Archive for July, 2014

Complications of Acellular Dermal Matrices in breast surgery Despite the fact that acellular dermal matrices are treated under aseptic conditions to minimize immunogenicity while simultaneously maintaining matrix structure to permit host cells to repopulate the graft.22,24 the theoretical risk of infection has been investigated thoroughly. Ultimately, human acellular dermal matrix should be able to resist […]

Acellular Dermal Matrices for Secondary Deformities in Breast Augmentation Owing to the benefits of acellular dermal matrices in breast reconstruction surgeries, it has also been applied to various implant related changes, namely implant associated breast deformities.31 The use of acellular dermal matrices can be used to improve coverage and durability of implants as well as […]

Acellular Dermal Matrices for Breast Implant Reconstruction after Mastectomy The use of a tissue expander or a breast implant in post mastectomy breast reconstruction can be a daunting task. Most reconstructive surgeons prefer the use of autologous tissue. Despite the fact that implant based reconstruction may appear to be technically easier, quicker and less costly, […]

The use of acellular dermal matrices in breast reconstruction is becoming more popular in part due to the better cosmetic and psychological outcomes associated with their use.8,9 Their benefits in primary prosthetic breast reconstruction which include a lower incidence of capsular contracture, improved implant coverage and support and better management of implant position have been […]

The Lateral Paramedian: Revisiting a Forgotten Incision Introduction The objective of this review article is to revisit the lateral paramedian incision and examine its strengths and weaknesses as a portal of entry into the peritoneal cavity, and why it has, over the last 20 years, become so infrequently performed.  The midline incision has become the […]

Complications of Breast Augmentation Complications of breast augmention surgery include hematoma, seroma, wound infection, and permanent alterations in nipple sensation. (In Dr. Hughes’s extensive experience, these represent less than 1% of cases). Implant complications include displacement, rippling, and rupture. Hematoma development after breast augmentation has both short-term effects (pain, disfigurement, blood loss) and long-term consequences […]

Capsular Contracture in Breast Augmentation Capsular contracture results from an exaggerated scar response to a foreign prosthetic material. The amount of capsular contracture can be graded according to severity Grade I No palpable capsule The augmented breast feels as soft as a natural one. Grade II Minimal firmness The breast is less soft; the implant […]

Incisions and Approaches to Breast Augmentation: Transaxillary and Transumbilical Transaxillary Breast Augmentation (implant through the armpit) The transaxillary approach involves making an incision in the armpit. The pocket for the implant can be dissected blindly and bluntly with special instruments. It can also be dissected with an endoscope and electrocautery under direct vision. The endoscope […]

Introduction Scars are the inevitable result of any surgical procedure.  The goal of the Plastic Surgeon is to generate a scar that does not impair form or function to any significant degree.  Attention to detail and precision in wound creation and closure maximize the opportunity for producing an excellent scar as the primary result after […]

  Determining Implant Size and Incisions in Breast Augmentation: Inframammary and Infraareolar Determining the Right Size Implant for the Patient The most important clinical factor in determining breast implant size is the base width or diameter of the patient’s native breast. If the patient would like more volume to obtain a larger cup size, the […]