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Chen J, Sun Y, Liu Q, Yip J, Yick KL. Construction of multi-component finite element model to predict biomechanical behaviour of breasts during running and quantification of the stiffness impact of internal structure. Biomech Model Mechanobiol 2024:10.1007/s10237-024-01862-2. [PMID: 38806750 DOI: 10.1007/s10237-024-01862-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 05/15/2024] [Indexed: 05/30/2024]
Abstract
This study aims to investigate the biomechanical behaviour and the stiffness impact of the breast internal components during running. To achieve this, a novel nonlinear multi-component dynamic finite element method (FEM) has been established, which uses experimental data obtained via 4D scanning technology and a motion capture system. The data are used to construct a geometric model that comprises the rigid body, layers of soft tissues, skin, pectoralis major muscle, fat, ligaments and glandular tissues. The traditional point-to-point method has a relative mean absolute error of less than 7.92% while the latest surface-to-surface method has an average Euclidean distance (d) of 7.05 mm, validating the simulated results. After simulating the motion of the different components of the breasts, the displacement analysis confirms that when the motion reaches the moment of largest displacement, the displacement of the breast components is proportional to their distance from the chest wall. A biomechanical analysis indicates that the stress sustained by the breast components in ascending order is the glandular tissues, pectoralis major muscle, adipose tissues, and ligaments. The ligaments provide the primary support during motion, followed by the pectoralis major muscle. In addition, specific stress points of the breast components are identified. The stiffness impact experiment indicates that compared with ligaments, the change of glandular tissue stiffness had a slightly more obvious effect on the breast surface. The findings serve as a valuable reference for the medical field and sports bra industry to enhance breast protection during motion.
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Affiliation(s)
- Jiazhen Chen
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Yue Sun
- School of Fashion Design and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Qilong Liu
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Joanne Yip
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Kit-Lun Yick
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
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2
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Duraes M, Briot N, Connesson N, Chagnon G, Payan Y, Duflos C, Rathat G, Captier G, Subsol G, Herlin C. Evaluation of breast skin and tissue stiffness using a non-invasive aspiration device and impact of clinical predictors. Clin Anat 2024; 37:329-336. [PMID: 38174585 DOI: 10.1002/ca.24134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/01/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
A personalized 3D breast model could present a real benefit for preoperative discussion with patients, surgical planning, and guidance. Breast tissue biomechanical properties have been poorly studied in vivo, although they are important for breast deformation simulation. The main objective of our study was to determine breast skin thickness and breast skin and adipose/fibroglandular tissue stiffness. The secondary objective was to assess clinical predictors of elasticity and thickness: age, smoking status, body mass index, contraception, pregnancies, breastfeeding, menopausal status, history of radiotherapy or breast surgery. Participants were included at the Montpellier University Breast Surgery Department from March to May 2022. Breast skin thickness was measured by ultrasonography, breast skin and adipose/fibroglandular tissue stiffnesses were determined with a VLASTIC non-invasive aspiration device at three different sites (breast segments I-III). Multivariable linear models were used to assess clinical predictors of elasticity and thickness. In this cohort of 196 women, the mean breast skin and adipose/fibroglandular tissue stiffness values were 39 and 3 kPa, respectively. The mean breast skin thickness was 1.83 mm. Only menopausal status was significantly correlated with breast skin thickness and adipose/fibroglandular tissue stiffness. The next step will be to implement these stiffness and thickness values in a biomechanical breast model and to evaluate its capacity to predict breast tissue deformations.
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Affiliation(s)
- Martha Duraes
- Department of Breast Surgery, Montpellier University Hospital, Montpellier, France
- Faculty of Medicine Montpellier-Nîmes, Laboratory of Anatomy of Montpellier, Montpellier University, Montpellier, France
- Research-Team ICAR, LIRMM, University of Montpellier, Montpellier, France
| | - Noemie Briot
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, Grenoble, France
| | - Nathanael Connesson
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, Grenoble, France
| | - Gregory Chagnon
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, Grenoble, France
| | - Yohan Payan
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, TIMC, Grenoble, France
| | - Claire Duflos
- Department of Clinical Unit Epidemiology, Montpellier University Hospital, Montpellier, France
| | - Gauthier Rathat
- Department of Breast Surgery, Montpellier University Hospital, Montpellier, France
| | - Guillaume Captier
- Faculty of Medicine Montpellier-Nîmes, Laboratory of Anatomy of Montpellier, Montpellier University, Montpellier, France
- Research-Team ICAR, LIRMM, University of Montpellier, Montpellier, France
| | - Gerard Subsol
- Research-Team ICAR, LIRMM, University of Montpellier, Montpellier, France
| | - Christian Herlin
- Research-Team ICAR, LIRMM, University of Montpellier, Montpellier, France
- Department of Plastic Surgery, Montpellier University Hospital, Montpellier, France
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McGhee DE, Steele JR. Changes to breast structure and function across a woman's lifespan: Implications for managing and modeling female breast injuries. Clin Biomech (Bristol, Avon) 2023; 107:106031. [PMID: 37379771 DOI: 10.1016/j.clinbiomech.2023.106031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 05/02/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Female breasts change throughout a woman's life in response to fluctuating hormonal influences. Individuals managing active women and those modeling female breasts must understand these structural and functional changes across a female's lifespan because these changes affect breast injuries sustained by women. METHODS We initially review female breast structure and function and then describe how breast structure changes across a woman's lifespan. Key studies about direct contact and frictional breast injuries are then summarized. Limitations of current breast injury research, gaps in knowledge about breast injuries incurred by specific populations, and the lack of breast injury models are also highlighted. FINDINGS With minimal anatomical protection, it is unsurprising that breast injuries occur. Although research about breast injuries is scant, direct contact during blunt force trauma to the anterior chest wall and frictional breast injuries have been reported. There is a lack, however, of research documenting the incidence and severity of breast injuries incurred in occupational settings and in women's sports. Therefore, to design effective breast protective equipment, we recommend research to model and investigate the mechanisms and forces involved in breast injuries, particularly injuries sustained during sport. INTERPRETATION This unique review summarizes how female breasts change over a woman's life span, with implications for breast injuries sustained by females. Knowledge gaps about female breast injuries are highlighted. We conclude by recommending research required to develop evidence-based strategies to improve how we classify, prevent, and clinically manage breast injuries sustained by females. SUMMARY We review changes to the breast across a woman's lifespan, highlighting implications for managing and modeling female breast injuries.
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Affiliation(s)
- Deirdre E McGhee
- Breast Research Australia, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong, Australia.
| | - Julie R Steele
- Breast Research Australia, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong, Australia.
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Chen W, Lu W, Yuan Y, Li L, Deng H, Ye X. The role of ultrasound quantitative parameters in the assessment of acute radiodermatitis after breast-conserving surgery. JOURNAL OF RADIATION RESEARCH 2023:7153713. [PMID: 37154691 DOI: 10.1093/jrr/rrad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/14/2022] [Indexed: 05/10/2023]
Abstract
This study aimed to assess the severity of acute radiodermatitis (ARD) by ultrasound quantitative parameters and to try to identify the influencing factors of skin toxicity. A total of 55 patients who underwent radiotherapy after unilateral breast-conserving surgery (BCS) were included in the study. The irradiated side of the breast was used as the research object and the quantitative ultrasound parameters (skin thickness, shear wave elasticity) were evaluated before radiotherapy, every week during radiotherapy. Two weeks after radiotherapy, the patients were divided into two groups, according to the World Health Organization scoring standard: mild (0-2 grade) and severe (3-4 grade). The differences in the parameters between the groups and the changes during radiotherapy were compared, and the relationship between these parameters and the severity of ARD was analyzed. In addition, some clinical factors that may affect ARD were also included in our study. Ninety-eight percent of patients developed different degrees of ARD, and Group 2 accounted for ~31%. At the end of 5 weeks of radiotherapy, the difference in thickness between the two groups was statistically significant (P < 0.05). There was no significant change in the elastic modulus of breast skin between the two groups (P > 0.05). Body mass index >25 kg/m2, breast thickness ≥18 mm, skin basic elastic modulus <23 kPa and skin thickness increment >0.3 mm were considered to be associated with severe skin reactions (P < 0.05). Ultrasound can be a useful tool for the non-invasive and objective assessment of skin changes during radiotherapy, documenting quantitative changes in the skin of breast cancer patients following BCS undergoing radiotherapy.
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Affiliation(s)
- Wenqin Chen
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Wenjuan Lu
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Ya Yuan
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Lu Li
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Hongyan Deng
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Xinhua Ye
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
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Zhang J, Liang R, Lau N, Lei Q, Yip J. A Systematic Analysis of 3D Deformation of Aging Breasts Based on Artificial Neural Networks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:468. [PMID: 36612790 PMCID: PMC9819929 DOI: 10.3390/ijerph20010468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
The measurement and prediction of breast skin deformation are key research directions in health-related research areas, such as cosmetic and reconstructive surgery and sports biomechanics. However, few studies have provided a systematic analysis on the deformations of aging breasts. Thus, this study has developed a model order reduction approach to predict the real-time strain of the breast skin of seniors during movement. Twenty-two women who are on average 62 years old participated in motion capture experiments, in which eight body variables were first extracted by using the gray relational method. Then, backpropagation artificial neural networks were built to predict the strain of the breast skin. After optimization, the R-value for the neural network model reached 0.99, which is within acceptable accuracy. The computer-aided system of this study is validated as a robust simulation approach for conducting biomechanical analyses and predicting breast deformation.
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Affiliation(s)
- Jun Zhang
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Ruixin Liang
- Laboratory for Artificial Intelligence in Design, Hong Kong Science Park, New Territories, Hong Kong, China
| | - Newman Lau
- School of Design, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Qiwen Lei
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Joanne Yip
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
- Laboratory for Artificial Intelligence in Design, Hong Kong Science Park, New Territories, Hong Kong, China
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Van Nuffel M, Meulyzer C, Gheysen B, Böhrer A, Anthonissen M, Van den Kerckhove E, Degreef I. Palmar skin elasticity measured by the Cutometer MPA 580 is decreased in mild Dupuytren's disease compared to healthy controls. HAND THERAPY 2022; 27:14-21. [PMID: 37904791 PMCID: PMC10584061 DOI: 10.1177/17589983211061616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/04/2021] [Indexed: 11/01/2023]
Abstract
Introduction Involvement of the palmar skin is often seen in patients with Dupuytren's disease (DD) with severe finger contractures. However, skin elasticity may be already decreased earlier in the disease. The Cutometer MPA 580 could provide an objective skin measurement tool to assess this decrease in elasticity. Linking objective skin measurements to functional outcome measures could lead to better prediction of disease progression. We set up a study to investigate if the Cutometer was able to detect differences in skin elasticity between patients with mild Dupuytren's disease and healthy controls. Methods A cross-sectional analytical study was performed. Three assessors measured skin elasticity (palmar hand) on two sites using the Cutometer on 30 patients with mild DD and 30 healthy controls. Student's t-test was used to evaluate differences in skin elasticity and a linear model to evaluate interactions between the groups and sites. Results Significant differences in skin elasticity were found between DD patients and controls, as well as differences based on the location examined. Discussion Similar to other skin conditions, the Cutometer MPA 580 was able to demonstrate a significant lower elasticity in the palmar skin in DD patients compared to healthy controls. A decrease in skin elasticity in different locations of the hand correlated with areas that often pose problems in the treatment of more severe DD. The Cutometer could potentially be a tool to identify these areas earlier in the disease.
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Affiliation(s)
- Maarten Van Nuffel
- Department of Medical Sciences, KU Leuven-University of Leuven; Hand Unit, Department of Orthopaedic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Caroline Meulyzer
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Britt Gheysen
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Arne Böhrer
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Mieke Anthonissen
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
- Oscare, Organisation for Burns, Scar After-care and Research, Antwerp, Belgium
| | - Eric Van den Kerckhove
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
- Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ilse Degreef
- Department of Medical Sciences, KU Leuven-University of Leuven; Hand Unit, Department of Orthopaedic Surgery, University Hospitals Leuven, Leuven, Belgium
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Janzekovic J, Hunt J, Peltz T, Wagels M, Brown T, Hutmacher DW. Biomechanical Principles of Breast Implants and Current State of Research in Soft Tissue Engineering for Cosmetic Breast Augmentation. Aesthetic Plast Surg 2022; 46:1-10. [PMID: 34494126 DOI: 10.1007/s00266-021-02559-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/22/2021] [Indexed: 12/17/2022]
Abstract
Currently there are limited implant-based options for cosmetic breast augmentation, and problems associated with those have been increasingly appreciated, most commonly capsular contracture, which occurs due to a chronic foreign body reaction against non-degradable implant materials such as silicone and polyurethane leading to scar tissue formation, pain, and deformity. The underlying biomechanical concepts with implants create a reciprocal stress-strain relationship with local tissue, whilst acting as a deforming force. This means that with time, as the implant continues to have an effect on surrounding tissue the implant and host's biomechanical properties diverge, making malposition, asymmetry, and other complications more likely. Research directed towards development of alternative therapies based on tissue engineering and regenerative medicine seeks to optimize new tissue formation through modulation of tissue progenitors and facilitating tissue regeneration. Scaffolds can guide the process of new tissue formation by providing both an implant surface and a three-dimensional space that promotes the development of a microenvironment that guides attachment, migration, proliferation, and differentiation of connective tissue progenitors. Important to scaffold design are the architecture, surface chemistry, mechanical properties, and biomaterial used. Scaffolds provide a void in which vascularization, new tissue formation, and remodelling can sequentially occur. They provide a conduit for delivery of the different cell types required for tissue regeneration into a graft site, facilitating their retention and distribution. Whilst recent research from a small number of groups is promising, there are still ongoing challenges to achieving clinical translation. This article summarizes the biomechanical principles of breast implants, how these impact outcomes, and progress in scaffold-guided tissue engineering approaches to cosmetic breast augmentation. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Jan Janzekovic
- Centre for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, QLD, 4000, Australia
- Plastic and Reconstructive Surgery, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, QLD, 4102, Australia
| | - Jeremy Hunt
- Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Tim Peltz
- Centre for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, QLD, 4000, Australia
- Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
- St Luke's and Prince of Wales Hospital Plastic Surgery Research Group, Potts Point, NSW, 2011, Australia
| | - Michael Wagels
- Plastic and Reconstructive Surgery, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, QLD, 4102, Australia
- St Luke's and Prince of Wales Hospital Plastic Surgery Research Group, Potts Point, NSW, 2011, Australia
| | - Tim Brown
- Centre for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, QLD, 4000, Australia.
- Plastic Surgeon in Private Practice in Melbourne, 40-42 Clyde Road, Suite 2, Berwick, VIC, 3806, Australia.
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, Brisbane, QLD, 4000, Australia.
| | - Dietmar W Hutmacher
- Centre for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, QLD, 4000, Australia
- School of Mechanical, Medical and Process Engineering, Science and Engineering Faculty, Queensland University of Technology, Brisbane, QLD, 4000, Australia
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4000, Australia
- ARC ITTC in Additive Biomanufacturing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, 4000, Australia
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Brisbine BR, Steele JR, Phillips EJ, McGhee DE. Can Physical Characteristics and Sports Bra Use Predict Exercise-Induced Breast Pain in Elite Female Athletes? Clin J Sport Med 2021; 31:e380-e384. [PMID: 32073475 DOI: 10.1097/jsm.0000000000000831] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 01/19/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate whether a simple 4-factor model using self-reported data could be used to predict exercise-induced breast pain in elite female athletes. DESIGN Survey study. SETTING Online or hard-copy surveys completed at sporting competitions and training facilities around Australia. PARTICIPANTS Four hundred ninety female athletes competing nationally or internationally across 49 sports. INDEPENDENT VARIABLES A binomial logistic regression analysis was used to evaluate the strength of a predictive model that included 2 continuous independent variables (age and body mass index) and 2 binary independent variables (breast size and sports bra use). Odds ratios were also calculated to determine the likelihood of an athlete reporting exercise-induced breast pain in association with each of the 4 variables. MAIN OUTCOME MEASURES Exercise-induced breast pain was the binary dependent variable. RESULTS The model incorporating athlete age, breast size, body mass index, and sports bra use was found to be statistically significant, but weak, in its ability to predict exercise-induced breast pain in elite female athletes (correctly identified 66% of athletes). For every 1-year increase in age, a significant 2.6% increase in the likelihood of experiencing exercise-induced breast pain was observed. Athletes with medium-to-hypertrophic sized breasts were 5.5 times more likely to experience exercise-induced breast pain than athletes with small breasts. CONCLUSIONS Although the current model was not sensitive enough for use by clinicians and coaches, age and breast size were both identified as critical variables in the prediction of exercise-induced breast pain. Future research is encouraged to investigate whether incorporating additional variables such body fat percentage, bra fit, and other relevant factors can add strength to the model.
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Affiliation(s)
- Brooke R Brisbine
- the Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Australia
- Applied Technology & Innovation, Australian Institute of Sport, Canberra, Australia ; and
| | - Julie R Steele
- the Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Australia
| | - Elissa J Phillips
- Performance Networks & Partnerships, Australian Institute of Sport, Canberra, Australia
| | - Deirdre E McGhee
- the Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Australia
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Pontello J, Roxo AC, Abreu ML, Torezani R, Pamplona D. Relation Between Post-Augmentation Parenchymal Atrophy and Local Tissue Pressure. Aesthet Surg J 2021; 41:NP1486-NP1495. [PMID: 34096996 DOI: 10.1093/asj/sjab242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Breast parenchyma interacts dynamically with an inserted implant, which may lead to local atrophy and sensory involvement, changes in vascular tissue and lactation, and volume reduction over time. The inversely proportional relationship between pressure and volume cannot be stated with certainty; that is, the larger implants having more local pressure would lead to compression, thus leading to atrophy of parenchyma more intensely compared with smaller implants. The objective of this study was to assess and list breast parenchyma volume changes with different pressure levels due to silicone implants of several sizes. OBJECTIVES The authors sought to list the pressure exerted by silicone implants and the atrophy caused in the breast tissue. METHODS Thirty-six women were placed in 3 groups (n = 12) and subjected to augmentation mammoplasty in the subglandular plane. The measurement of pressure in millimeters of mercury was conducted with help of molds with the same base and projection of implants introduced posteriorly. MRI was conducted in all participants in the preoperative period and at 6 and 12 months after surgery. RESULTS Twelve months after breast implant insertion, the groups had a significant glandular volume reduction (mean, 12.97% in the right breast and 12.42% in the left breast). There was a statistically significant difference in the proportions of volume reduction and the pressure levels measured. CONCLUSIONS A reduction in breast volume was verified. This reduction was also related to the level of pressure exerted on the implant. LEVEL OF EVIDENCE: 3
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Affiliation(s)
- João Pontello
- Division of Plastic Surgery, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Ana Claudia Roxo
- Division of Plastic Surgery, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Maria Lidia Abreu
- Division of Plastic Surgery, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Rodrigo Torezani
- Division of Radiology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Djenane Pamplona
- Division of Mechanical Engineering PUC RIO, Rio de Janeiro, Brazil
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10
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van Dongen JA, Boxtel JV, Willemsen JC, Brouwer LA, Vermeulen KM, Tuin AJ, Harmsen MC, van der Lei B, Stevens HP. The Addition of Tissue Stromal Vascular Fraction to Platelet-Rich Plasma Supplemented Lipofilling Does Not Improve Facial Skin Quality: A Prospective Randomized Clinical Trial. Aesthet Surg J 2021; 41:NP1000-NP1013. [PMID: 33687052 DOI: 10.1093/asj/sjab109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Lipofilling has become popular as a treatment to improve aging-related skin characteristics (eg, wrinkles, pigmentation spots, pores, or rosacea). Different additives such as platelet-rich plasma (PRP) or stromal vascular fraction (SVF) have been combined with lipofilling to increase the therapeutic effect of adipose-derived stromal cells (ASCs). OBJECTIVES The aim of this study was to examine the hypothesis that mechanically isolated SVF augments the therapeutic effect of PRP-supplemented lipofilling to improve facial skin quality. METHODS This prospective, double-blind, placebo-controlled, randomized trial was conducted between 2016 and 2019. In total, 28 female subjects were enrolled; 25 completed the follow-up. All patients received PRP-supplemented lipofilling with either mechanically isolated SVF or saline. SVF was isolated by fractionation of adipose tissue (tSVF). Results were evaluated by changes in skin elasticity and transepidermal water loss, changes in skin-aging-related features, ie, superficial spots, wrinkles, skin texture, pores, vascularity, and pigmentation, as well as patient satisfaction (FACE-Q), recovery, and number of complications up to 1 year postoperative. RESULTS The addition of tSVF to PRP-supplemented lipofilling did not improve skin elasticity, transepidermal water loss, or skin-aging-related features. No improvement in patient satisfaction with overall facial appearance or facial skin quality was seen when tSVF was added to PRP-supplemented lipofilling. CONCLUSIONS In comparison to PRP-supplemented lipofilling, PRP-supplemented lipofilling combined with tSVF does not improve facial skin quality or patient satisfaction in a healthy population. PRP-supplemented lipofilling combined with tSVF can be considered a safe procedure. LEVEL OF EVIDENCE: 2
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Affiliation(s)
| | - Joeri V Boxtel
- Catharina Hospital Eindhoven, Eindhoven, the Netherlands
| | - Joep C Willemsen
- Albert Schweitzer Hospital Dordrecht, Dordrecht, the Netherlands
| | - Linda A Brouwer
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center of Groningen, Groningen, the Netherlands
| | - Karin M Vermeulen
- Department of Epidemiology, University of Groningen and University Medical Center of Groningen, Groningen, the Netherlands
| | - Aartje Jorien Tuin
- Department of Maxillofacial Surgery, University of Groningen and University Medical Center of Groningen, Groningen, the Netherlands
| | - Martin C Harmsen
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center of Groningen, Groningen, the Netherlands
| | - Berend van der Lei
- Department of Plastic Surgery, University of Groningen and University Medical Center of Groningen, Groningen, the Netherlands
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11
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Jiao J, Lu H, Wang S. Photo-responsive prodrug nanoparticles for efficient cytoplasmic delivery and synergistic photodynamic-chemotherapy of metastatic triple-negative breast cancer. Acta Biomater 2021; 126:421-432. [PMID: 33774201 DOI: 10.1016/j.actbio.2021.03.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 02/19/2021] [Accepted: 03/17/2021] [Indexed: 02/07/2023]
Abstract
Triple-negative breast cancer (TNBC) have been considered as the most malignant subtype of breast cancer with leading incidence and mortality among females. Herein, photo-responsive prodrug nanoparticles (AlP/CPT-NPs) were designed with efficient cytoplasmic delivery of anti-cancer agent for cooperative photodynamic-chemotherapy. AlP/CPT-NPs were prepared using photosensitizer Al(III) phthalocyanine chloride disulfonic acid (AlP) and ROS-activatable camptothecin prodrug (CPT-PD). AlP/CPT-NPs could induce intracellular 1O2 generation upon light exposure, which not only initiate immediate disassembly of AlP/CPT-NPs but also promote cytoplasmic delivery of CPT through 1O2-mediated lysosomal rupture. The released intracellular CPT could be translocated into nuclei in only 5 min post-irradiation. Consequently, AlP/CPT-NPs efficiently suppressed the tumor growth and metastasis of TNBC in a spatiotemporally controlled manner, providing a promising option for effective treatment of metastatic TNBC. STATEMENT OF SIGNIFICANCE: Breast cancer is a complex disease with leading incidence among females, in which triple-negative breast cancer (TNBC) is considered as the most malignant subtype with increased risk of resistance, recurrence and metastasis. Herein, we designed photo-responsive prodrug nanoparticles (AlP/CPT-NPs) for synergistic treatment of metastatic TNBC. Upon 660 nm light exposure, the 1O2 generated by AlP/CPT-NPs could initiate immediate disassembly of AlP/CPT-NPs and further promote cytoplasmic delivery of the therapeutic payloads (camptothecin, CPT). The prepared AlP/CPT-NPs induced potent in vivo phototherapeutic damage through photodynamic-chemotherapy, resulting in complete tumor ablation with metastasis suppression.
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Affiliation(s)
- Jian Jiao
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning Province 110016, PR China
| | - Hongyan Lu
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning Province 110016, PR China
| | - Siling Wang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning Province 110016, PR China.
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Abstract
Although half the world's population will develop breasts, there is limited research documenting breast structure or motion. Understanding breast structure and motion, however, is imperative for numerous applications, such as breast reconstruction, breast modeling to better diagnose and treat breast pathologies, and designing effective sports bras. To be impactful, future breast biomechanics research needs to fill gaps in our knowledge, particularly related to breast composition and density, and to improve methods to accurately measure the complexities of three-dimensional breast motion. These methods should then be used to investigate breast biomechanics while individuals, who represent the full spectrum of women in the population, participate in a broad range of activities of daily living and recreation.
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Affiliation(s)
- Deirdre E McGhee
- Biomechanics Research Laboratory, University of Wollongong, Wollongong, Australia
| | - Julie R Steele
- Biomechanics Research Laboratory, University of Wollongong, Wollongong, Australia
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Abstract
More systematic breast biomechanics research and better translation of the research outcomes are necessary to provide information upon which to design better sports bras and to develop effective evidence-based strategies to alleviate exercise-induced breast pain for women who want to participate in physical activity in comfort.
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Affiliation(s)
- Deirdre E McGhee
- Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
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Sukhovei Y, Kostolomova E, Unger I, Koptyug A, Kaigorodov D. Difference between the biologic and chronologic age as an individualized indicator for the skin care intensity selection: skin topography and immune system state studies, parameter correlations with age difference. BIOMEDICAL DERMATOLOGY 2020. [DOI: 10.1186/s41702-019-0050-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
Abstract
Background
Present research addresses the issue of skin aging and corresponding skin treatment individualization. Particular research question was on the developing of simplified criterion supporting patient-specific decision on the necessity and intensity of skin treatment. Basing on the published results and a wide pool of experimental data, we have formulated a hypothesis that a difference between biologic and chronologic age can be used as an express criterion of skin aging.
Methods
In present paper, we report the results of studies with 80 volunteers between 15 and 65 years of age, linking parameters reflecting immune state, skin state, and topography to the difference between biologic and chronologic age. Facial skin topography, skin moisture, sebum level, and skin elasticity were studied using commercial devices. Blood immunology studies were performed using venous blood samples. Correlations between all measured parameters and age difference were calculated. Also, cross correlations between skin cell profile and blood immune profile parameters, and skin roughness parameters were calculated.
Results
Age dependencies of the blood immunological parameters on the biologic and chronologic age difference are less pronounced as compared to the changes in skin cell profile parameters. However, the changes in the tendencies when biologic age becomes equal to chronologic one are visible for all studied parameters.
All measured skin roughness parameters show correlations with age difference, but average skin roughness and depth of the deepest profile valley have the largest correlation coefficient values. Many of the measured skin cell profile and blood immunology parameters show strong correlations with average skin roughness and deepest profile valley, with some of the coefficients exceeding 0.5–0.6.
Conclusions
Basing on own experiments and published research results, it is possible to suggest using the difference between calculated biologic age and chronologic age as an individualized criterion supporting decisions on skin treatment strategy. Further research involving larger numbers of participants and aiming on optimizing the expressions for calculating biologic age could lead to reliable and easily available express criterion supporting the decision making for an individualized skin treatment.
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Spencer L, Fary R, McKenna L, Jacques A, Lalor J, Briffa K. The relationship between breast size and aspects of health and psychological wellbeing in mature-aged women. WOMEN'S HEALTH (LONDON, ENGLAND) 2020; 16:1745506520918335. [PMID: 32419664 PMCID: PMC7235664 DOI: 10.1177/1745506520918335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/12/2019] [Accepted: 03/02/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Increases in breast size with age are common but have not been widely examined as a factor that could affect the health and psychological wellbeing of mature-aged women. The purpose of this study was to examine the relationships between breast size and aspects of health and psychological wellbeing in mature-aged women. METHODS This was a cross-sectional study of mature-aged women (⩾40 years). Breast size (breast size score) was determined from self-reported bra size and was examined against health-related quality of life (Medical Outcomes Study Short-Form 36 and BREAST-Q), body satisfaction (numerical rating scale), breast satisfaction (BREAST-Q), physical activity levels (Human Activity Profile), the presence of upper back pain and breast and bra fit perceptions. RESULTS Two hundred sixty-nine women (40-85 years) with bra band sizes ranging from 8 to 26 and bra cup sizes from A to HH participated. The mean (standard deviation) breast size score of 7.7 (2.7) was equivalent to a bra size of 14DD. Increasing breast size was associated with significantly lower breast-related physical wellbeing (p < 0.001, R2 = 0.043) and lower ratings of body (p = 0.002, R2 = 0.024) and breast satisfaction (p < 0.001, R2 = 0.065). Women with larger breasts were more likely to be embarrassed by their breasts (odds ratio: 1.49, 95% confidence interval: 1.31 to 1.70); more likely to desire a change in their breasts (odds ratio: 1.55, 95% confidence interval: 1.37 to 1.75) and less likely to be satisfied with their bra fit (odds ratio: 0.84, 95% confidence interval: 0.76 to 0.92). Breast size in addition to age contributed to explaining upper back pain. For each one-size increase in breast size score, women were 13% more likely to report the presence of upper back pain. CONCLUSION Larger breast sizes have a small but significant negative relationship with breast-related physical wellbeing, body and breast satisfaction. Larger breasts are associated with a greater likelihood of upper back pain. Clinicians considering ways to improve the health and psychological wellbeing of mature-aged women should be aware of these relationships.
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Affiliation(s)
- Linda Spencer
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Robyn Fary
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Leanda McKenna
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Angela Jacques
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Jennifer Lalor
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Kathy Briffa
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
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Sukhovei Y, Kostolomova E, Unger I, Koptyug A, Kaigorodov D. Difference between the biologic and chronologic age as an individualized indicator for the skincare intensity selection: skin cell profile and age difference studies. BIOMEDICAL DERMATOLOGY 2019. [DOI: 10.1186/s41702-019-0051-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Abstract
Background
The present research addresses the issue of skin aging and corresponding skin treatment individualization. Particular research question was on the development of a simplified criterion supporting patient-specific decisions about the necessity and intensity of skin treatment. Basing on published results and a wide pool of our own experimental data, a hypothesis is formulated that a difference between biologic and chronologic age can be used as a powerful indicator of skin aging.
Methods
In the present paper, we report the results of studies with 80 volunteers between 15 and 65 years of age linking skin cell profile parameters to biologic and chronologic age. Biologic age was calculated using the empirical expressions based on the forced vital lung capacity, systolic blood pressure, urea concentration, and blood cholesterol level. Epidermis and derma cellular structures were studied using skin biopsy samples taken from the gluteal region.
Results
The present study supports the conclusion that biologic and chronologic age difference is changing in the progress of life. Our studies are showing that time point when calculated biologic age becomes equal to the chronologic one reflecting the onset of specific changes in the age dependencies of experimentally measured skin cell profile parameters. Thus, it is feasible that a difference between chronologic and individually assessed biologic age indeed reflects the process of skin aging.
Conclusions
With all reservations to the relatively small number of study participants, it seems feasible that a difference between biologic and chronologic age can be used as an indicator of skin aging. Additional research linking blood immune profile and skin topography to the difference of biologic and chronologic age (reported in the following paper) provides further support for the formulated hypotheses. So, a difference between calculated biologic age and chronologic age can be used as an individualized criterion supporting decisions on skin treatment strategies. Further research involving larger numbers of participants aimed at optimizing the expressions for calculating biologic age could lead to reliable and easily available express criterion supporting the decision for the individualized skin treatment.
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Identifying Preoperative Factors Associated with the Volume Discrepancy in Patients Undergoing Breast Reconstruction with the Extended Latissimus Dorsi Musculocutaneous Flap Coverage. Aesthetic Plast Surg 2019; 43:1490-1496. [PMID: 31218382 DOI: 10.1007/s00266-019-01417-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/30/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The latissimus dorsi (LD) flap is a versatile option for breast reconstruction. However, the indications are limited because of volume discrepancy between the breast and the flap. We conducted this study to identify preoperative factors associated with the volume discrepancy in patients undergoing breast reconstruction with the extended LD flap. METHODS A retrospective study was performed in 69 patients (69 breasts) who underwent breast reconstruction with the extended LD flap between March 2015 and March 2018. We evaluated age, body weight, height, preoperative body mass index (BMI), postoperative BMI, breast skin defect size, breast volume, flap volume, and volume discrepancy [breast volume - flap volume]. RESULTS Mean age, height, body weight, preoperative BMI, postoperative BMI, skin defect size, breast volume, flap volume, and volume discrepancy were 45.6 ± 7.1, 157.8 ± 0.1, 59 ± 8.1, 23.7 ± 3.2, 23.5 ± 3.3, 16.5 ± 9.3, 252.2 ± 107.1, 229.4 ± 95.6, and 32.6 ± 31.4, respectively. Spearman's rank correlation coefficients indicated significant positive linear correlations between volume discrepancy and preoperative BMI (correlation coefficient = 0.267, P = 0.027), volume discrepancy and breast volume (correlation coefficient = 0.472, P < 0.001), and between volume discrepancy and skin defect size (correlation coefficient = 0.609, P < 0.001). Stepwise multiple regression analysis yielded the following formula: predicted log volume discrepancy (ml) = 1.2891 + 0.0639 × skin defect size + 0.0025 × breast volume (R2 = 0.421). CONCLUSION Skin defect size and breast volume were preoperative factors associated with volume discrepancy in patients who have undergone breast reconstruction with the extended LD flap. Considering these factors, we can predict the lack of volume and plan any necessary secondary procedures. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Cha HG, Kwon JG, Kim EK, Lee HJ. Tattoo-only nipple-areola complex reconstruction: Another option for plastic surgeons. J Plast Reconstr Aesthet Surg 2019; 73:696-702. [PMID: 31862266 DOI: 10.1016/j.bjps.2019.11.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 08/14/2019] [Accepted: 11/22/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Total breast reconstruction involves a long process consisting of mastectomy, breast reconstruction, and adjuvant therapy. For various reasons, some patients refuse the final step of nipple-areola reconstruction. Some patients have potential risk factors for poor outcome after undergoing conventional techniques. We have performed tattoo-only nipple-areola complex (NAC) reconstruction in these situations and accomplished satisfactory results for both patients and surgeons. METHODS Ninety-five patients who underwent NAC reconstruction between October 2017 and June 2018 were included. We retrospectively evaluated the breast reconstruction timing and type, history of a secondary breast procedure or other operations, history of adjuvant therapy, reasons for performing a tattoo-only procedure, and average operative time. Overall patient satisfaction was assessed and compared. RESULTS Twenty patients (21%) underwent tattoo-only NAC reconstruction. The main reasons for performing the tattoo-only technique were patient reluctance to undergo another operation, thin and/or tight breast skin in patients with implant-based reconstruction, radiation therapy after implant-based reconstruction, adverse chemotherapy effects, scar across the central breast mound, and smoking habit. The average time for tattooing was 29 min (range, 15-45 min). The average overall satisfaction score was 8.1 on a 10-point scale, which was significantly the highest compared with that of other techniques. CONCLUSION The tattoo-only NAC reconstruction technique is an essential option to consider and utilize in selected patients who refuse another nipple reconstruction operation for various reasons. Moreover, tattoo-only NAC reconstruction has distinct advantages for patients with potential risk factors and poor outcome after conventional NAC reconstruction.
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Affiliation(s)
- Han Gyu Cha
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Jin Geun Kwon
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - Eun Key Kim
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.
| | - Hwa Jeong Lee
- Department of Nursing, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
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Şendur HN, Gültekin S, Salimli L, Cindil E, Cerit M, Şendur AB. Determination of Normal Breast and Areolar Skin Elasticity Using Shear Wave Elastography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1815-1822. [PMID: 30472800 DOI: 10.1002/jum.14877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/22/2018] [Accepted: 10/24/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES In this study, we aimed to determine reference values for normal breast and areolar skin elasticity using shear wave elastography. METHODS The right breasts of 200 female participants were evaluated. The age, weight, body mass index, menopausal status, and parity number of all participants were noted. The elasticity values and thickness of the areolar skin and 4 quadrants of the breast skin of all participants were measured. To assess the reproducibility of shear wave elastography, a randomly selected subgroup of 35 participants was reevaluated by a second observer. RESULTS The mean age of the participants ± SD was 48.79 ± 10.74 years (range, 18-79 years). The mean elasticity measurements for the superior, inferior, lateral, and medial regions of the breast and areolar skin were 33.54, 29.84, 30.16, 29.20, and 31.35 kPa, respectively. The mean of the 4-quadrant measurements of breast skin elasticity was 30.68 ± 9.11 kPa. Age had a moderate negative correlation with breast skin elasticity (r = -0.353; P < .001) and a weak negative correlation with areolar skin elasticity (r = -0.237; P = .001). The parity number had weak negative correlations with breast (r = -0.150; P = .034) and areolar (r = -0.207; P < .001) skin elasticity. The interobserver agreement varied from good to excellent (intraclass correlation coefficients, 0.67-0.91) for the breast and areolar skin elasticity measurements. CONCLUSIONS Shear wave elastography is a reproducible imaging modality for evaluations of breast and areolar skin elasticity, and our results may provide important pilot data for evaluations of clinical entities that affect the breast and areolar skin structures.
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Affiliation(s)
- Halit Nahit Şendur
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Serap Gültekin
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Leyla Salimli
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Emetullah Cindil
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Mahinur Cerit
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
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Coltman CE, Steele JR, McGhee DE. Effects of age and body mass index on breast characteristics: a cluster analysis. ERGONOMICS 2018; 61:1232-1245. [PMID: 29792567 DOI: 10.1080/00140139.2018.1481229] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 04/04/2018] [Accepted: 05/20/2018] [Indexed: 06/08/2023]
Abstract
UNLABELLED Limited research has quantified variation in the characteristics of the breasts among women and determined how these breast characteristics are influenced by age and body mass. The aim of this study was to classify the breasts of women in the community into different categories based on comprehensive and objective measurements of the characteristics of their breasts and torsos, and to determine the effect of age and body mass index on the prevalence of these breast categories. Four breast characteristic clusters were identified (X-Large, Very-ptotic & Splayed; Large, Ptotic & Splayed; Medium & Mildly-ptotic; and Small & Non-ptotic), with age and BMI shown to significantly affect the breast characteristic clusters. These results highlight the difference in breast characteristics exhibited among women and how these clusters are affected by age and BMI. The breast characteristic clusters identified in this study could be used as a basis for future bra designs and sizing systems in order to improve bra fit for women. Practitioner summary: This original research provides evidence for bra designers and manufacturers on the diverse breast characteristics exhibited by women within the population and the significant effect that both body mass index and age have on the breast characteristic clusters. Future bra designs should consider the variation in breast characteristics among women. ABBREVIATIONS BMI: Body Mass Index; UBCC: Under-bust chest circumference.
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Affiliation(s)
- Celeste E Coltman
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
| | - Julie R Steele
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
| | - Deirdre E McGhee
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
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Coltman CE, Steele JR, McGhee DE. Can breast characteristics predict upper torso musculoskeletal pain? Clin Biomech (Bristol, Avon) 2018; 53:46-53. [PMID: 29448080 DOI: 10.1016/j.clinbiomech.2018.02.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 01/05/2018] [Accepted: 02/05/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Several studies have associated a large breast size with an increased prevalence and severity of musculoskeletal pain, particularly pain in the upper torso. Despite this evidence, no research has explored whether breast size or related characteristics are risk factors for upper torso musculoskeletal pain. METHODS A backward multiple regression analysis was performed to identify whether characteristics of the breasts and upper torso, as well as physical factors known to be associated with musculoskeletal pain, could predict musculoskeletal pain among a cohort of 378 Australian women aged 18 years and over who had a wide range of breast sizes. FINDINGS The model identified that breast volume, age and nipple-to-nipple distance predicted 23% of the variance in upper torso musculoskeletal pain reported by the participants. INTERPRETATION Women with a larger breast volume, lower age and a greater nipple-to-nipple distance were predicted to report a higher upper torso musculoskeletal pain score.
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Affiliation(s)
- Celeste E Coltman
- Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Avenue, Wollongong, New South Wales 2522, Australia.
| | - Julie R Steele
- Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Avenue, Wollongong, New South Wales 2522, Australia.
| | - Deirdre E McGhee
- Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Avenue, Wollongong, New South Wales 2522, Australia.
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Coltman CE, Steele JR, McGhee DE. Breast volume is affected by body mass index but not age. ERGONOMICS 2017; 60:1576-1585. [PMID: 28532249 DOI: 10.1080/00140139.2017.1330968] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND This study aimed to establish normative breast volume data for women of varying ages, body masses and breast sizes, and to determine the effect of age and body mass index (BMI) on breast volume. METHODS The breast volume of 356 women (age range: 18.1-83.7 years; BMI range: 18.4-54.5 kg/m²) was measured using three-dimensional scanning in a prone position. RESULTS Breast volumes ranged from 48 to 3100 mL. Although breast volume was not significantly affected by age, it was significantly affected by BMI, with the breast volume of overweight and obese women being two-to-three times greater than women with normal BMI's. CONCLUSION It is recommended that bra cups must be designed to support the wide range and increasing magnitude of breast volumes exhibited by women. Practitioner summary: This original research provides evidence for bra designers and manufacturers on the range of breast volumes of women and the significant effect of BMI on breast volume. Bra cups need to be designed to support the wide range and increasing magnitude of breast volumes exhibited by women.
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Affiliation(s)
- Celeste E Coltman
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
| | - Julie R Steele
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
| | - Deirdre E McGhee
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
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