• Archives of Plastic Surgery
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• 제38권4호
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• pp.535-538
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• 2011

Purpose: The reverse abdominoplasty has been reported infrequently as a procedure to improve the upper abdominal wall contour. Especially, there have been rare cases on the surgical techniques with augmentation mammoplasty using implant. It is known to maintain the result. Methods: This is a retrospective review of the senior surgeon's patients who underwent reverse abdominoplasty with augmentation mammoplasty. A 63-year-old female was dissatisfied with her contracted breast and upper abdominal contour after previous abdominal wall liposuction. We performed reverse abdominoplasty with augmentation mammoplasty through same inframammary incision. Results: There was a significant improvement of the upper abdominal wall and breast contour. There was no perioperative complication. The patients was satisfied with the results and retained a good shape during the 3 months follow-up periods. Conclusion: Reverse abdominoplasty with augmentation mammoplasty is an acceptable technique that provides good results and should be considered in cases of upper abdominal laxity with capsular contracture on both breasts.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.703-706
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• 2011

Purpose: Augmentation mammoplasty by cohesive silicone gel implant is becoming more popular nowadays. Many types of complications have been reported, such as hematoma, seroma, infection, capsular contracture and etc. But there were no report of deep vein thrombosis(DVT) after augmentation mammoplasty in Korea. The authors experienced one case of DVT after augmentation mammoplasty using a cohesive silicone gel implant. Methods: A 38-year-old woman with breast cancer underwent reconstruction by tissue expander and augmentation mammoplasty by cohesive silicone gel implant, and exchange of expander to cohesive silicone gel implant. The operation was finished without any complicating event. On 4th day after the operation, the patient complained of intermittent right lower leg pain. By doppler ultrasonography, the patient was diagnosed with acute venous thrombosis of the popliteal vein, posterior tibial vein and peroneal vein. Results: Intravenous heparinization and oral warfarin were started immediately and elastic compression stocking was applied. Intravenous heparinization was continued until INR (blood coagulation unit) reached to target levels. The patient was discharged on 11th day of operation with oral warfarin. Other complication has not been reported after 10 weeks of operation. Conclusion: To our knowledge, this is the first report of DVT after silicone implant based breast augmentation.

• Archives of Plastic Surgery
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• 제38권3호
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• pp.323-325
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• 2011

Purpose: Breast implant ruptures and displacement are problematic complications after augmentation mammoplasty. The authors report a patient whose cohesive silicone gel implant ruptured and migrated into the pleural cavity after augmentation mammoplasty. Methods: A 23-year-old female had received augmentation mammoplasty at a local clinic a week before visiting our hospital. When the patient's doctor performed a breast massage on the sixth postoperative day, the left breast became flattened. The doctor suspected a breast implant rupture and performed revision surgery. The implant, however, was not found in the submuscular pocket and no definite chest wall defect was found in the operative field. The doctor suspected implant migration into the pleural cavity, and after inserting a new breast implant, the doctor referred the patient to our hospital for further evaluation. The patient's vital signs were stable and she showed no specific symptoms except mild, intermittent pain in the left chest. A CT scan revealed the ruptured implant in the left pleural cavity and passive atelectasis. Results: The intrapleurally migrated ruptured implant was removed by video-assisted thoracic surgery (VATS). There were no adhesions but there was mild inflammation of the pleura. No definite laceration of the pleura was found. The patient was discharged on the first day after the operation without any complications. Conclusion: Surgeons should be aware that breast implants can rupture anytime and the injury to the chest wall, which may displace the breast implant into the pleural cavity, can happen during submuscular pocket dissection and implant insertion.

• Archives of Plastic Surgery
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• 제50권5호
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• pp.488-491
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• 2023

Silicone breast implant insertion is a commonly performed surgical procedure for breast augmentation or reconstruction. Among various postoperative complications, infection is one of the main causes of patient readmission and may ultimately require explantation. We report a case of infective costochondritis after augmentation mammoplasty, which has rarely been reported and is therefore difficult to diagnose. A 36-year-old female visited the clinic for persistent redness, pain, and purulent discharge around the left anteromedial chest, even after breast implant explantation. Magnetic resonance imaging showed abscess formation encircling the left fourth rib and intracartilaginous and bone marrow signal alteration at the left body of the sternum and left fourth rib. En bloc resection of partial rib and adjacent sternum were done and biopsy results confirmed infective costochondritis. Ten months postoperatively, the patient underwent chest wall reconstruction with an artificial bone graft and acellular dermal matrix. As shown in this case, early and aggressive surgical debridement of the infected costal cartilage and sternum should be performed for infective costochondritis. Furthermore, delayed chest wall reconstruction could significantly contribute to the quality of life.

• Archives of Plastic Surgery
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• 제32권6호
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• pp.767-769
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• 2005

Late capsular hematoma is one of the rare complication of augmentation mammoplasty. Although the cause has not unfolded yet, the possible damage of capsular vessels chafed against the textured prostheses is questioned. Reviewing the literatures, we present a 23-year-old female subjects to incidental swelling of the right breast a year later after augmentation mammaplasty with saline-filled textured prostheses. An MRI study confirmed intracapsular fluid collection sparing the prostheses. The exploration was followed and serosanguinous fluids was drained out of the intracapsular space, and then the existing prostheses were replaced with the smooth surface ones. In the 9 months since the last surgery the patient remained well without any further problem. Intensive massage of the breasts might be accounted to the probable cause of late hematoma in this case.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.767-772
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• 2009

Purpose: Among reasons for reoperations in augmentation mammoplasty, palpable implant, due to thin skin is relatively common, but not easy to correct, especially if thin skin area is wide. The capsule around the implant is a physiologic response to foreign body, naturally formed, and suitable for use as a flap because of its high vascularity. Authors report that capsular flap is very effective and successful method for correction of implant palpability in secondary breast augmentation. Methods: From September 2007 to September 2008, the capular flaps were performed on 5 patients having palpable and wrinkling breast implants due to very thin skin among the cases on whom secondary augmentation mammaplasty had been performed. After the capsular flap was elevated according to thin skin area, the capsular flap was turned down or over to cover the thin skin area and made the thin skin area thick. Results: Post - implant palpable breast wrinkling had been successfully corrected by capsular flaps and breast implants were not palpable any more during the follow - up period(average 9.2 months). All patients who suffered from deformed breast were satisfied. Conclusion: Authors suggest that the capsular flap is a ideal, effective and useful method in management of implant palpability.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.373-377
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• 2022

Currently, robot-assisted latissimus dorsi muscle flap (RLDF) surgery is used in treating patients with Poland syndrome and for breast reconstruction. However, conventional RLDF surgery has several inherent issues. We resolved the existing problems of the conventional system by introducing the da Vinci single-port system in patients with Poland syndrome. Overall, three patients underwent RLDF surgery using the da Vinci single-port system with gas insufflation. In the female patient, after performing RLDF with silicone implant, augmentation mammoplasty was also performed on the contralateral side. Both surgeries were performed as single-port robotic-assisted surgery through the transaxillary approach. The mean operating time was 449 (335-480) minutes; 8.67 (4-14) minutes were required for docking and 59 (52-67) minutes for robotic dissection and LD harvesting. No patients had perioperative complication and postoperative problems related to gas inflation. The single-port robot-assisted surgical system overcomes the drawbacks of previous robotic surgery in patients with Poland syndrome, significantly shortens the procedure time of robotic surgery, has superior cosmetic outcomes in a surgical scar, and improves the operator's convenience. Furthermore, concurrent application to another surgery demonstrates the possibility in the broad application of the robotic single-port surgical system.

• Investigative Magnetic Resonance Imaging
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• 제19권2호
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• pp.127-130
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• 2015

Direct injection of foreign material, such as liquid paraffin and silicone, into the breast can induce a foreign body granulomatous reaction and fibrosis, resulting in hard, nodular breast masses and architectural distortion that can mimic neoplasm. Conventional methods, including physical examination, mammography, and ultrasonography are of little use to differentiate between foreign body-induced mastopathy and breast cancer. In patients with foreign body injection such as breast augmentation, dynamic contrast enhanced MR imaging is an excellent imaging modality. Here, the authors report the MR imaging and pathological findings of ductal carcinoma in situ (DCIS) with multicystic changes in a 41-year-old woman with a previous history of interstitial mammoplasty by paraffin injection.

• 대한영상의학회지
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• 제83권1호
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• pp.230-238
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• 2022

폴리아크릴 아마이드겔(polyacrylamide gel; 이하 PAAG)은 중국, 동유럽 등에서 유방 확대술에 이용되던 물질이었으나, 다양한 부작용을 일으키는 것으로 밝혀져 현재는 사용이 금지된 물질이다. 그러나 위에서 언급된 국가의 여성들이 다른 국가로 이주하게 되면서, 우리나라에서도 PAAG를 이용한 유방 확대술을 시행한 환자들을 만나게 되었다. 이를 시행한 경우, 매우 다양한 영상의학적 소견을 보이며, 이로 인해 악성 종양이나 다른 진단과의 감별이 어렵기 때문에 정확한 진단 및 치료 계획을 세우기 위해 다양한 영상의학적 소견에 대해 숙지하는 것이 필요하다. 현재까지 한국에서의 PAAG 유방 확대술에 의한 부작용과 관련된 영상의학적 소견에 대해 보고된 바가 적기 때문에, 이에 PAAG 유방 확대술을 시행한 네 개의 증례 통해 다양한 영상의학적 진단 도구를 통한 영상의학적 소견에 대하여 보고하고자 한다.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.545-552
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• 2008

Purpose: The transaxillary approach for breast augmentation has been advocated for patients and surgeons for several decades. However, this blind technique had many disadvantages including, traumatic dissection, difficult hemostasis, displacement of implants, and ill-defined asymmetrical location of inframammary crease. In the present study, the precise endoscopic electrocautery dissection was applied to eliminate the limits of blunt dissection throughout the procedures. Methods: From December 2006 to December 2007, a total of 103 patients with an average age of 29.5 years underwent endoscopic assisted transaxillary dual plane augmentation mammoplasty. The mean implant size was 243 cc with the range between 150 and 350 cc. Through a 4 cm axillary incision, electrocautery dissection for submuscular pockets was carried out under the endoscopic control. The costal origin of pectoralis muscle was completely divided to expose subcutaneous tissue and to make type I dual plane. Results: Using the endoscopic dissection, we achieved good aesthetic results including a short recovery period, less morbidity, and symmetrical well-defined inframammary crease. Type I dual plane procedure could support the consistent inframammary fold shape and be applied to most patients without breast ptosis. Minor complications did not occur, however, four major complications of capsular contracture occurred. Conclusion: In contrast to the era of the blind techniques, endoscopic assisted transaxillary dual plane breast augmentation can now be performed effectively and reproducibly. With Its advantage, the axillary application of endoscopy for augmentation mammaplasty is useful to achieve the optimal cosmetic outcomes.