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Bertozzi S, Londero AP, Nanez JAD, Leone F, Baita B, La Verghetta L, Nobile M, Almesberger D, Cedolini C. Updates and Debate Concerning Margin Adequacy and Management following Breast-Conserving Surgery. CLIN EXP OBSTET GYN 2022. [DOI: 10.31083/j.ceog4912268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Albanese R, Zingaretti N, Almesberger D, Parodi PC. Intravenous Tranexamic Acid in Implant-Based Breast Reconstruction Safely Reduces Hematoma without Thromboembolic Events. Plast Reconstr Surg 2022; 149:139e-140e. [PMID: 34855714 DOI: 10.1097/prs.0000000000008610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Roberta Albanese
- Clinic of Plastic and Reconstructive Surgery, Department of Medical Area, Academic Hospital of Udine, University of Udine, Udine, Italy
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Zingaretti N, Galvano F, Vittorini P, De Francesco F, Almesberger D, Riccio M, Vaienti L, Parodi PC. Smooth Prosthesis: Our Experience and Current State of Art in the Use of Smooth Sub-muscular Silicone Gel Breast Implants. Aesthetic Plast Surg 2019; 43:1454-1466. [PMID: 31342127 DOI: 10.1007/s00266-019-01464-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The objective of this clinical review is to provide an overview of the use of silicone gel-filled breast implants placed in the sub-muscular position, with a focus on complication rates reported for both smooth and textured implants. Furthermore, our experience in this field is also reviewed. METHODS MEDLINE, EMBASE, Web of Science, Scopus, the Cochrane Central and Google Scholar databases were reviewed to identify the literature related to smooth breast implants. Each article was reviewed by two independent reviewers to ensure all relevant publications were identified. The literature search identified 98 applicable articles. Of these, just a few articles were found to have a therapeutic level of evidence. The reference lists in each relevant paper were screened manually to include relevant papers not found through the initial search. RESULTS Eight articles report the risk of capsular contracture when the breast implants were placed in the sub-muscular position. Six of these articles report a similar rate of capsular contracture in smooth and textured implants. Local complications such as wrinkling, late seroma and double capsules were found to be associated with the use of textured breast implants (4 articles). All articles concerning BIA-ALCL reported a total absence occurring in smooth breast implants. All cases have been associated with textured mammary prostheses. CONCLUSION With our expertise in the field and the results of this up-to-date literature review, it can be concluded that there are no significant advantages of using one type of implant surface over the other when placed in the sub-pectoral position. 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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Calabrese S, Zingaretti N, De Francesco F, Riccio M, De Biasio F, Massarut S, Almesberger D, Parodi PC. Long-term impact of lipofilling in hybrid breast reconstruction: retrospective analysis of two cohorts. Eur J Plast Surg 2019. [DOI: 10.1007/s00238-019-01577-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AbstractLipofilling has recently gained popularity as a tool in primary treatment of breast cancer, and its association with two-stage implant breast reconstruction is considered as standard treatment in many centers. However, no data are available about the long-term results of the association of lipofilling in combination with expander-implant reconstruction. A retrospective analysis was conducted on patients treated between January 2010 and December 2014. Two groups were compared. Group 1 had a standard expander-implant two-stage reconstruction. Group 2 underwent hybrid breast reconstruction (HBR). Patient characteristics, hospitalization, outcomes, reoperation details, outpatient visits, and evaluation questionnaires were taken into consideration. Intergroup comparison was performed using Wilcoxon Mann-Whitney U test and Pearson’s chi-square test or Fisher’s exact test for categorical variables. Two hundred fourteen patients were evaluated: 130 patients in group 1 and 84 patients in group 2. Group 2 showed significant benefits over group 1 in terms of capsular contracture rate, breast pain, and displacement/rotation of the implant (p = 0.005). The HBR protocol is associated with lower rate of capsular contracture, less breast pain at long follow-up times, and lower overall rates of revision surgery compared to standard expander-implant reconstruction. A specific cost analysis will help further clarify the advantages of this protocol over a standard procedure.Level of Evidence: Level III, risk/prognostic, therapeutic study.
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Zingaretti N, Guarneri GF, De Biasio F, Rampino Cordaro E, Almesberger D, Parodi PC. A Simple and Fast Technique to Perform Submuscular Breast Augmentation. Indian J Surg 2019. [DOI: 10.1007/s12262-019-01886-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Biasio FD, Bertozzi S, Londero AP, Almesberger D, Zanin C, Marchesi A, Cedolini C, Risaliti A, Parodi PC. Surgical and oncological outcomes of free dermal fat graft for breast reconstruction after breast-conserving surgery. ADV CLIN EXP MED 2018; 27:773-780. [PMID: 29790683 DOI: 10.17219/acem/68977] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Oncoplastic breast surgery originated in order to improve the esthetic result of breast-conserving surgery (BCS). Autologous free dermal fat graft (FDFG) is an emerging oncoplastic technique to improve the cosmetic outcome of breast-conserving surgery. OBJECTIVES The aim of this study was to analyze our experience with FDFGs in breast reconstruction after breast-conserving surgery. Oncological outcomes, surgical complications and cosmetic results were considered. MATERIAL AND METHODS This retrospective chart review study considered all consecutive oncoplastic breast treatment by means of FDFG reconstruction during the period between September 2011 and September 2012 in our Clinic of Surgery (University of Udine, Italy). The data collected included patient and tumor characteristics and outcomes (cosmetic and oncological). RESULTS During the study period, 37 women were treated by breast cancer surgery and immediate breast reconstruction by FDFG. At a 3-year follow-up, we found no cases of recurrence among breast cancer patients treated by FDFG; at a 18-month follow-up, we found a prevalence of 75.0% of women extremely satisfied with their oncoplastic surgery and a high prevalence of excellent or good cosmetic outcomes (70.3%) according to objective and subjective cosmetic assessment. CONCLUSIONS Immediate breast reconstruction by FDFG after BCS in a population selected for a low risk of breast cancer recurrence seems to be an oncologically safe option, with a good cosmetic outcome and a high prevalence of women satisfied with the treatment.
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Affiliation(s)
- Fabrizio De Biasio
- Clinic of Plastic and Reconstructive Surgery, Department of Medical Area, University of Udine, Italy
| | - Serena Bertozzi
- Clinic of Surgery, Department of Medical Area, University of Udine, Italy
| | | | - Daria Almesberger
- Clinic of Plastic and Reconstructive Surgery, Department of Medical Area, University of Udine, Italy
| | - Chiara Zanin
- Clinic of Plastic and Reconstructive Surgery, Department of Medical Area, University of Udine, Italy
| | - Andrea Marchesi
- Department of Plastic and Reconstructive Surgery, IRCCS Policlinico San Donato, University of Milan, Italy
| | - Carla Cedolini
- Clinic of Surgery, Department of Medical Area, University of Udine, Italy
| | - Andrea Risaliti
- Clinic of Surgery, Department of Medical Area, University of Udine, Italy
| | - Pier C Parodi
- Clinic of Plastic and Reconstructive Surgery, Department of Medical Area, University of Udine, Italy
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De Biasio F, Zingaretti N, Marchesi A, Vaienti L, Almesberger D, Parodi PC. A Simple and Effective Technique of Breast Remodelling After Conserving Surgery for Lower Quadrants Breast Cancer. Aesthetic Plast Surg 2016; 40:887-895. [PMID: 27704197 DOI: 10.1007/s00266-016-0709-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 09/23/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Quadrantectomy is an oncologically safe procedure for the treatment of early-stage breast cancer, but it often results in poor aesthetic outcomes such as breast shape deformity, which is more visible if the tumour is located in the lower pole. We recommend the use of the transverse incision, which retains the oncological advantages of the quadrantectomy while leading to better aesthetical results. METHOD We evaluated the clinical results of 24 patients with breast cancer who underwent quadrantectomy of the lower breast pole and volume replacement with remodelling through three posterior scorings from January 2012 to January 2014, with cosmetic evaluations performed according to the criteria set by the Japanese Breast Cancer Society. RESULTS Minimum follow-up after surgery was 2 years, with an average of 28.4 months. Among treated patients, the percentage of complications was extremely low and the degree of satisfaction fairly good. Moreover, the assessment of the medical team matched patient self-assessments. CONCLUSION Immediate breast reconstruction of a defect performed after a quadrantectomy of the lower breast pole using the "posterior scoring technique" provided better cosmetic results compared to the transposition of residual breast tissue. This technique provides reliable and reproducible results, and it also appears to be rather successful on patients with small-moderate breasts in the absence of a certain degree of ptosis, therefore increasing its already considerable appeal. LEVEL OF EVIDENCE V This journal requires that the 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)
- Fabrizio De Biasio
- Breast Unit, Department of Plastic and Reconstructive Surgery, University of Udine, c/o Ospedale "S. Maria della Misericordia", piazzale santa maria della misericordia 15, 33100, Udine, Italy
| | - Nicola Zingaretti
- Breast Unit, Department of Plastic and Reconstructive Surgery, University of Udine, c/o Ospedale "S. Maria della Misericordia", piazzale santa maria della misericordia 15, 33100, Udine, Italy.
| | - Andrea Marchesi
- Plastic Surgery Department, IRCCS Policlinico San Donato, University of Milan, Milan, Italy
| | - Luca Vaienti
- Plastic Surgery Department, IRCCS Policlinico San Donato, University of Milan, Milan, Italy
| | - Daria Almesberger
- Breast Unit, Department of Plastic and Reconstructive Surgery, University of Udine, c/o Ospedale "S. Maria della Misericordia", piazzale santa maria della misericordia 15, 33100, Udine, Italy
| | - Pier Camillo Parodi
- Breast Unit, Department of Plastic and Reconstructive Surgery, University of Udine, c/o Ospedale "S. Maria della Misericordia", piazzale santa maria della misericordia 15, 33100, Udine, Italy
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Zingaretti N, Guarneri GF, Almesberger D, Riccio M, Parodi PC. When Expanding a Margin of Skin Cancers After Reconstruction with Local Flap: Where to Do It? J Cutan Aesthet Surg 2015; 8:183-4. [PMID: 26644748 PMCID: PMC4645154 DOI: 10.4103/0974-2077.167289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Nicola Zingaretti
- Department of Plastic and Reconstructive Surgery, University of Udine, Ancona, Italy
| | | | - Daria Almesberger
- Department of Plastic and Reconstructive Surgery, University of Udine, Ancona, Italy
| | - Michele Riccio
- Department of Reconstructive Plastic Surgery-Hand Surgery, AOU "Ospedali Riuniti", Ancona, Italy E-mail:
| | - Pier Camillo Parodi
- Department of Plastic and Reconstructive Surgery, University of Udine, Ancona, Italy
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Almesberger D, Zingaretti N, Di Loreto C, Massarut S, Pasqualucci A, Parodi PC. Seri™: A surgical scaffold for breast reconstruction or for bacterial growth? J Plast Reconstr Aesthet Surg 2015; 68:870-1. [DOI: 10.1016/j.bjps.2015.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 12/16/2014] [Accepted: 02/03/2015] [Indexed: 10/24/2022]
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Zanotti B, Zingaretti N, Almesberger D, Verlicchi A, Stefini R, Ragonese M, Guarneri GF, Parodi PC. Enhancing dermal and bone regeneration in calvarial defect surgery. Indian J Plast Surg 2015; 47:325-32. [PMID: 25593416 PMCID: PMC4292108 DOI: 10.4103/0970-0358.146581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION To optimize the functional and esthetic result of cranioplasty, it is necessary to choose appropriate materials and take steps to preserve and support tissue vitality. As far as materials are concerned, custom-made porous hydroxyapatite implants are biomimetic, and therefore, provide good biological interaction and biointegration. However, before it is fully integrated, this material has relatively low mechanical resistance. Therefore, to reduce the risk of postoperative implant fracture, it would be desirable to accelerate regeneration of the tissues around and within the graft. OBJECTIVES The objective was to determine whether integrating growth-factor-rich platelet gel or supportive dermal matrix into hydroxyapatite implant cranioplasty can accelerate bone remodeling and promote soft tissue regeneration, respectively. MATERIALS AND METHODS The investigation was performed on cranioplasty patients fitted with hydroxyapatite cranial implants between 2004 and 2010. In 7 patients, platelet gel was applied to the bone/prosthesis interface during surgery, and in a further 5 patients, characterized by thin, hypotrophic skin coverage of the cranial lacuna, a sheet of dermal matrix was applied between the prosthesis and the overlying soft tissue. In several of the former groups, platelet gel mixed with hydroxyapatite granules was used to fill small gaps between the skull and the implant. To confirm osteointegration, cranial computed tomography (CT) scans were taken at 3-6 month intervals for 1-year, and magnetic resonance imaging (MRI) was used to confirm dermal integrity. RESULTS Clinical examination performed a few weeks after surgery revealed good dermal regeneration, with thicker, healthier skin, apparently with a better blood supply, which was confirmed by MRI at 3-6 months. Furthermore, at 3-6 months, CT showed good biomimetism of the porous hydroxyapatite scaffold. Locations at which platelet gel and hydroxyapatite granules were used to fill gaps between the implant and skull appeared to show more rapid integration of the implant than untreated areas. Results were stable at 1-year and remain so to date in cases where follow-up is still ongoing. CONCLUSIONS Bone remodeling time could be reduced by platelet gel application during cranioplasty with porous hydroxyapatite implants. Likewise, layering dermal matrix over such implants appears to promote dermal tissue regeneration and the oshtemo mimetic process. Both of these strategies may, therefore, reduce the likelihood of postsurgical fracture by promoting mechanical resistance.
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Affiliation(s)
- Bruno Zanotti
- Neurosurgery Clinic, University of Udine, Reggio Emilia, Italy
| | - Nicola Zingaretti
- Department of Plastic and Reconstructive Surgery, University of Udine, Reggio Emilia, Italy
| | - Daria Almesberger
- Department of Plastic and Reconstructive Surgery, University of Udine, Reggio Emilia, Italy
| | - Angela Verlicchi
- Neurology Unit, Free University of Neuroscience "Anemos", Reggio Emilia, Italy
| | | | - Mauro Ragonese
- Urologic Clinic, Catholic University Medical School of Rome, Italy
| | - Gianni Franco Guarneri
- Department of Plastic and Reconstructive Surgery, University of Udine, Reggio Emilia, Italy
| | - Pier Camillo Parodi
- Department of Plastic and Reconstructive Surgery, University of Udine, Reggio Emilia, Italy
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