• Title/Summary/Keyword: 유방 재건술

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The legal status of the breast in assessing physical disability (신체장애 평가에서 유방의 법적 지위 - 장기 해당 여부, 수유장애, 노동력상실에 대하여 -)

  • Kim, Bong Kyum
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.265-295
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    • 2017
  • Breast tissue is composed of skin, mammary gland(including lactiferous duct), subcutaneous fat layer. The anatomical position is on the anterior chest wall(the outside of the chest cavity) but not on the inside of the thorax. Therefore, when the internal organs in the thoracic cavity are defined and expressed as 'organs' and the internal organs of each are labeled for a long time, for the breast located outside the thoracic cavity, it is thought that there is considerable difficulty in defining and recognizing the breast tissue as organs. For this reason, it is necessary to discourage the controversy over whether or not the breast is contained in the chest(or intra-thoracic cavity). In order to completely exclude it, it is assumed that the "chest-abdomen" can be called the "intra-thoraxic or intra-abdominal." But it is difficult to change the terms in various laws and regulations, I think that it would be necessary to insert only the clue clause "Breasts are excluded" in the detailed criteria for grading. In order to include it, it is necessary to change the terms of the ordinance or to say that the breast is exceptionally included.

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Classification of Deep Inferior Epigastric Perforator Courses Based on Computed Tomography Angiography: Incidences and Clinical Implications (컴퓨터 단층 촬영 혈관 조영술을 이용한 심하복벽 혈관과 천공지의 박리 용이성에 따른 분류)

  • Lee, Yeonhoon;Kim, Sung Chan;Eom, Jin Sup;Kim, Eun Key
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.281-289
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    • 2018
  • Purpose: Preoperative surgical planning utilizing computed tomography angiography (CTA) has now become a routine in many practices. We analyzed the course of the deep inferior epigastric artery (DIEA) and its perforators (DIEP) that would either facilitate or hinder flap dissection based on CTA to aid surgical planning. Methods: The 115 consecutive patients who underwent abdominally based free flap breast reconstruction were enrolled in this prospective study. DIEA/P courses were categorized mainly according to their intramuscular courses and their incidences were investigated. Results: A total of 425 perforators were identified preoperatively on the CTA, with an average number of 3.7 distinctly visualized in the entire flap territory. Eighty-nine perforators (20.9%) had a favorable (less than 1 cm intramuscular course) pattern, namely long submuscular (34.8% of the patients), long subfascial (15.6%), and total circummuscular (13.9%). Overall 56.5% of the patients had at least one favorable DIEA/P. On the other hand, absence of DIEA and absence of adequate (>1 mm) DIEP was reported in 3 and 8 hemiabdomen. Conclusion: Preoperative CTA evaluation of DIEA/P can be used to identify favorable as well as unfavorable courses for dissection to aid surgical planning.

Evaluation of artifacts around the breast expander according to magnetic field strength (자장의 세기에 따른 유방 확장기 주위의 인공물 평가)

  • Jung, Dong- Il;Kim, Jae-Seok
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.24 no.9
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    • pp.1144-1149
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    • 2020
  • The magnetic valve of the breast tissue expander generates imaging artifacts during MRI examination, so MRI examination is limited. To evaluate the effect of imaging artifacts on the diagnosis area for patients with breast tissue expander who need MRI examination. Imaging artifacts were measured using self-made phantoms and actual clinical conditions. Imaging artifacts were measured differently depending on the environment of 1.5 Tesla and 3.0 Tesla, and the effects of imaging artifacts were less in the C-spine and L-spine tests. If MRI due to breast cancer metastasis is absolutely necessary, head & neck examination and L-spine can be examined mainly at 1.5 Tesla, but some sequences may cause distortion due to image artifacts. In terms of safety, MRI scans of patients with breast tissue expanders can be performed conditionally at 1.5T, avoiding 3.0T.

Evaluation of MR Safety of Breast Expander on 1.5T and 3.0T MRI (유방 조직 확장기의 1.5T와 3.0T MRI 환경 내 안정성 평가)

  • Jung, Dong-Il;Kim, Jae-Seok
    • Journal of the Korean Society of Radiology
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    • v.14 no.4
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    • pp.361-366
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    • 2020
  • The purpose of this study is to evaluate the safety of the breast tissue expander implanted patients who require MRI examination. Torques were 0ml, 150 ml, 300 ml, 450 ml at 1.5 Tesla forward direction, 4, 3, 3, and 2 respectively, and 1.5 Tesla reverse direction at 4, 4, 4, 3 respectively. In the 3.0 T environment, 4 was shown in all conditions. In the overturning experiment, no overturning occurred in more than 300 ml in the 1.5Tesla environment, and most of the overturning occurred in the 3.0 Tesla environment. In terms of safety, MRI scans of patients with breast tissue expanders should be avoided at 3.0 Tesla and conditionally at 1.5 Tesla.

Understanding Silicone Breast Implant-Associated Complications for Radiologists (영상의학과 의사들을 위한 실리콘 유방 보형물 관련 합병증의 이해)

  • Jeongmin Lee;Sung Hun Kim;Jae Hee Lee;Boo Kyung Han
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.49-65
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    • 2021
  • With the increase in the number of cases of silicone implant insertion either for cosmetic surgery or breast reconstruction after mastectomy, it is not unusual to encounter patients with silicone implants in clinical settings. Recently, the first case of breast implant-associated anaplastic large cell lymphoma was reported in Korea. In addition to previously known complications, such as implant rupture or contracture, the number of implant-associated imaging examinations has also increased. Considering this background, radiologists should have sufficient knowledge about the type of examination required in patients who have undergone implant insertion and imaging findings to correctly identify implant-associated complications. In this article, various complications of silicone implants are discussed, including various imaging findings, which radiologists should know.

Evaluation of Usefulness of Image by Using New Compression Paddle for Mammoplasty Patient During Mammography (유방촬영 시 유방보형물 환자에 대한 새로운 압박대 적용의 유용성 평가)

  • Hong, Dong-Hee
    • Journal of radiological science and technology
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    • v.38 no.3
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    • pp.229-235
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    • 2015
  • Mammoplasty is currently increasing not only for cosmetic surgery, but as well as for the recovery after breast cancer surgery. The prostheses inserted into the breasts of women who have undergone mammoplasty, hide the breast substances and it is becoming increasingly difficult to diagnose breast disease, and fear is growing by the concern of the prostheses bursting by the strap. So we want to develop a strap applicable to women with prostheses inserted, to determine the usefulness, and we also want to compare the utility by comparing the total area of the Inner and Outer parts of the breast and Posterior Nipple Line (PNL), after obtaining video by applying the existing strap and the developed strap to phantom of the prostheses inserted patient shape. When the pressure by the developed pressure, the total area increased by 10.09% from CC view to $9,813.797mm^2$, 3.88% from CC-ID view to $7,621.531mm^2$, PNL increased by 3.41% from CC view to $90.916mm^2$, 1.64% from CC-ID view to$75.357mm^2$. And the breast tissue of the thorax side increased 3.53% from CC view to $177.725mm^2$, and 6.57% from CC-ID view to $152.510mm^2$, and we could verify that the prostheses were completely eliminated in the CC-ID images of developed strap, compared with the existing strap.

Oncological and Aesthetic Outcomes of Nipple-Areolar Complex(NAC) Sparing Mastectomy and Immediate Breast Reconstruction (유둔-유륜 복합체 보존 유방절제술 및 즉시 유방 재건술 후 종양학적 미용학적 결과)

  • Park, Chan Woo;Ahn, Hee Chang;Kim, Youn Hwan;Jung, Min Sung
    • Archives of Reconstructive Microsurgery
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    • v.21 no.2
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    • pp.118-130
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    • 2012
  • Background: Women receiving mastectomy usually prefer a single-stage surgical procedure without the need for additional surgery. Hence, nipple sparing mastectomy was introduced, and the follow-up data on the aesthetic outcome and recurrence of breast cancer were investigated in this study. Materials and Methods: The study subjects comprised 22 patients who received nipple-sparing mastectomy and immediate breast reconstruction using the free transverse abdominal rectus abdominis myocutaneous flap between June of 2007 and June of 2012. The patients' aesthetic outcomes were measured with 2 methods for the objective result: Breast size measurements and breast volume calculation both at preoperative phase and postoperative 1 years phase. Also, the patients' satisfaction was evaluated at postoperative 1 year with the self-assessment questionnaire. Follow up check for assessing cancer recurrence was performed for an average period of postoperative 1063 days. Results: First, in objective aesthetic outcome, there were no significant differences between the preoperative and postoperative results on both the breast size and the volume. Second, the patient satisfaction analysis scores were graded as very good in 15 patients (68.2%), and as good in 6 patient (27.3%). Most of the patients were very satisfied with our surgery method. Last, there was no local or distant recurrence in these 22 patients during the follow-up period. Conclusion: In this study, the nipple-sparing mastectomy achieved satisfactory results for the breast scar and shape with a single-stage surgical procedure, and the cancer recurrence rate was not significantly different from that of the conventional mastectomy. Besides, the nipple-sparing mastectomy is more cost-effective than the conventional mastectomy since it reduces the need for additional procedures. However, we think that it is necessary to determine the long-term outcomes about the recurrence rate.

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Breast Reconstruction after Modified Radical Mastectomy with Becker Permanent Tissue Expander (변형 근치 유방절제술 후 Becker 확장형 보형물을 이용한 유방 재건술)

  • Hong, Yong Taek;Yoon, Eul Sik;Choi, Kyu Jin;Dhong, Eun Sang;Son, Gil Soo
    • Archives of Plastic Surgery
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    • v.34 no.2
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    • pp.222-228
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    • 2007
  • Purpose: Report of the good results of breast reconstruction using Becker permanent tissue expander that showed a short operation time and a quick post-operation recovery time, little side effects and usually superb aesthetic results without the need for additional incisions or donor site morbidity. The authors, after carrying out breast reconstruction operations using Becker permanent tissue expander on patients with appropriate indications, attempted to analyze several factors such as complication rates and patient satisfaction measurements. Methods: 11 cases of breast reconstruction using Becker expander implants were carried out on a total of 10 patients between March 2000 and February 2003. The patients were followed up at outpatient visit for an average of 6 months. Results: The most common post-operation complication was pain resulting from saline injection into the expanders, complained by 5 patients(50%). rib fractures, skin necrosis, implant removal due to infection, and breast cancer recurrence each occurred in 1 patient (9.9%). There was no occurrence of skin contracture complications which occurs frequently in case of silicone implant insertion. Patient complacency was surveyed by patient interviews made right after the operations and during outpatient follow-up periods: 5(50%) patients out of 10 showed excellent, 3(30%) good, and 2(20%) showed fair, leaving no patients who were disappointed with operation results. On routine follow-up, 80% of patients expressed satisfaction with the cosmetic outcome of their post-mastectomy beast reconstruction. Conclusion: Breast reconstruction using the Becker expander is a reliable alternative to other reconstructive methods but good patient selection is essential for satisfactory results.

Transabdominal Augmentation of Contralateral Breast in TRAM Breast Reconstruction (횡복직근 피판을 이용한 유방 재건시 복부 절개선을 통한 반대측 유방 확대술)

  • Kim, Eun Key;Lee, Taik Jong
    • Archives of Plastic Surgery
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    • v.36 no.1
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    • pp.29-32
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    • 2009
  • Purpose: Introduction of the mammary implant through the abdominal route has been well known since late 1960s, but the use of transabdominal route for contralateral breast augmentation in transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction patients has not been reported in Korean literature. The authors report their experience with technical points as well as the selection of the appropriate patients. Methods: Simultaneous contralateral augmentation mammaplasty through transabdominal route was performed in 11 patients who underwent TRAM breast reconstruction from August 2003 to May 2008 with a mean follow up of 27 months. The pocket was created under direct vision: 3 subglandular, 7 subpectoral, and 1 dual plane was dissected. Eight saline and 3 silicone gel implants were used with an average volume of 165 cc. Results: There were no complications such as infection, hematoma, implant displacement, and capsular contracture. The result was well maintained throughout the follow up period. Conclusion: Transabdominal route could be recommended in selected patients for contralateral augmentation in TRAM breast reconstruction.