• Title/Summary/Keyword: 유방성형술

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Evaluation of Breast Dose in Mammography for Breast Implant Patient using a Monte Carlo Simulation (몬테칼로 모의모사를 이용한 유방성형술 환자의 유방선량평가)

  • Kim, Ji-Soo;Cho, Yong-In;Kim, Jung-Hoon
    • Journal of the Korean Society of Radiology
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    • v.14 no.3
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    • pp.253-259
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    • 2020
  • Mammography has the advantage of being economical, simple and effective in detecting microcalcification, but breast is a highly sensitive organ and is accompanied by the risk of an over-exposure. While accurate dose assessments are important to prevent this, current breast dose assessments are limited to breast implant patients. This purpose of this study was to identify dose variations due to tube voltages by forming a mock-up with breast implants for an accurate dosimetric assessment on breast implant patients. As a result, doses from the presence of breast implants were smaller than those from the absence of the mammal. As the result of the change of the voltage to 26, 28, 30, and 32 kV, the imcreased tube voltage included larger dose regardless of the presence of Breast implant. Therefore, it is believed that diagnosis recommendations for breast implants will be possible if further studies on internal and external bioretical imaging and quality assessment are carried out as the basis for this study.

Reverse Abdominoplasty with Augmentation Mammoplasty Using Breast Implant: A Case Report (보형물을 이용한 유방성형술을 동반한 역복부성형술의 치험례)

  • Bae, In-Ho;Lee, Yoon-Ho
    • Archives of Plastic Surgery
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    • v.38 no.4
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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.

Decision Making Experience on Breast Reconstruction for Women with Breast Cancer (한국 유방암 여성들의 유방재건술에 관한 의사결정 경험)

  • Yi, Myungsun;Joung, Woo Joung;Park, Eun Young;Kwon, Eun Jin;Kim, Haejin;Seo, Ji Young
    • Journal of Korean Academy of Nursing
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    • v.46 no.6
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    • pp.894-904
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    • 2016
  • Purpose: The purpose of this study was to explore decision making experiences of Korean women with breast cancer who underwent breast reconstruction with/after a mastectomy. Methods: Data were collected during 2015-2016 through individual in-depth interviews with 10 women who had both mastectomy and breast reconstruction, and analyzed using phenomenological method to identify essential themes on experiences of making a decision to have breast reconstruction. Results: Five theme clusters emerged. First, "expected loss of sexuality and discovery of autonomy" illustrates various aims of breast reconstruction. Second, "holding tight to the reputation of doctors amid uncertainty" specifies the importance of a trust relationship with their physician despite a lack of information. Third, "family members to step back in position" describes support or opposition from family members in the decision making process. Fourth, "bewilderment due to the paradox of appearance-oriented views" illustrates paradoxical environment, resulting in confusion and anger. Lastly, "decision to be made quickly with limited time to oneself" describes the crazy whirling process of decision making. Conclusion: Findings highlight aims, worries, barriers, and facilitators that women with breast cancer experience when making a decision about breast reconstruction. Deciding on breast reconstruction was not only a burden for women in a state of shock with a diagnosis of breast cancer, but also an opportunity to decide to integrate their body, femininity, and self which might be wounded from a mastectomy. These findings will help oncology professionals provide effective educational counselling before the operation to promote higher satisfaction after the operation.

Differential Diagnosis of Breast Mass and Staging of Breast Cancer Using F-18-FDG PET (F-18-FDG PET을 이용한 유방종괴의 감별진단과 유방암의 병기설정)

  • Yeo, Jeong-Seok;Lee, Dong-Soo;Kang, Keon-Wook;Noh, Dong-Young;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.6
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    • pp.502-511
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    • 1999
  • Purpose: F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been proven to be useful in the differential diagnosis of breast mass and staging of breast cancer. This study assessed the diagnostic accuracy of F-18-FDG PET in the differentiation of breast mass and staging of breast cancer. Materials and Methods: Total 42 patients who had breast mass underwent F-18-FDG PET (all female, 40: 10 year old). We compared F-18 FDG PET results with pathologic findings in 24 patients Results: In the differentiation of breast mass, sensitivity and specificity were 95% (19/20) and 77% (7/9) respectively. Three false positive cases were due to inflammation and one false negative patient had small tumor less than 1 cm. In the assessment of axillary lymph node status, sensitivity and specificity were 73% (8/11) and 100% (7/7) respectively. We found distant metastasis that were not suspected before F-18-FDG PET in 2 patients. Conclusion: F-18-FDG PET shows good diagnostic performance in differentiation of breast mass and staging of breast cancer.

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Capsular Flaps for Correcting Implant Palpability in Secondary Augmentation Mammoplasty (유방성형술의 재수술에서의 보형물 만져짐 교정을 위한 피막 피판)

  • Yoo, Gyeol;Lee, Paik-Kwon
    • Archives of Plastic Surgery
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    • v.36 no.6
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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.

Mastopexy with Mammary Parenchymal Z-plasty Pattern (유방 실질 조직 Z-성형술을 이용한 유방 하수 교정술)

  • Kim, Kyung-Pil;Kim, Ji-Hoon;Hwang, Jae-Ha;Kim, Kwang-Seog;Lee, Sam-Yong
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.408-414
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    • 2011
  • Purpose: To correct breast ptosis, reduction mammoplasty and mastopexy have been developed in a way that minimizes complications. Recently, as the mean age of breast cancer occurrence is decreasing, the need for breast reconstruction in patients with breast cancer is rising. If mastopexy is performed with breast reconstruction at the same time, the size of the normal breast and the new one is not quite different. We decided to apply Z-plasty, which is a widely-used technique in plastic surgery to lengthen or change the direction of tension of the tissue. Methods: From March 2008 to December 2009, we performed breast reconstruction in 6 patients with breast cancer and scar contracture. After breast reconstruction, mastopexy with Z-plasty was applied to correct the asymmetry. The new nipple-areolar complex is placed on the line connecting the midclavicle and the current nipple. The inferior border of the new areola corresponds with the inferior border of the original areola, and the superior border about 2 cm upward the original superior border. We drew two oblique lines connecting the medial end of the incision line lower to the nipple-areola complex and the lateral end of the inframammary fold for Z-plasty. The excess tissue between these two lines was removed and the new triangular flaps were put together. Results: The average age of patients was 42.6 years, aged from 36.1 to 48.1 The weight of removed tissue was between 54g and 95 g, with the mean of 74 g. The average distance from the midclavicle to the nipple was 24 cm before surgery, and 21 cm after the surgery. The average operation time per patient (1 mastopexy) was 45 minutes, and the patients were satisfied with the size and shape. Conclusion: Applying Z-plasty for the mastopexy on the normal breast ptosis is a relatively simple way to achieve symmetry in patients who need breast reconstruction.

Usefulness of Muscle Plication and Synthetic Mesh in Breast Reconstruction Using TRAM Pedicled Flap (배곧은근피판을 이용한 유방재건 시 복벽의 주름형성과 합성그물을 이용한 복부성형술의 유용성)

  • Park, Jung Min;Park, Su Seong;Lee, Keun Cheol;Kim, Seok Kwun;Cho, Se Hyun
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.643-647
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    • 2006
  • Purpose: The transverse rectus abdominis myocutaneous(TRAM) flap has become a mainstay of breast reconstruction. The chief disadvantage of the TRAM flap is its potential to create a weakness in the abdominal wall. Nowadays true hernia is less frequent, but bulging that appears at the muscle donor site, or at the contralateral side, or at the epigastric area is still remained as a problem. To prevent this complications, we have used synthetic mesh as well as abdominal muscle plication. Now we report the result of our methods. Methods: We started to use synthetic mesh and muscle plication as supplementary reinforcement for entire abdominal wall, after TRAM flap harvesting, in an attempt to stabilize it and achieve a superior aesthetic result since 2002. We observed complications of TRAM flap donor site, and compared our results (from January, 2002 to January, 2006) with other operator's result (before 2001) at the same hospital in aspect of incidence of abdominal complications. Results: 42 consecutive patients have been performed routine reinforcement with the extended mesh technique and muscle plication from January, 2002 to January, 2006. Mean patient follow up was 25.2 months. No hernia or mesh related infection were encountered and only one patient had a mild abdominal bulging. Nevertheless the our good results, there were no significant statistical differences were observed between two groups. Conclusion: We recommend the using of synthetic mesh and muscle plication for donor site reconstruction after TRAM flap breast reconstruction to improve strength as well as aesthetic quality of the abdominal wall.

Closure of Atrial Septal Defects through a Video-assisted Mini-thoracotomy (흉강경하 최소절개를 이용한 심방중격결손의 폐쇄)

  • Min, Ho-Ki;Yang, Ji-Hyuk;Jun, Tae-Gook;Park, Pyo-Won;Choi, Seon-Uoo;Park, Seung-Woo;Min, Sun-Kyung;Lee, Jae-Jin
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.568-572
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    • 2008
  • Background: Minimally invasive surgery is currently popular, but this has been applied very sparingly to cardiac surgery because of some limitations. Our study evaluated the safety and efficacy of atrial septal defect (ASD) closure through a video-assisted mini-thoracotomy. Material and Method: Fifteen patients were analyzed. Their mean age was $31{\pm}6$ years. The mean ASD size was $24{\pm}5mm$ and there were 3 cases of significant tricuspid regurgitation. The working window was made through the right 4th intercostal space via a $4{\sim}5cm$ inframammary skin incision, CPB was conducted with performing peripheral cannulation. After cardioplegic arrest, the ASDs were closed with a patch (n=11) or direct sutures (n=4), and the procedures were assisted by using a thoracoscope. There were 3 cases of tricuspid repair and 1 case of mitral valve repair. The mean CPB time and aortic occlusion time were $160{\pm}47\;and\;70{\pm}26 $minutes, respectively. Result: There was no mortality, but there were 3 minor complications (one pneumothorax, one wound dehiscence and one arrhythmia). The mean hospital stay was $5.9{\pm}1.8$ days. The mean follow-up duration was $10.7{\pm}6.4$ months. The follow-up echocardiogram noted no residual ASD or significant tricuspid regurgitation. Three patients suffered from pain or numbness. Conclusion: This study showed satisfactory clinical and cosmetic results. Although the operative time is still too long, more experience and specialized equipment would make this technique a good option for treating ASD.