokinetic, dose, and its side effects. Alpelisib is being developed by Novartis company. The first clinical trials started in Oct 2010. It was approved in the USA on May 24th, 2019. Alpelisib works by inhibiting the phosphatidylinositol 3-kinase (PI3K) which leads to inhibiting the activation of some signaling pathways. Alpelisib is used in combination with fulvestrant to treat advanced breast cancer in postmenopausal women with some genetic mutations.

Edukasi Tentang Perawatan Payudara Ibu Hamil Untuk Meningkatkan Produksi Asi Ibu Di Wilayah Kerja Puskesmas Bantimurung

Breastfeeding is one of the best investments for survival and improving health, socio-economic development of individuals and nations. This coverage cannot be separated from problems that occur during the breastfeeding process, including the false belief that little milk comes out or that breast milk is not sufficient for the baby's needs. This situation is caused by several factors, including the mother's psychological condition, abnormal breast shape, baby sucking, which can affect breast milk production. Various studies have been carried out to facilitate breast milk production, including the Oxytocin Massage method, Marmet Technique, Rolling Massage (back), Endorphin massage, Breast Care, but due to limited information in health services regarding implementation procedures, these methods are only known but rarely given by health workers as care givers to patients. The service is carried out with the aim of providing knowledge to mothers and the community about Endorphine Massage in Increasing Breast Milk Production. The method used in community service begins with giving a pre-test, delivering material, evaluating with a post-test and practice. The target audience is pregnant women and breastfeeding mothers at the Bantimurung Community Health Center. The result of this community service was that 71.4% of participants' knowledge increased about Endorphine Massage in Increasing Breast Milk Production. This was proven by the enthusiasm of the participants who actively asked questions, discussed and shared breastfeeding experiences. After this activity takes place, there needs to be follow-up from the participants to apply the counseling that has been given.

Impact of Adjuvant Radiotherapy on Free Flap Volume in Autologous Breast Reconstruction: A Scoping Review.

In autologous breast reconstruction, a sufficient flap volume is fundamental to restore breast shape and ensure an aesthetic outcome. After mastectomy, postoperative irradiation is regularly indicated in the oncological treatment algorithm. When administering radiation therapy after autologous reconstruction, the tissue transferred is inherently irradiated. Although there is evidence that points to a reduction in flap volume after adjuvant radiotherapy, the data have been contradicting and inconclusive. To address this anecdotal evidence, we performed a scoping review of the current literature that addresses the effect of radiotherapy on breast flap volume. Six two-armed studies, comprising a total of 462 patients, reported on the effect of adjuvant radiotherapy on free flap volume changes. Of those, two studies found a significant negative impact of radiotherapy on free flap volume, while the other four studies did not. Reported flap volume changes ranged from no change to a reduction of 26.2%, measured up to two years postoperatively. The selected studies contain varying patient numbers, follow-up timepoints, types of flaps, and measuring methods, contributing to a relatively high heterogeneity. While we present some evidence suggesting a significant impact of adjuvant radiotherapy on breast flap volume, future studies are needed to further investigate this potential correlation.

Allergic manifestations in women with silicone breast implants

IntroductionSilicone breast implants (SBI) result in immune dysregulation and are associated with autoimmune diseases. Recently, we reported dysregulated levels of IgG autoantibodies directed against G protein-coupled receptors (GPCRs) of the autonomic nervous system which were linked to the autoimmune dysautonomia in silicone breast implant illness (SBII). AimsWe aimed to explore the possible association between allergy with dysregulated IgE autoantibodies directed against GPCRs of the autonomic nervous system in women with SBI. MethodsCirculating levels of IgE autoantibodies against GPCRs of the autonomic nervous system (adrenergic, muscarinic, endothelin and angiotensin receptors) have been evaluated in women with SBIs who complained of allergic symptoms, and compared to subjects with SBI without allergic manifestations and to age-matched healthy women without SBI. ResultsWe report a significant dysregulation in three circulating autoantibodies: IgE-beta1 adrenergic receptor (B1AR), IgE-alpha 1 adrenergic receptor (A1AR) and IgE-muscarinic acetylcholine receptor type 1 (M1R) autoantibodies in women with SBI who complained of allergic symptoms. ConclusionsAllergic reactions associated with SBI are not uncommon. Imbalance of circulating levels of IgE autoantibodies against GPCRs of the autonomic nervous system might play a role not only in allergic reactions, but also in other enigmatic aspects of SBII such as autoimmune dysautonomia.

Incidental Bystander or Essential Culprit: A Systematic Review of Bacterial Significance in the Pathogenesis of Breast Implant-Associated Anaplastic Large Cell Lymphoma.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a distinct subtype of T-cell non-Hodgkin lymphoma that arises in the context of prolonged exposure to textured breast implants. The intent of this manuscript is to explore whether the bacterial presence in biofilms on these implants is a mere incidental finding or plays a pivotal role in the pathogenesis of BIA-ALCL. Our goal is to delineate the extent of bacterial involvement, offering insights into potential underlying mechanisms, and establishing future research priorities aimed at resolving the remaining uncertainties surrounding this complex association. A comprehensive systematic review of several databases was performed. The search strategy was designed and conducted by an experienced librarian using controlled vocabulary with keywords. The electronic search identified 442 publications. After evaluation, six studies from 2015 to 2021 were included, encompassing 201 female patients aged 23 to 75. The diagnosis span post-implantation ranged from 53 to 135.6 months. Studies consistently found bacteria near breast implants in both BIA-ALCL cases and controls, with varied microbial findings. Both BIA-ALCL cases and controls exhibited the presence of specific bacteria, including Pseudomonas aeruginosa, Klebsiella oxytoca, Staphylococcus aureus, and Ralstonia spp., without any statistically significant differences between groups. The use of antiseptic and antimicrobial agents during implant insertion did not demonstrate any impact on reducing or altering the risk of developing BIA-ALCL. Our systematic review reveals that the current evidence is inadequate to link bacterial etiology as a central factor in the development of BIA-ALCL. The limitations in the existing data prevent a complete dismissal of the role of biofilms in its pathogenesis. The observed gap in knowledge underscores the need for more focused and comprehensive research, which should be structured in a multi-faceted approach. Initially, this involves the utilization of sophisticated genomic and proteomic methods. Following this, it is crucial to delve into the study of immunological reactions specifically induced by biofilms. Finally, this research should incorporate extended observational studies, meticulously tracking the evolution of biofilm development and its correlation with the emergence of BIA-ALCL. In light of the inconclusive nature of current findings, further investigation is not only justified but urgently needed to clarify these unresolved issues.

Effectiveness of a Novel Temperature-Responsive Hydrogel (PF72) for Postoperative Pain Relief in Breast Augmentation.

Breast augmentation can cause severe postoperative pain, leading to an increased length of hospital stay. Postoperative pain management following breast surgery has traditionally involved intravenous and oral analgesics. However, the misuse of opioids can cause severe complications. As a result, several alternative methods have been suggested. Fifty patients were included in this study. All the patients underwent dual-plane pocket dissection using the transaxillary approach and received smooth-type breast implants. The intervention group included 25 patients who received PF72 combined with ropivacaine, and the control group included 25 patients who received only bupivacaine. The Numerical Rating Scale (NRS) score was used to evaluate each patient's pain. Three hours after the surgery, the average NRS scores of the control and intervention groups were 3.75 and 2.48, respectively. Six hours after the operation, the NRS scores of the control and intervention groups increased to 4.77 and 3.02, respectively. PF72 combined with ropivacaine was more effective than only bupivacaine for pain control in patients who underwent breast augmentations.

PCOS Detection and Breast Cancer Detection

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder that affects people with ovaries, typically during their reproductive years. Detecting PCOS is crucial for timely intervention and management. PCOS detection involves a multifaceted approach, encompassing both clinical and laboratory methods. Clinical assessment of PCOS often begins with a comprehensive medical history, physical examination, and evaluation of symptoms, such as irregular menstruation, excess hair growth, and acne. Transvaginal ultrasound is commonly employed to visualize the ovaries and identify the characteristic cysts. Blood tests, measuring hormone levels like testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH), aid in the diagnosis. Additionally, insulin resistance and glucose tolerance tests may be conducted, as PCOS is frequently associated with metabolic disturbances. Breast Cancer Detection: Breast cancer is a significant global health concern, and early detection is essential for improved prognosis and survival rates. Various techniques are employed for breast cancer detection, combining clinical assessment, imaging, and biopsy procedures. Clinical breast examination involves a physical assessment by a healthcare professional to identify any palpable lumps, changes in breast shape, or skin abnormalities. Mammography, a low-dose X-ray, is a primary imaging modality for breast cancer screening. Other imaging techniques, such as ultrasound and magnetic resonance imaging (MRI), are used for supplemental evaluation. In cases where abnormalities are detected, a biopsy is performed to confirm the presence of cancer cells. Biopsies may include fine-needle aspiration, core needle biopsy, or surgical biopsy, providing definitive evidence of malignancy. Advances in technology, such as digital mammography and the development of artificial intelligence algorithms for image analysis, continue to enhance the precision and efficiency of breast cancer detection, thereby contributing to early diagnosis and effective treatment.

(Invited) Towards GaN-on-GaN High-Power Electronic Devices

Application of gallium nitride (GaN) substrates in electronic and optoelectronic industries is constantly increasing. In order to fabricate wafers, GaN crystals of the highest structural quality and desired electrical (and sometimes optical) properties must be grown. Today, there are three main GaN crystallization methods: i/ halide vapor phase epitaxy (HVPE) with its derivatives: halide-free VPE and oxide VPE; ii/ sodium-flux; and iii/ ammonothermal. The last approach can be basic or acidic depending on what mineralizer is used to increase the solubility of GaN in the feedstock zone. In this paper we will focus on HVPE and basic ammonothermal growth of GaN [1]. Not only bulk growth will be presented. The HVPE method will also be discussed as the best method to crystallize the drift layers necessary for high-power vertical electronic devices (FET transistors, Schottky diodes).One of the best methods for introducing dopants into semiconductors is ion implantation. The introduced structural damage can be removed by a proper annealing process. The high-temperature treatment enables also electrical and/or optical activation of the implanted dopants. In the case of GaN, annealing at high temperature (~1300°C - 1400°C) seems difficult. This compound loses its thermodynamic stability slightly above 800°C at atmospheric pressure. At higher temperature the crystal will decompose. One of the solutions is to anneal GaN at high nitrogen (N2) pressure. Such technology is called ultra-high-pressure annealing (UHPA) [2]. In this paper, application of UHPA for GaN crystals and layers implanted by different ions (acceptors and donors) will be presented. The latest results of the implantation with magnesium (Mg), beryllium (Be), zinc (Zn), and calcium (Ca) ions into GaN in order to obtain p-type conductivity will be discussed [3,4]. Silicon (Si) implantation into GaN for n-type doping will also be analyzed. Structural, electrical and optical properties of implanted GaN after UHPA will be discussed in terms of application for GaN-based devices.A kV class, low ON-resistance, vertical GaN junction barrier Schottky (JBS) diode with selective-area p-regions formed via Mg implantation followed by high-temperature, ultra-high pressure post-implantation activation anneal without a capping layer was already demonstrated [5]. The forward characteristics of the JBS diode showed ideality factor (n) 1.03, turn-on voltage (VON) 0.75 V, current ON/OFF ratio (at ±3 V) ~1011, and specific differential ON-resistance (RON) 0.6 mΩ·cm2. The breakdown voltage of the JBS diode was 915 V.

Estimating Local Diagnostic Reference Levels for Mammography in Dubai.

As the total volume of mammograms in Dubai is increasing consistently, it is crucial to focus on the process of dose optimization by determining dose reference levels for such sensitive radiographic examinations as mammography. This work aimed to determine local diagnostic reference levels (DRLs) for mammography procedures in Dubai at different ranges of breast thickness. A total of 2599 anonymized mammograms were randomly retrieved from a central dose survey database. Mammographic cases for screening women aged from 40 to 69 years were included, while cases of breast implants and breast thickness outside the range of 20-100 mm were excluded. Mean, median, and 75 percentiles were obtained for the mean glandular dose (MGD) distribution of each mammography projection for all compressed breast thickness (CBT) ranges. The local DRLs for mammography in Dubai were found to be between 0.80 mGy and 0.82 mGy for the craniocaudal (CC) projection and between 0.89 mGy and 0.971.8 mGy for the mediolateral oblique (MLO) projection. Local DRLs were proposed according to different breast thicknesses, starting from 20 to 100 mm. All groups of CBT showed a slight difference in MGD values, with higher values in MLO views rather than CC views. The local DRLs in this study were lower than some other Middle Eastern countries and lower than the standard reference levels reported by the International Atomic Energy Agency (IAEA) at 3 mGy/view.

Asia Syndrome and Breast Implants, Report of A Case and Review of The Literature

Background: Over the past decades, evidence has accumulated that autoimmune symptoms can be triggered by exposure to environmental immunostimulatory factors that act as adjuvants in genetically susceptible individuals, with several unexplained symptoms. Adjuvant-induced autoimmune/autoinflammatory Syndrome (ASIA) was described in 2011 by Shoenfeld and Agmon-Levin and defined the diagnostic criteria. However, the association of this syndrome with silicone breast implants is controversial. Objective: To describe a case of ASIA syndrome in a silicone breast implant carrier and review of the literature. Clinical Case: JKT 36-year-old woman with luminal infiltrating ductal carcinoma; with negative extension studies, a conservative mastectomy of the skin and areola was performed with immediate reconstruction with an implant with a breast prosthesis and hormone therapy; Her follow-up was torpid with fatigue, pain in the arm, depression and sleep disturbances and affected breast skin, without infection. As she did not respond to conservative management, it was decided to remove the prosthesis, resection of the capsule and skin, due to the suspicion of the syndrome. From ASIA, as there was no involvement or persistence of breast cancer, with immediate improvement. Method: Bibliographic review of original articles written in English on cases of ASIA syndromes, associated with silicone breast implants from their description to the present. Results: Until 2019, 126 cases of ASIA syndrome due to silicone breast prostheses and implants were reported. Removal of the prosthesis improves symptoms. Conclusion: ASIA syndrome is recent, it is still considered an evolving concept, it is necessary to identify risk factors for the development of autoimmune phenomena in individuals who will receive some type of adjuvant to prevent cases of this syndrome.

Pharmacokinetics of Locally Applied Antibiotic Prophylaxis for Implant-Based Breast Reconstruction

Antibiotic irrigation of breast implants is widely used internationally, but no clinical study has investigated the pharmacokinetics of antibiotic prophylaxis in the breast implant pocket. To evaluate how long locally applied gentamicin, cefazolin, and vancomycin concentrations in the implant pocket remain above the minimum inhibitory concentration (MIC) for the most common bacterial infections and to measure systemic uptake. This prospective cohort study was performed at the Department of Plastic Surgery and Burns Treatment, Rigshospitalet, Copenhagen, Denmark, between October 25, 2021, and September 22, 2022, among 40 patients undergoing implant-based breast reconstruction who were part of the ongoing BREAST-AB trial (Prophylactic Treatment of Breast Implants With a Solution of Gentamicin, Vancomycin and Cefazolin Antibiotics for Women Undergoing Breast Reconstructive Surgery: a Randomized Controlled Trial). Patients were randomized to receive locally applied gentamicin, cefazolin, and vancomycin or placebo. Samples were obtained from the surgical breast drain and blood up to 10 days postoperatively. The breast implant and the implant pocket were irrigated with 160 μg/mL of gentamicin, 2000 μg/mL of cefazolin, and 2000 μg/mL of vancomycin in a 200-mL saline solution. The primary outcome was the duration of antibiotic concentrations above the MIC breakpoint for Staphylococcus aureus according to the Clinical and Laboratory Standards Institute: gentamicin, 4 μg/mL; cefazolin, 2 μg/mL; and vancomycin, 2 μg/mL. Secondary outcomes included the time above the MIC for Pseudomonas aeruginosa and other relevant bacteria, as well as systemic uptake. The study included 40 patients (median age, 44.6 years [IQR, 38.3-51.4 years]; median body mass index, 23.9 [IQR, 21.7-25.9]) with a median number of 3 drain samples (range, 1-10 drain samples) and 2 blood samples (range, 0-6 blood samples). Vancomycin and cefazolin remained above the MIC for S aureus significantly longer than gentamicin (gentamicin, 0.9 days [95% CI, 0.5-1.2 days] for blood samples vs 6.9 days [95% CI, 2.9 to 10.9 days] for vancomycin [P = .02] vs 3.7 days [95% CI, 2.2-5.2 days] for cefazolin [P = .002]). The gentamicin level remained above the MIC for P aeruginosa for 1.3 days (95% CI, 1.0-1.5 days). Only cefazolin was detectable in blood samples, albeit in very low concentrations (median concentration, 0.04 μg/mL [range, 0.007-0.1 μg/mL]). This study suggests that patients treated with triple-antibiotic implant irrigation during breast reconstruction receive adequate prophylaxis for S aureus and other common implant-associated, gram-positive bacteria. However, the protection against P aeruginosa may be inadequate.

Combined treatment with basalt stone and placenta extract to improve the chronic pain and scar after breast cancer surgery: a case report

BackgroundThe changes in body image caused by breast deformities and postoperative pain have a detrimental influence on the physical and mental health of patients with breast cancer. The postoperative quality of life (QOL) of these patients reduces significantly owing to the changes in the breast, an organ unique to women, that occur following breast cancer surgery.Case presentationThis case report presents the case of a Asian woman in her early 40 s with postoperative hypertrophic scarring and contraction of the scar following mastectomy; the patient presented with decreased range of motion of the upper arm, hyperpigmentation from radiation burns, changes in breast shape, and chronic pain. The patient received a combination therapy comprising Basalt Stone Treatment and the application of horse placenta extract. As a result of a total of eight sessions conducted once every two weeks, the patient's pain and scar improved. No adverse events were observed after the therapy.ConclusionCombination therapy with Basalt Stone Treatment and horse placenta extract improved the chronic pain and scar after breast cancer surgery.

Anophthalmic socket in retinoblastoma: Exploring complications and risk factors in a tertiary centre in Malaysia.

To evaluate the complications of anophthalmic socket in retinoblastoma patients at a tertiary centre in Malaysia. Retrospective study. Patients who underwent enucleation for retinoblastoma were reviewed from 2004-2020. Details were recorded, including demographics, diagnosis, surgical techniques, implant types, additional therapies, and complications. Of 250 patients with retinoblastoma managed over the period, the anophthalmic sockets of 160 eyes who underwent enucleation were analysed. The mean age at enucleation was 2.03 years (26 days to 9.18 years). The follow-up periods after enucleation range from 5 days to 16.83 years. Porous polyethylene (Medpor) implants were used in 135 patients (84.4%), as were Bioceramic in 9, glass balls in 7, acrylic in 7, dermis fat grafts in 1, and silicone implants (Aurosphere) in 1. The overall complications in our study were 28.8%. Complications seen in the study included implant exposure (12.5%), shallow inferior fornix (10.6%), granuloma formation (3.1%), discharge (2.5%), implant migration (1.9%), ptosis (0.6%), and orbital dystopia (0.6%). Implant exposure is solely found in Medpor, more common in those with donor sclera caps, and exposure times range from 28 days to 11.42 years. The suturing of the Tenon and conjunctiva in separate layers significantly reduced the rate of implant exposure. Six out of seven radiation patients had shallow inferior fornixes. Long-term post-enucleation complications were not uncommon. Luckily, most had good outcomes, with a few needing surgical intervention. Meticulous suturing technique on the Tenon and conjunctival layer is essential to prevent implant exposure.

Comparison of analog and digitally evaluated volume of the female breast in reconstructive breast surgery. Validation of a noninvasive measurement method with 3D camera1.

Reconstructive surgery is established as a standard treatment option after mastectomy due to cancer. It is crucial to patients to achieve a natural and symmetric looking breast through reconstruction. Anthropometric measurements are used to assess the objective symmetry of the breast, which are prone to errors and difficult to reproduce. The aim of this work is to validate breast volumetry using three-dimensional surface imaging. We compared preoperatively analog and digitally evaluated volume of the breast with our gold standard, direct water displacement measurement of the mastectomy specimen. We examined 34 breast specimens in total. Each measurement method (Breast Sculptor, VAM, Breast-V) for breast volume/mass determination demonstrates acceptable agreement ranges when compared with resected volumes and masses. The strongest volumetry instrument is Breast Sculptor (digital), the weakest is Breast-V (analog). 3D surface imaging is a quick, effective, and convenient method to evaluate breast shape and volume. The accuracy, reproducibility, and reliability of 3D surface imaging were comparable with MRI in our study.This takes us a step closer to the long-term goal of establishing robust instruments to plan breast reconstructive surgery, achieve better surgical results, and contribute to quality assurance in breast surgery.

Silicone Particles in Capsules Around Breast Implants: An Investigation Into Currently Available Implants in North America.

Breast implants have always been composed of a silicone elastomer envelope filled with either silicone gel or saline. Breast implant illness (BII) is a set of symptoms that has previously been linked to the leakage of silicone particles from the implants into the body. Our research aimed to quantify the number of silicone particles present in the capsules of breast implants available in North America. Thirty-five periprosthetic capsules were sampled and analyzed, and silicone particles were counted and measured. The capsule surface area was then measured and utilized to calculate particle density and total number of silicone particles. Eighty-five percent of capsules analyzed from silicone gel implants contained silicone, with an average of 62 particles per mm3 of capsular tissue. These implants had approximately 1 million silicone particles per capsule. In contrast, none of the saline implant capsules contained silicone. Capsules from macrotextured tissue expanders contained fewer and larger silicone particles. Silicone gel implants presented silicone particle bleeding into the periprosthetic capsule, totaling on average 1 million silicone particles per capsule. On the other hand, no silicone particle bleeding was observed from saline breast implants. These data suggest that particle bleeding comes from the inner silicone gel, and not from the smooth outer silicone shell. Previous studies have reported the presence of breast implant illness in patients with both silicone- and saline-filled implants. Therefore, our data suggest that silicone migration is not the sole cause of BII.