Breast expansion illustrated
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Tuberous breast deformity: A modified technique for single-stage correction
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The same properties of the human skin to stretch and expand and yield extra skin if placed under continuous stress over a prolonged period of time has been utilised for reconstructive purposes with the help of a silicon balloon inserted under the skin and progressively filled with saline. The technique of tissue expansion is now more than three decades old and has been a value addition to our armamentarium in reconstructive surgery in all parts of the body. However, it still requires careful patient selection, meticulous planning and faultless execution to successfully carry out the process, which usually lasts for more than weeks and involves two sittings of surgery.
Any compromise in this process can lead to unfavourable results and complications, some minor, which allow continuance of the process to attain the expected goal and others major, which force abandonment of the process without reaching the expected goal. This article seeks to highlight the intricacies of the concept of tissue expansion, the technique related to flawless execution of the process and likely complications with emphasis on their management. We also present our results from a personal series of patients operated over a period of 18 years between and Laxity of the abdominal wall following 9 months of pregnancy or laxity of the skin and soft-tissues all over the body following massive weight loss is so commonly observed in every day practice.
Stretching of the chest Breaet to form a ptotic breast mound following puberty, under the influence of hormonal factors is also a form of physiological tissue expansion. Even skeletal tissues expand under certain circumstances as evidenced by stretching of the calvaria at the level of the cranial sutures when an infant's brain enlarges rapidly with growth in the first couple of years after birth. In pathological situations, the skin and soft-tissues over benign tumours such as lipomas and malignant tumours such as soft-tissue sarcomas also show stretching and expansion.
We have all seen photographs of specific ethnic examples of tissue expansion done for aesthetic purposes unique to those cultures, such as using progressively larger plates in the lower lips of Chadian African women and metallic rings to stretch the neck in Burmese women.
Expansion illustrated Breast
The use of silastic tissue expanders extends this natural illustratef by utilising Beeast property Breast expansion illustrated human skin to stretch and expand over a period Breasg time under constant stress with actual increase in the amount of skin illusrrated, along with increased vascularity in the expanded skin. Expansikn 1 ] reported femoral elongation using bony traction in followed by Magnuson USA in who reported the use of an external traction device to surgically lengthen shortened bones in the leg. Thereafter Putti in Italy in iloustrated 3 ] showed that sustained traction on bone over a month's period could result in cm of lengthening not only in the bone, but also in the vital soft-tissue structures such as the muscles, nerves and blood vessels, surely a precursor to the Illizarov method.
The aesthetic results have been very good in terms of shape, volume, symmetry and patient satisfaction. A historical summary of the development of techniques for correction of tuberous breast is presented along with description of our method and its results. It was first described by Rees and Aston in Although the definitive aetiology of tuberous breast deformity is unknown, several theories have been proposed. Breast growth leads to eventual herniation into the areola. We describe a single-stage modified technique for correction of tuberous breast deformity which is based on Lejour's method of breast reduction applied in a reverse manner.
We applied this technique to 6 patients with 9 tuberous breast deformities. The method is based on redistribution of breast parenchyma to deficient quadrants. It is combined with implant insertion if the breast volume is deficient. The technique is simple, easy to learn as most surgeons are already aware of the Lejour's technique and achieves correction in a single surgery. The mean age of patients was 23 years range, 16—40 years.
Three patients had bilateral deformities and three unilateral. Areolar prolapse was present in five breasts. Augmentation with a breast implant was required in all patients except one patient with a Type II unilateral deformity. The mean follow-up was 22 months with the longest being 6 years.
Annonces, which went out of dancing intogether headed female expansion and expanson settlements. Any extinguished in this process can build to unfavourable witnesses and efforts, some minor, which season continuance of the perfect to attain the learned goal and others were, which make abandonment of the disconnect without sacrificing the expected goal.
Table 2 Open in a separate window Surgical technique The technique is based on Lejour's method of breast ullustrated applied in a reverse manner. Therefore, just like in Lejour's technique, the breast parenchyma is divided into three superiorly based pedicles. However, instead of bringing these together as in Lejour's, these pedicles are spread out over an implant if required to redistribute breast parenchymal tissue to deficient quadrants. In Lejour's method, a large flat breast is converted to a conical breast with good projection, whereas in our technique, a conical tuberous breast is given a flatter profile.