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Özdamar MY, Biçer Ş. Importance of parental anxiety in management of developmental breast conditions in children: A study with a prospective hierarchical regression model. Medicine (Baltimore) 2024; 103:e38514. [PMID: 38875389 PMCID: PMC11175848 DOI: 10.1097/md.0000000000038514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/18/2024] [Accepted: 05/17/2024] [Indexed: 06/16/2024] Open
Abstract
The parent is the most critical link and decision-maker between the patient and the healthcare provider in treating many pediatric diseases. This entity is essential for the management of pediatric breast diseases for which the rate of surgical intervention is known to be very low. Although previous publications have emphasized that pediatric breast diseases may cause alarming anxiety in parents, the demographic factors that influence this anxiety have not been investigated. Even if practitioners complete patient management with appropriate procedures, treatment is incomplete if the questions remain unanswered. In this observational prospective study, we investigated the demographic factors that affect parental anxiety, which should be prioritized to prevent incomplete management. The Beck Anxiety Inventory score (BAS) created by the parents of 409 boys and girls aged 0 to 17 with breast conditions was recorded at the diagnosis, termination of treatment, and final control stages. A 2-stage hierarchical logistic regression model was applied to show how strongly the demographic characteristics of parents and their children predicted the parental BAS. Of the demographic characteristics, there was a significant correlation (P < .05) between the patient's sex, age, developmental period, Tanner stage, referral status, management method, family's place of residence, economic distress, and BAS. However, according to the 2-stage hierarchical regression model, only 3 demographic characteristics, the patient's gender, place of residence, and method used in patient management, significantly predicted BAS (P < .05, ΔR2 = .35). Among the many factors that affect anxiety experienced by parents whose son or daughter has breast problems, the gender of the child, place of residence of the family, and management methods used by the practitioner are demographic characteristics that should be taken into consideration.
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Affiliation(s)
- Mustafa Yaşar Özdamar
- Department of Pediatric Surgery, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Şenol Biçer
- Department of Pediatric Surgery, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey
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Lo AC, Ronckers C, Aznar MC, Avanzo M, van Dijk I, Kremer LCM, Gagliardi G, Howell RM, Rancati T, Constine LS, Marcus KJ. Breast Hypoplasia and Decreased Lactation From Radiation Therapy in Survivors of Pediatric Malignancy: A PENTEC Comprehensive Review. Int J Radiat Oncol Biol Phys 2024; 119:549-559. [PMID: 34627655 DOI: 10.1016/j.ijrobp.2021.08.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/21/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Breast hypoplasia and impaired lactation are poorly studied sequelae of chest radiation therapy (RT) in children. The Pediatric Normal Tissue Effects in the Clinic female breast task force aimed to quantitate the radiation dose-volume effects on these endpoints. METHODS AND MATERIALS A literature search was conducted of peer-reviewed manuscripts evaluating breast hypoplasia and lactation after chest RT in children, yielding 789 abstracts. Only 2 studies on children irradiated at <4 years of age for angioma of the breast provided dosimetric data correlated with breast hypoplasia. For patients who received brachytherapy, the dose was converted to external beam RT in equivalent 2 Gy fractions (DEBRT), although the limitations of this type of mathematical conversion need to be recognized. We calculated relative risks (RR) and 95% confidence intervals (95% CIs) based on these data. Only 1 study was relevant to the lactation endpoint, in which patients were given RT for Hodgkin lymphoma at age 14 to 40 years. RESULTS The 3 studies involved 206 patients in total. In patients <4 years old at the time of RT, the prevalence of patient-perceived breast hypoplasia was 38% (RR 2.5; 95% CI, 1.3-4.6) after DEBRT of <0.34 Gy, 61% (RR 4.0; 95% CI, 2.1-7.4) after DEBRT 0.34-0.97 Gy, and 97% (RR 6.3; 95% CI, 3.6-10.8) after DEBRT ≥0.97 Gy to the breast anlage. A simple linear regression model (r = 0.72; P < .001) showed that the treated breast was smaller than the untreated breast by 13% at DEBRT = 0.5 Gy, 20% at DEBRT = 1 Gy, 32% at DEBRT = 2 Gy, 51% at DEBRT = 4 Gy, 66% at DEBRT = 6 Gy, 79% at DEBRT = 8 Gy, and 90% at DEBRT = 10 Gy. The risk of unsuccessful breastfeeding was 39% after a median mediastinal dose of 41 Gy, compared with 21% in a sibling control group (P = .04). RT dose of ≥42 Gy was not associated with less breastfeeding success compared with <42 Gy, and data on lower doses were unavailable. CONCLUSIONS Based on extremely limited data, young adults exposed to thoracic RT as children seem to be at significant risk of breast hypoplasia and impaired lactation. Doses as low as 0.3 Gy to immature breasts can cause breast hypoplasia. Additional studies are needed to quantify dose and technique effects with modern RT indications. Prospective collection of clinical outcomes and dosimetric factors would enhance our understanding of RT-induced breast hypoplasia and impaired lactation.
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Affiliation(s)
- Andrea C Lo
- Department of Radiation Oncology, BC Cancer, Vancouver, British Columbia, Canada.
| | - Cecile Ronckers
- Department of Pediatric Oncology, Prinses Maxima Centrum, Utrecht, the Netherlands
| | - Marianne C Aznar
- Division of Cancer Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, United Kingdom
| | - Michele Avanzo
- Medical Physics Department, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Irma van Dijk
- Department of Radiation Oncology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Leontien C M Kremer
- Department of Pediatrics, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Giovanna Gagliardi
- Department of Medical Physics, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - Rebecca M Howell
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tiziana Rancati
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Louis S Constine
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York
| | - Karen J Marcus
- Department of Radiation Oncology, Brigham and Women's Hospital, Boston, Massachusetts
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Donnenfield JI, Nuzzi LC, McNamara CT, White AG, Labow BI. The Impact of Tuberous Breast on Adolescents: A Cross-sectional Study. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5530. [PMID: 38268714 PMCID: PMC10807874 DOI: 10.1097/gox.0000000000005530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/23/2023] [Indexed: 01/26/2024]
Abstract
Background Tuberous breast deformity is a nondiagnostic, descriptive term for a congenital breast difference that becomes apparent at puberty. Although the negative physical and psychosocial effects of macromastia and breast asymmetry are established, no studies to date have explored the impact of tuberous breasts on health-related quality of life (HRQoL) outcomes using a robust sample size. Methods In this cross-sectional study, HRQoL surveys were administered to adolescent women with tuberous breasts and healthy female controls, aged 12-21 years. Surveys included the Short-Form 36v2, Rosenberg Self-Esteem Scale, and Eating Attitudes Test-26. Demographics were compared, and linear regressions were fit to determine the effect of tuberous breast deformity on survey scores, with body mass index (BMI) category as a covariate. Results Thirty-four patients with tuberous breasts and 264 controls participated. Patients with tuberous breasts had higher mean BMI than controls (P < 0.05). After adjusting for differences in BMI category, patients with tuberous breasts scored lower than controls on the Rosenberg Self-Esteem Scale and in Short-Form 36v2 domains related to physical and psychological health (P < 0.05, all). Compared with controls, patients with tuberous breasts had a higher mean score on the Eating Attitudes Test-26 (P < 0.05). Conclusions Tuberous breast deformity may negatively impact patients' physical and psychosocial HRQoL and increase their risk for disordered eating and higher BMIs. It is imperative that healthcare providers and third-party payors understand tuberous breast deformity is not just a cosmetic issue and tailor care and coverage policies accordingly.
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Affiliation(s)
- Jonah I. Donnenfield
- From the Adolescent Breast Center, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
- Department of Plastic and Oral Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
| | - Laura C. Nuzzi
- From the Adolescent Breast Center, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
- Department of Plastic and Oral Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
| | - Catherine T. McNamara
- From the Adolescent Breast Center, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
- Department of Plastic and Oral Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
| | - Ava G. White
- From the Adolescent Breast Center, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
- Department of Plastic and Oral Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
| | - Brian I. Labow
- From the Adolescent Breast Center, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
- Department of Plastic and Oral Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
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Labow BI, Alshamekh SA, Carlberg VM, Zacur JL, Uihlein LC, Mulliken JB, Liang MG. Infantile Hemangioma of the Breast: Long-Term Assessment of Outcomes. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5506. [PMID: 38196847 PMCID: PMC10773794 DOI: 10.1097/gox.0000000000005506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/24/2023] [Indexed: 01/11/2024]
Abstract
Background The literature is meager regarding the natural history and outcomes of infantile hemangiomas (IHs) in the breast. Treatment in childhood may be considered due to psychosocial and physical concerns with breast development. Early surgical intervention may cause iatrogenic breast asymmetry and possibly impair lactation later in life. This study characterizes the clinical presentation, management, and long-term outcomes of IHs arising in the breast. Methods Female patients aged 11 years or older at presentation were included in a retrospective review of the Vascular Anomalies Center database for patients with IHs of the breast seen at our institution between 1980 and 2020. Breast development was ascertained by a structured telephone interview, physical examination, or photographs. Results A total of 10 patients met criteria for inclusion in this study. The median age at enrollment was 14 years (11-36 years). Breast asymmetry was noted in 60% of patients (n = 6). Of the four patients who underwent subtotal excision of breast IH, three developed ipsilateral breast hypoplasia. Breast asymmetry was also noted in three of five patients who did not receive medical treatment: two with hypoplasia and one with hyperplasia. No asymmetry was noted in the single patient who received corticosteroid. Conclusions IHs involving the nipple-areola complex can be associated with breast asymmetry. Hypoplasia was noted in patients not treated with corticosteroid or resection in childhood. These findings suggest that systemic treatment should be considered. Longitudinal follow-up on patients treated with propranolol will elucidate its possible benefits in minimizing breast asymmetry.
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Affiliation(s)
- Brian I. Labow
- From the Harvard Medical School, Boston, Mass
- Department of Plastic and Oral Surgery, Boston Children’s Hospital, Boston, Mass
| | - Shomoukh A. Alshamekh
- From the Harvard Medical School, Boston, Mass
- Dermatology Program, Boston Children’s Hospital, Boston, Mass
- Department of Dermatology, King Saud University, Riyadh, Saudi Arabia
| | - Valerie M. Carlberg
- From the Harvard Medical School, Boston, Mass
- Dermatology Program, Boston Children’s Hospital, Boston, Mass
- Dermatology Program, Children’s Hospital Wisconsin, Milwaukee, Wis
| | - Jennifer L. Zacur
- From the Harvard Medical School, Boston, Mass
- Dermatology Program, Boston Children’s Hospital, Boston, Mass
- St Joseph Mercy Chelsea Hospital, Chelsea, Mich
| | - Lily C. Uihlein
- From the Harvard Medical School, Boston, Mass
- Dermatology Program, Boston Children’s Hospital, Boston, Mass
- Department of Dermatology, Kaiser Permanente, Petaluma, Calif
| | - John B. Mulliken
- From the Harvard Medical School, Boston, Mass
- Department of Plastic and Oral Surgery, Boston Children’s Hospital, Boston, Mass
| | - Marilyn G. Liang
- From the Harvard Medical School, Boston, Mass
- Dermatology Program, Boston Children’s Hospital, Boston, Mass
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Stahl S, Dannehl D, Daigeler A, Jorge C, Brendlin A, Hagen F, Santos Stahl A, Feng YS, Nikolaou K, Estler A. Definitions of Abnormal Breast Size and Asymmetry: A Cohort Study of 400 Women. Aesthetic Plast Surg 2023; 47:2242-2252. [PMID: 37253846 DOI: 10.1007/s00266-023-03400-4] [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: 03/08/2023] [Accepted: 04/23/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Macromastia, micromastia and breast asymmetry have an impact on health and quality of life. However, there is scarce information addressing breast size and asymmetry frequency distribution in reference populations. OBJECTIVE The current study aims to identify factors that influence breast size and symmetry and classifies abnormal breast sizes and breast asymmetries in an adult German population. METHODS Breast base dimensions, breast volume, symmetry, and other breast anthropometric parameters of 400 German female patients were determined in a retrospective review of the MRI archives at our institution. Professional medical MRI-segmentation software was used for volume measurement. RESULTS A total of 400 Patients were retrospectively enrolled. The patients had a mean age of 50 ± 12 years (min: 24; max: 82), mean BMI of 25.0 ± 5.0 (min: 14.7, max: 45.6), and a mean total breast volume of 976 ml (right: 973 ml, min: 64, max: 4777; left: 979 ml, min: 55, max: 4670). The strongest correlation of breast volume was observed with BMI (r = 0.834, p < 0.001), followed by breast base width (r = 0.799, p < 0.001). Smaller breasts have higher breast volume asymmetry ratios (r = - 0.124, p < 0.014). For a BMI between 18.5 and 24.9 kg/m2, micromastia is defined by breast volumes below 250 ml (5th percentile) and macromastia by volumes above 1250 ml (95th percentile). Abnormal breast volume asymmetry (< 5th and > 95th percentile) is equivalent to an absolute difference of approximately 25% relative to the smallest side (bidirectional asymmetry ratio 5th percentile - 19%; 95th percentile 26%). CONCLUSION This study provides normative data of German women, as well as selected size-for-BMI percentiles and asymmetry ratio percentiles. The normative data may help to establish transparent and objective coverage criteria for health insurances. LEVEL OF EVIDENCE IV 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)
- Stéphane Stahl
- CenterPlast Private Practice, Bahnhofstr. 36, 66111, Saarbrücken, Germany
| | - Dominik Dannehl
- Department of Women's Health, University Hospital Tübingen, Calwerstr 7/6, 72076, Tübingen, Germany
| | - Adrien Daigeler
- Department of Plastic Hand and Reconstructive Surgery, BG Trauma Center Tübingen, Schnarrenbergstr 95, 72076, Tübingen, Germany
| | - Cristina Jorge
- Department of General-, Visceral-, Vascular-, and Pediatric Surgery, Saarland University Medical Center, Kirrberger Straße, 66421, Homburg, Saar, Germany
| | - Andreas Brendlin
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Florian Hagen
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | | | - You-Shan Feng
- Institute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany
| | - Arne Estler
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.
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Sergesketter AR, Geng Y, Tian WM, Langdell HC, Shammas RL, Knackstedt R, Rezak K. The Influence of Age on Complications After Correction of Congenital Breast Deformities: A National Analysis of the Pediatric and Adult NSQIP Data Sets. Aesthet Surg J 2023; 43:1273-1282. [PMID: 37157865 DOI: 10.1093/asj/sjad137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Timing of surgical intervention is controversial among patients seeking correction of congenital breast deformities. OBJECTIVES This study aimed to assess the influence of age on 30-day complications and unplanned healthcare utilization after reconstruction of congenital breast deformities. METHODS Female patients undergoing breast reconstruction for congenital breast deformities and Poland syndrome were identified on the basis of International Classification of Diseases (ICD) codes in the 2012 to 2021 pediatric and adult National Surgical Quality Improvement Project (NSQIP) data sets. Complications based on age at correction were compared, and multivariate logistic regression was used to identify predictors of overall and wound healing complications. RESULTS Among 528 patients meeting inclusion criteria, mean (SD) age at surgical correction was 30.2 (13.3) years. Patients most commonly underwent implant placement (50.5%), mastopexy (26.3%), or tissue expander placement (11.6%). Across the cohort, overall incidence of postoperative complications was 4.4%, most commonly superficial surgical site infection (1.0%), reoperation (1.1%), or readmission (1.0%). After multivariate adjustment, increasing age at time of correction was associated with higher incidence of wound complications [odds ratio (OR) 1.001; 95% confidence interval (CI) 1.0003-1.002; P = .009], in addition to BMI (OR 1.002; 95% CI 1.0007-1.004; P = .006) and tobacco use (OR 1.06; 95% CI 1.02-1.11; P = .003). CONCLUSIONS Breast reconstruction for congenital breast deformities may be safely undertaken at a young age with a low associated risk of postoperative complications. Large, multi-institutional studies are needed to assess the influence of surgical timing on psychosocial outcomes in this population.
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Makram M, Noaman A, Abozeid M. 3D Volume Assessment as an Objective Tool in Breast Asymmetry Management. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4904. [PMID: 37038412 PMCID: PMC10082228 DOI: 10.1097/gox.0000000000004904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 02/09/2023] [Indexed: 04/12/2023]
Abstract
Throughout history, the female breast has been a universal symbol of femininity. The breast's normal symmetrical appearance is an important aspect of the female form. Female breasts are not perfectly symmetrical by nature, and minor differences in shape or volume are common. However, it can be psychologically distressing for patients and affect their perception of their bodies. Aesthetic breast surgeons strive to minimize these differences in order to make them more acceptable to patients. This study aimed to provide an objective and practical strategy for effectively managing breast asymmetry. Method This study was conducted between November 2017 and September 2021 on 20 female patients seeking breast asymmetry correction at Kasr El-Ainy Hospital. All patients had volumetric breast assessment using a three-dimensional (3D) imaging system (3D LifeViz, Quantificare system), and MRI breast volumetry was done preoperatively in all patients. The patients were managed with different single-stage surgical procedures depending on the objective assessment of the volume differences between their breasts. Results Breast volume assessment using the 3D camera was done preoperatively and postoperatively. The preoperative mean volume difference was 159.45 cm3, and the postoperative mean difference was 16.75 cm3 with an overall reduction in mean volume difference of 89.5%. Comparing the 3D camera and MRI in assessing breast volume difference showed no statistical significance. Conclusions The 3D technology is a useful objective tool to augment the surgeon's experience. It helped achieve an 84.57% reduction in volume difference in managing breast asymmetry with a single-stage procedure.
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Affiliation(s)
- Mahmoud Makram
- From the Department of Plastic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayman Noaman
- From the Department of Plastic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohammed Abozeid
- From the Department of Plastic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
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Chicco M, Dheansa B. U-turn on funding for breast asymmetry treatment - is it fair to apply restrictions to patients previously treated on the NHS? J Plast Reconstr Aesthet Surg 2023; 76:27-28. [PMID: 36512999 DOI: 10.1016/j.bjps.2022.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Maria Chicco
- Department of Plastic and Reconstructive Surgery, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
| | - Baljit Dheansa
- Department of Plastic and Reconstructive Surgery, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK.
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Body Self-Perception After Breast Reconstruction in Young Female Patients Affected by Poland Syndrome. Aesthetic Plast Surg 2023; 47:122-129. [PMID: 35338392 PMCID: PMC9944005 DOI: 10.1007/s00266-022-02859-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/26/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cosmetic and social aspects of breast anomalies in Poland syndrome are not negligible. Early diagnosis and appropriate therapeutic timing may have a positive impact on quality of life. METHODS Females affected by Poland syndrome, who had breast reconstruction between 2014 and 2018, were asked to complete the Body Uneasiness Test and the postoperative Breast-Q. Correlation between scores was evaluated. Correlation between scores was statistically evaluated. RESULTS Thirty patients who had completed breast reconstruction at 20.9 ± 6.5 yo fulfilled the questionnaires at the average age of 26.5 ± 8.1 yo. BUT scores were similar to healthy population considering different age groups, with the exception of Compulsive Self-Monitoring subscale for 16-17-year age group. A correlation between Depersonalization and "Thighs" and "Legs" was present. On average, satisfaction with breast resulted 79.1%, satisfaction with surgical outcome was 94.9%, psychosocial well-being was 78.5%, sexual well-being was 75.3%, and relative physical well-being in chest and upper body was 36.9%. Global Uneasiness, Avoidance, Weight Phobia, Body Image Concern and Depersonalization were significantly correlated with lower psychosocial well-being. Avoidance was significantly correlated with lower sexual well-being. CONCLUSIONS Breast reconstruction in Poland syndrome can help to improve quality of life. However, general body uneasiness can affect satisfaction with the final result. LEVEL OF EVIDENCE IV 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 http://www.springer.com/00266 .
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Casanova D, Eraud J, Philandrianos C, Bertrand B, Abellan Lopez M. [Classification of mammary asymmetries and principles of treatment]. ANN CHIR PLAST ESTH 2022; 67:335-357. [PMID: 36075798 DOI: 10.1016/j.anplas.2022.07.021] [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: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 11/18/2022]
Abstract
Constitutional breast asymmetries are responsible not only for esthetic unsightliness, but also, at times, for psychological disorders, and medical management is necessitated. While surgical treatment is the only viable therapeutic option, given the wide variety of morphological presentations of mammary asymmetries, the surgeon is called upon to be well versed in breast surgery techniques. The authors have put forward a classification of mammary asymmetries and principles of treatment.
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Affiliation(s)
- D Casanova
- Service de chirurgie plastique et réparatrice, hôpital de la Conception, Marseille, France.
| | - J Eraud
- Service de chirurgie plastique et réparatrice, hôpital de la Conception, Marseille, France
| | - C Philandrianos
- Service de chirurgie plastique et réparatrice, hôpital de la Conception, Marseille, France
| | - B Bertrand
- Service de chirurgie plastique et réparatrice, hôpital de la Conception, Marseille, France
| | - M Abellan Lopez
- Service de chirurgie plastique et réparatrice, hôpital de la Conception, Marseille, France
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11
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Restrepo R, Cervantes LF, Swirsky AM, Diaz A. Breast development in pediatric patients from birth to puberty: physiology, pathology and imaging correlation. Pediatr Radiol 2021; 51:1959-1969. [PMID: 34236480 DOI: 10.1007/s00247-021-05099-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 03/01/2021] [Accepted: 05/02/2021] [Indexed: 10/20/2022]
Abstract
Breast tissue undergoes a series of changes from birth to puberty. The majority of the changes are transient, related to physiological hormonal changes. Although the breast is identical in both sexes at birth, its histology and development will eventually differ. It is important for radiologists to have a basic understanding of endocrinological changes and appearance on imaging to avoid potential pitfalls, particularly on ultrasound, which is the primary modality used to evaluate the breast.
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Affiliation(s)
- Ricardo Restrepo
- Department of Radiology, Nicklaus Children's Hospital, 3100 SW 62nd Ave., Miami, FL, 33155, USA.
| | - Luisa F Cervantes
- Department of Radiology, Nicklaus Children's Hospital, 3100 SW 62nd Ave., Miami, FL, 33155, USA
| | | | - Alejandro Diaz
- Division of Pediatric Endocrinology, Nicklaus Children's Hospital, Miami, FL, USA
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12
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Noisser V, Eigenberger A, Weiherer M, Seitz S, Prantl L, Brébant V. Surgery of congenital breast asymmetry-which objective parameter influences the subjective satisfaction with long-term results. Arch Gynecol Obstet 2021; 305:95-102. [PMID: 34480228 PMCID: PMC8782804 DOI: 10.1007/s00404-021-06218-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/20/2021] [Indexed: 10/24/2022]
Abstract
PURPOSE Congenital breast asymmetry is a serious gynecological malformation for affected patients. The condition hits young women in puberty and is associated with socio-esthetic handicap, depression, and psychosexual problems. Surgical treatment is usually early in the patient's lifetime, so a long-term sustainable solution is important. Although postoperative outcome has been evaluated in several studies before, this study is the first to analyze which objective parameters have the greatest influence on subjective satisfaction with long-term results. METHODS Thirty-four patients diagnosed with congenital breast asymmetry that underwent either lipofilling or implant therapy between the years of 2008 to 2019 were examined. On average, our collective comprised patients seven years after surgery. Data were mainly gathered through manual measurements, patient-reported outcome measures (Breast Q™), and breast volumetry based on 3D scans (Vectra® H2, Canfield Scientific). RESULTS Among all analyzed parameters, only areolar diameter correlated significantly negatively with the subjective outcome satisfaction of the patient. Regarding the subjective assessment of postoperative satisfaction with similarity of the breasts, again the mean areolar diameter, but also the difference in areolar diameter and breast volume between the right and left breasts correlated significantly negatively. CONCLUSION Areolar diameter was revealed as being a significant factor influencing subjective long-term satisfaction in breast asymmetry patients. Moreover, 3D volumetry proves to be an effective tool to substantiate subjective patient assessments. Our findings may lead to further improvements to surgical planning and will be expanded in further studies.
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Affiliation(s)
- Vivien Noisser
- University Centre for Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Andreas Eigenberger
- University Centre for Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.,Faculty of Mechanical Engineering, Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Regensburg, Germany
| | - Maximilian Weiherer
- Regensburg Medical Image Computing (ReMIC), Ostbayerische Technische Hochschule Regensburg (OTH Regensburg), Regensburg, Germany
| | - Stephan Seitz
- Department of Obstetrics and Gynecology, Caritas Hospital St. Josef, University of Regensburg, Regensburg, Germany
| | - Lukas Prantl
- University Centre for Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Vanessa Brébant
- University Centre for Plastic, Aesthetic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
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13
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Nuzzi LC, Firriolo JM, Pike CM, Cerrato FE, DiVasta AD, Labow BI. The Effect of Surgical Treatment on the Quality of Life of Young Women with Breast Asymmetry: A Longitudinal, Cohort Study. Plast Reconstr Surg 2020; 146:400e-408e. [PMID: 32969994 DOI: 10.1097/prs.0000000000007149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Young women with congenital breast asymmetry have impaired psychological well-being and self-esteem. However, little is known regarding the effects of surgical intervention in this population. This cohort study aims to assess postoperative changes in health-related quality of life following surgical treatment of breast asymmetry in young women using a prospective, longitudinal study design. METHODS From 2008 to 2018, 45 young women undergoing surgical correction of breast asymmetry of benign cause and 101 unaffected, female controls completed the following surveys: Short-Form 36v2, Rosenberg Self-Esteem Scale, and Eating-Attitudes Test-26. Surveys were administered at baseline and at up to 9-year follow-up. RESULTS Participants with breast asymmetry scored significantly worse than controls at baseline on the Rosenberg Self-Esteem Scale and in two Short-Form 36v2 domains: Social-Functioning and Role-Emotional. Asymmetry participants experienced significant postoperative improvements on the Rosenberg Self-Esteem Scale, and in three Short-Form 36v2 domains: Role-Physical, Social Functioning, and Mental Health. These improvements were sustained for a minimum of 5 years. Postoperatively, asymmetry participants' quality of life was comparable to controls and did not vary by age at the time of surgery, asymmetry severity, or diagnosis. CONCLUSIONS Surgical treatment of breast asymmetry in young women yields significant and sustained improvements in psychosocial quality of life. Postoperatively, patients returned to a level of functioning commensurate with their peers. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
- Laura C Nuzzi
- From the Adolescent Breast Center, the Department of Plastic and Oral Surgery, Boston Children's Hospital; and the Division of Adolescent/Young Adult Medicine, Boston Children's Hospital and Harvard Medical School
| | - Joseph M Firriolo
- From the Adolescent Breast Center, the Department of Plastic and Oral Surgery, Boston Children's Hospital; and the Division of Adolescent/Young Adult Medicine, Boston Children's Hospital and Harvard Medical School
| | - Carolyn M Pike
- From the Adolescent Breast Center, the Department of Plastic and Oral Surgery, Boston Children's Hospital; and the Division of Adolescent/Young Adult Medicine, Boston Children's Hospital and Harvard Medical School
| | - Felecia E Cerrato
- From the Adolescent Breast Center, the Department of Plastic and Oral Surgery, Boston Children's Hospital; and the Division of Adolescent/Young Adult Medicine, Boston Children's Hospital and Harvard Medical School
| | - Amy D DiVasta
- From the Adolescent Breast Center, the Department of Plastic and Oral Surgery, Boston Children's Hospital; and the Division of Adolescent/Young Adult Medicine, Boston Children's Hospital and Harvard Medical School
| | - Brian I Labow
- From the Adolescent Breast Center, the Department of Plastic and Oral Surgery, Boston Children's Hospital; and the Division of Adolescent/Young Adult Medicine, Boston Children's Hospital and Harvard Medical School
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14
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Baldelli I, Baccarani A, Barone C, Bedeschi F, Bianca S, Calabrese O, Castori M, Catena N, Corain M, Costanzo S, Barbato GDP, De Stefano S, Divizia MT, Feletti F, Formica M, Lando M, Lerone M, Lorenzetti F, Martinoli C, Mellini L, Nava MB, Porcellini G, Puliti A, Romanini MV, Rondoni F, Santi P, Sartini S, Senes F, Spada L, Tarani L, Valle M, Venturino C, Zaottini F, Torre M, Crimi M. Consensus based recommendations for diagnosis and medical management of Poland syndrome (sequence). Orphanet J Rare Dis 2020; 15:201. [PMID: 32758259 PMCID: PMC7405453 DOI: 10.1186/s13023-020-01481-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/26/2020] [Indexed: 01/08/2023] Open
Abstract
Background Poland syndrome (OMIM: 173800) is a disorder in which affected individuals are born with missing or underdeveloped muscles on one side of the body, resulting in abnormalities that can affect the chest, breast, shoulder, arm, and hand. The extent and severity of the abnormalities vary among affected individuals. Main body The aim of this work is to provide recommendations for the diagnosis and management of people affected by Poland syndrome based on evidence from literature and experience of health professionals from different medical backgrounds who have followed for several years affected subjects. The literature search was performed in the second half of 2019. Original papers, meta-analyses, reviews, books and guidelines were reviewed and final recommendations were reached by consensus. Conclusion Being Poland syndrome a rare syndrome most recommendations here presented are good clinical practice based on the consensus of the participant experts.
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Affiliation(s)
- Ilaria Baldelli
- Policlinico San Martino Hospital IRCCS for Oncology, Genoa, Italy.,Associazione Italiana Sindrome Poland, Via Asiago, 3r, 16137, Genoa, Italy
| | - Alessio Baccarani
- Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Modena, Italy
| | - Chiara Barone
- Medical Genetics, Referral Centre for Rare Genetic Diseases, ARNAS Garibaldi, Catania, Italy
| | - Francesca Bedeschi
- Clinical Genetics Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sebastiano Bianca
- Medical Genetics, Referral Centre for Rare Genetic Diseases, ARNAS Garibaldi, Catania, Italy
| | - Olga Calabrese
- Medical Genetic Unit, University Hospital of Modena, Modena, Italy
| | - Marco Castori
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Nunzio Catena
- Pediatric Orthopedic and Traumatology Unit Azienda Ospedalieria SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Massimo Corain
- Hand Surgery Unit - Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Sara Costanzo
- Pediatric Surgery Unit, V. Buzzi Children's Hospital, Milan, Italy
| | | | - Santa De Stefano
- Associazione Italiana Sindrome Poland, Via Asiago, 3r, 16137, Genoa, Italy
| | | | - Francesco Feletti
- Department of Diagnostic Imaging AUSL of Romagna, U.O. of Radiology, "Santa Maria delle Croci" Civil Hospital, Ravenna, Italy
| | - Matteo Formica
- Orthopedic Clinic, Department of Surgical Sciences, University of Genova, Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Lando
- Department of Muscle-Skeletal Surgery, Hand and Microsurgery Division, Modena University Hospital, Modena, Italy
| | - Margherita Lerone
- Medical Genetics Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Fulvio Lorenzetti
- Plastic and Reconstructive Surgery Unit, University of Pisa, Santa Chiara Hospital, Pisa, Italy
| | - Carlo Martinoli
- Department of Health Science, Section of Radiology, University of Genoa, Genoa, Italy
| | - Lorenzo Mellini
- Associazione Italiana Sindrome Poland, Via Asiago, 3r, 16137, Genoa, Italy.,Department of Morphology Surgery and Experimental Medicine, Section of Radiology, University of Ferrara, Ferrara, Italy
| | - Maurizio Bruno Nava
- G.Re.T.A. Group for Reconstructive and Therapeutic Advancements, University of Genoa, Genoa, Italy
| | - Giuseppe Porcellini
- Department of Orthopaedics and Traumatology, Modena Policlinic, Modena, Italy
| | - Aldamaria Puliti
- Medical Genetics Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.,DiNOGMI, University of Genova, Genoa, Italy
| | - Maria Victoria Romanini
- Plastic and Reconstructive Surgery, Pediatric Surgery Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Franco Rondoni
- USL Umbria 1, Ospedale Città di Castello, Perugia, Italy
| | - Pierluigi Santi
- Policlinico San Martino Hospital IRCCS for Oncology, Genoa, Italy.,Associazione Italiana Sindrome Poland, Via Asiago, 3r, 16137, Genoa, Italy
| | - Silvana Sartini
- Hand Rehabilitation Center, Modena University Hospital, Modena, Italy
| | - Filippo Senes
- Reconstructive Surgery and Hand Surgery Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Lucia Spada
- Centro di Educazione Matrimoniale e Prematrimoniale, Genoa, Italy
| | - Luigi Tarani
- Department of Pediatrics, "Sapienza", University of Rome, Rome, Italy
| | - Maura Valle
- UOC Radiologia Neuroradiologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Federico Zaottini
- Department of Health Science, Section of Radiology, University of Genoa, Genoa, Italy
| | - Michele Torre
- Associazione Italiana Sindrome Poland, Via Asiago, 3r, 16137, Genoa, Italy.,Pediatric Thoracic and Airway Surgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marco Crimi
- Associazione Italiana Sindrome Poland, Via Asiago, 3r, 16137, Genoa, Italy. .,Kaleidos SCS-Onlus, Scientific Office, Bergamo, Italy.
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15
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The Central Mound Pedicle: A Safe and Effective Technique for Reduction Mammaplasty. Plast Reconstr Surg 2020; 146:725-733. [DOI: 10.1097/prs.0000000000007173] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Swami V, Tran US, Barron D, Afhami R, Aimé A, Almenara CA, Alp Dal N, Amaral ACS, Andrianto S, Anjum G, Argyrides M, Atari M, Aziz M, Banai B, Borowiec J, Brewis A, Cakir Kocak Y, Campos JADB, Carmona C, Chaleeraktrakoon T, Chen H, Chobthamkit P, Choompunuch B, Constantinos T, Crumlish A, Cruz JE, Dalley SE, Damayanti D, Dare J, Donofrio SM, Draksler A, Escasa-Dorne M, Fernandez EF, Ferreira MEC, Frederick DA, García AA, Geller S, George A, Ghazieh L, Goian C, Gorman C, Grano C, Handelzalts JE, Horsburgh H, Jackson T, Javela Delgado LGJ, Jović M, Jović M, Kantanista A, Kertechian SK, Kessels L, Król-Zielińska M, Kuan G, Kueh YC, Kumar S, Kvalem IL, Lombardo C, Luis López Almada E, Maïano C, Manjary M, Massar K, Matera C, Mereiles JFF, Meskó N, Namatame H, Nerini A, Neto F, Neto J, Neves AN, Ng SK, Nithiya DR, Omar SS, Omori M, Panasiti MS, Pavela Banai I, Pila E, Pokrajac-Bulian A, Postuvan V, Prichard I, Razmus M, Sabiston CM, Sahlan RN, Sarfo JO, Sawamiya Y, Stieger S, SturtzSreetharan C, Tee E, Ten Hoor GA, Thongpibul K, Tipandjan A, Tudorel O, Tylka T, Vally Z, Vargas-Nieto JC, Vega LD, Vidal-Mollón J, Vintila M, Williams D, Wutich A, Yamamiya Y, Zambrano D, Zanetti MC, Živčić-Bećirević I, Voracek M. The Breast Size Satisfaction Survey (BSSS): Breast size dissatisfaction and its antecedents and outcomes in women from 40 nations. Body Image 2020; 32:199-217. [PMID: 32032822 DOI: 10.1016/j.bodyim.2020.01.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 12/17/2022]
Abstract
The Breast Size Satisfaction Survey (BSSS) was established to assess women's breast size dissatisfaction and breasted experiences from a cross-national perspective. A total of 18,541 women were recruited from 61 research sites across 40 nations and completed measures of current-ideal breast size discrepancy, as well as measures of theorised antecedents (personality, Western and local media exposure, and proxies of socioeconomic status) and outcomes (weight and appearance dissatisfaction, breast awareness, and psychological well-being). In the total dataset, 47.5 % of women wanted larger breasts than they currently had, 23.2 % wanted smaller breasts, and 29.3 % were satisfied with their current breast size. There were significant cross-national differences in mean ideal breast size and absolute breast size dissatisfaction, but effect sizes were small (η2 = .02-.03). The results of multilevel modelling showed that greater Neuroticism, lower Conscientiousness, lower Western media exposure, greater local media exposure, lower financial security, and younger age were associated with greater breast size dissatisfaction across nations. In addition, greater absolute breast size dissatisfaction was associated with greater weight and appearance dissatisfaction, poorer breast awareness, and poorer psychological well-being across nations. These results indicate that breast size dissatisfaction is a global public health concern linked to women's psychological and physical well-being.
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Affiliation(s)
- Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Serdang, Malaysia.
| | - Ulrich S Tran
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
| | - David Barron
- Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
| | - Reza Afhami
- Department of Art Studies, Tarbiat Modares University, Tehran, Iran
| | - Annie Aimé
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, Canada
| | - Carlos A Almenara
- Institute for Research on Children, Youth, and Family, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - Nursel Alp Dal
- Midwifery Department, Munzur University, Tunceli, Turkey
| | - Ana Carolina Soares Amaral
- Federal Institute of Education, Science, and Technology of Southeast Minas Gerais, São Barbacena, Brazil
| | - Sonny Andrianto
- Department of Psychology, Islamic University of Indonesia, Yogyakarta, Indonesia
| | - Gulnaz Anjum
- Department of Social Sciences and Liberal Arts, Institute of Business Administration, Karachi, Pakistan
| | - Marios Argyrides
- School of Health Sciences, Neapolis University Paphos, Paphos, Cyprus
| | - Mohammad Atari
- Department of Psychology, University of Southern California, Los Angeles, United States
| | - Mudassar Aziz
- Department of Social Sciences, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan
| | - Benjamin Banai
- Department of Psychology, University of Zadar, Zadar, Croatia
| | - Joanna Borowiec
- Department of Physical Education and Lifelong Sports, Poznań University of Physical Education, Poznań, Poland
| | - Alexandra Brewis
- School of Human Evolution and Social Change, Arizona State University, Tempe, United States
| | | | | | - Carmen Carmona
- Department of Research Methods and Diagnosis in Education, University of Valencia, Valencia, Spain
| | - Trawin Chaleeraktrakoon
- Division of Psychology, Faculty of Liberal Arts, Thammasat University, Pathumthani, Thailand
| | - Hong Chen
- School of Psychology, Southwest University, Chongqing, China
| | - Phatthanakit Chobthamkit
- Division of Psychology, Faculty of Liberal Arts, Thammasat University, Pathumthani, Thailand; School of Psychology, University of Kent, Canterbury, United Kingdom
| | - Bovornpot Choompunuch
- Department of Educational Psychology and Counseling, Faculty of Education, Khon Kaen University, Khon Kaen, Thailand
| | | | - Aine Crumlish
- School of Psychology, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | | | - Simon E Dalley
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Devi Damayanti
- Department of Psychology, Ahmad Dahlan University, Yogyakarta, Indonesia
| | - Joanna Dare
- Department of Psychology, Chapman University, Orange, United States
| | - Stacey M Donofrio
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Anja Draksler
- Slovene Centre for Suicide Research, Andrej Marusic Institute and Department of Psychology FAMNIT, University of Primorska, Koper, Slovenia
| | | | | | | | | | | | - Shulamit Geller
- School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo, Yaffo, Israel
| | - Alexias George
- Department of Psychology, Panteion University of Athens, Athens, Greece
| | - Louai Ghazieh
- Department of Human Resources, Saint Joseph University, Beirut, Lebanon
| | - Cosmin Goian
- Department of Social Work, West University of Timișoara, Timișoara, Romania
| | - Colin Gorman
- School of Psychology, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Caterina Grano
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Heather Horsburgh
- School of Social Sciences, University of Southampton, Southampton, United Kingdom
| | - Todd Jackson
- Department of Psychology, University of Macau, Taipa, China
| | | | - Marija Jović
- Department of Marketing Management and Public Relations, University of Belgrade, Belgrade, Serbia
| | - Marko Jović
- Department of Plastic and Reconstructive Surgery, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Adam Kantanista
- Department of Physical Education and Lifelong Sports, Poznań University of Physical Education, Poznań, Poland
| | | | - Loes Kessels
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Magdalena Król-Zielińska
- Department of Physical Education and Lifelong Sports, Poznań University of Physical Education, Poznań, Poland
| | - Garry Kuan
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Yee Cheng Kueh
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Sanjay Kumar
- Department of Psychology, D.A.V. College, Muzaffarnagar, India
| | | | | | | | - Christophe Maïano
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Saint-Jérôme, Canada
| | - Mandar Manjary
- Department of Psychology, D.A.V. College, Muzaffarnagar, India
| | - Karlijn Massar
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Camilla Matera
- Department of Education, Languages, Intercultures, Literatures, and Psychology, University of Florence, Florence, Italy
| | | | - Norbert Meskó
- Department of General and Evolutionary Psychology, Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Hikari Namatame
- Department of Psychology, University of Tsukuba, Tsukuba, Japan
| | - Amanda Nerini
- Department of Education, Languages, Intercultures, Literatures, and Psychology, University of Florence, Florence, Italy
| | - Felix Neto
- Department of Psychology, University of Porto, Porto, Portugal
| | - Joana Neto
- Department of Psychology, Catholic University of Brasília, Taguatinga, Brazil
| | - Angela Nogueira Neves
- Division of Research, Physical Education College of the Brazilian Army, Rio de Janeiro, Brazil
| | - Siu-Kuen Ng
- Physical Education Unit, Chinese University of Hong Kong, Hong Kong, China
| | - Devi R Nithiya
- Department of Physiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeth, India
| | - Salma Samir Omar
- Department of Dermatology, Venereology, and Andrology, Alexandria University, Alexandria, Egypt
| | - Mika Omori
- Department of Psychology, Ochanomizu University, Tokyo, Japan
| | - Maria Serena Panasiti
- Santa Lucia Foundation, Scientific Institute for Research and Healthcare, Rome, Italy
| | | | - Eva Pila
- School of Kinesiology, University of Western Ontario, Ontario, Canada
| | - Alessandra Pokrajac-Bulian
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Rijeka, Rijeka, Croatia
| | - Vita Postuvan
- Slovene Centre for Suicide Research, Andrej Marusic Institute and Department of Psychology FAMNIT, University of Primorska, Koper, Slovenia
| | - Ivanka Prichard
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Magdalena Razmus
- Institute of Psychology, Marie Curie-Skłodowska University, Lublin, Poland
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Jacob Owusu Sarfo
- Department of Nursing, All Nations University College, Koforidua, Ghana
| | - Yoko Sawamiya
- Department of Psychology, University of Tsukuba, Tsukuba, Japan
| | - Stefan Stieger
- Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria; Department of Psychology, Research Methods, Assessment, and iScience, University of Konstanz, Konstanz, Germany
| | - Cindi SturtzSreetharan
- School of Human Evolution and Social Change, Arizona State University, Tempe, United States
| | - Eugene Tee
- Department of Psychology, HELP University, Shah Alam, Malaysia
| | - Gill A Ten Hoor
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Kulvadee Thongpibul
- Department of Psychology, Faculty of Humanities, Chiang Mai University, Chiang Mai, Thailand
| | - Arun Tipandjan
- Indira Gandhi Government General Hospital and Postgraduate Institute, Puducherry, India
| | - Otilia Tudorel
- Department of Psychology, West University of Timișoara, Timișoara, Romania
| | - Tracy Tylka
- Department of Psychology, Ohio State University, Columbus, United States
| | - Zahir Vally
- Department of Psychology and Counseling, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Luis Diego Vega
- Department of Psychology, Universidad Latina de Costa Rica, San José, Costa Rica
| | - Jose Vidal-Mollón
- Department of Research Methods and Diagnosis in Education, University of Valencia, Valencia, Spain
| | - Mona Vintila
- Department of Psychology, West University of Timișoara, Timișoara, Romania
| | - Deborah Williams
- College of Health Solutions, Arizona State University, Phoenix, Arizona, United States
| | - Amber Wutich
- School of Human Evolution and Social Change, Arizona State University, Tempe, United States
| | - Yuko Yamamiya
- Department of Undergraduate Studies, Temple University Japan, Tokyo, Japan
| | - Danilo Zambrano
- Department of Psychology, Fundación Universitaria Konrad Lonrez, Bogotá, Colombia
| | | | - Ivanka Živčić-Bećirević
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Rijeka, Rijeka, Croatia
| | - Martin Voracek
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
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17
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Abstract
PURPOSE OF REVIEW This article will provide an overview on female breast development and focus on common abnormalities of growth, the emerging role of breast self-awareness, and discuss trends in the evaluation and treatment of the breast masses and disorders most often encountered in the female adolescent population. RECENT FINDINGS Although the embryology of breast development is unchanged, data are emerging on the role of environmental factors on the timing of puberty and thelarche. As breast development occurs, the role of breast self-awareness is also a new trend that allows teens to be cognizant of changes in their own breast and to become more comfortable with their own anatomy. Finally, when breast treatments are needed or desired, the timing of breast treatments is a subject that must be individualized. SUMMARY There are numerous conditions that can result from disruption of normal breast development. These resultant breast disorders are generally benign but can still cause emotional distress to both the patient and family. It is thus imperative that healthcare providers be educated on breast development, the common breast masses that occur in the adolescent population and be prepared to discuss breast self-awareness and shared decision-making in this population.
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18
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Vaiman M, Shilco P, Roitblat Y, Padilla-Raygoza N, Leit A, Kavin A, Schonberger E, Nehuliaieva L, Buchris N, Shterenshis M. Screening Procedure for Hemihypertrophy: Preliminary Results of International Multicenter Prospective Study. Cent Asian J Glob Health 2019; 8:336. [PMID: 31321153 PMCID: PMC6564096 DOI: 10.5195/cajgh.2019.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction Isolated or congenital hemihypertrophy is a rare disorder characterized by asymmetric overgrowth of one side of the body. This article describes the protocol and preliminary results of a lateral body asymmetry (hemihypertrophy) screening procedure performed in healthy adolescents in a multicenter study. The reported incidence of hemihypertrophy varies between different publications and standardized protocols are needed to improve research in this area. Methods Our screening program is taking place in Australia, Israel, Mexico, Ukraine and USA. Procedure includes two steps: (1) “three measurements – three questions” screening, or assessment of face, palms, and shins; (2) in-depth assessment of selected cases in order to exclude localized, lesional, and syndrome-related cases as well as body asymmetry within normative range and to select suspected cases of isolated hemihypertrophy. This step includes measurements of various anatomical regions and a detailed questionnaire. Results At this stage, the screening procedure is completed and the selected participants are advised to refer to medical institutions for further clinical and genetic follow up to exclude possible tumors and other accompanying disorders. Conclusion We present an easy-to-use selection tool to identify children with suspected IH, which results in the selection of the risk group that may benefit from referral to a pediatrician and a clinical geneticist.
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Affiliation(s)
- Michael Vaiman
- Department of Otolaryngology, Assaf Harofeh Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Phillip Shilco
- "Briut HaShen" Dental Health Clinic, Jerusalem, Israel.,Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated with Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel
| | - Yulia Roitblat
- Department of Sciences, Belkind School for Special Education, Rishon-LeZion, Israel
| | - Nicolas Padilla-Raygoza
- Department of Nursing and Obstetrics, Division of Health Sciences and Engineering, Campus Celaya-Salvatierra, University of Guanajuato, Mexico
| | - Aidan Leit
- Department of Sciences, The Harley School, Rochester, NY, USA
| | - Aaron Kavin
- Department of Anatomy, Mount Moriah College, Sydney, Australia
| | | | - Liliia Nehuliaieva
- Department of Pediatrics, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Noa Buchris
- Dept. of Sciences, El Camino Real Charter High School, Woodland Hills, CA, USA.,Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated with Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel
| | - Michael Shterenshis
- Science Research Department, Alexander Muss High School in Israel (AMHSI) affiliated with Alexander Muss Institute for Israel Education (AMIIE), Hod HaSharon, Israel
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Waldman RA, Finch J, Grant-Kels JM, Stevenson C, Whitaker-Worth D. Skin diseases of the breast and nipple. J Am Acad Dermatol 2019; 80:1467-1481. [DOI: 10.1016/j.jaad.2018.08.066] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/03/2018] [Accepted: 08/06/2018] [Indexed: 12/31/2022]
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20
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Affiliation(s)
- Alexander Redman
- 1 The University of Queensland, Brisbane, Queensland, Australia.,2 Ochsner Clinical School, New Orleans, LA, USA
| | - Claire Natsios
- 1 The University of Queensland, Brisbane, Queensland, Australia.,2 Ochsner Clinical School, New Orleans, LA, USA
| | - Monika Dietrich
- 1 The University of Queensland, Brisbane, Queensland, Australia.,2 Ochsner Clinical School, New Orleans, LA, USA.,3 Tulane University, New Orleans, LA, USA
| | - Russel W Steele
- 1 The University of Queensland, Brisbane, Queensland, Australia.,2 Ochsner Clinical School, New Orleans, LA, USA.,3 Tulane University, New Orleans, LA, USA
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Management of the Lateral Breast. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1965. [PMID: 30534505 PMCID: PMC6250457 DOI: 10.1097/gox.0000000000001965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 08/07/2018] [Indexed: 11/25/2022]
Abstract
Breast asymmetry is a common finding in developing adolescents. In select cases, there is maldevelopment of 1 or both breasts, which persists into adulthood and causes significant negative impact on life. Various surgical techniques (eg, breast augmentation/reduction) and nonsurgical techniques (eg, bras/gel inserts) are currently in practice to achieve breast symmetry. We describe a unique case of a young lady with Poland’s syndrome, who presented with a lateralized right breast. We have used a V-Y advancement flap, along with a breast implant, to medialize the breast and achieve symmetry in contour and volume, followed by medialization of the nipple areolar complex. Using this technique produced an excellent result on our patient. We, therefore, feel that using the V-Y advancement flap is a novel and good option for dealing with difficult cases of lateralized breast.
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Pectoralis Major Musculocutaneous Flap With a Midline Sternal Skin Paddle for Head and Neck Reconstruction: A New Design. Ann Plast Surg 2018; 81:186-191. [PMID: 29762448 DOI: 10.1097/sap.0000000000001453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The pectoralis major musculocutaneous (PMMC) flap is a classic flap for head and neck reconstruction, relatively unpopular with the advancement of microsurgery and free flaps. The classic parasternal paddle design provided a thick flap with a small rotation arch leaving objectionable scarring. Our new symmetric midsternal design overcomes these problems. METHODS Chart review was done from the years 2000 to 2017. Flap skin paddle was placed symmetrically on both sides of the midsternal line. The pectoralis major (PM) muscle and aponeurosis were attached in the lateral half of the skin paddle. Most of PM muscle was elevated with the thoracoacromial vessel and dissected to the main trunk, where the PM muscle was cut and used for bulk. The flap was transferred to the neck and lower mandibular area. The flap was inset either supraclavicularly, covering the anterior neck, or subclavicularly, for intraoral/maxillary defects. RESULTS Eight patients underwent head and neck reconstruction using the new design of PMMC flap between the years 2000 and 2017. The etiologies of the defect were radiation necrosis in 3 patients, repair of cutaneous fistulas in 3, recurrent hypopharyngeal cancer in 1, and recurrent tongue cancer in 1 patient. There were no flap losses or major complications. CONCLUSIONS With the advancement of free-flap techniques, the classic flaps have become less popular. Our new design supplements the PMMC flap by providing a thin pliable flap with a long pedicle and rotation arc, allowing a combination of different types of flaps to cover composite head and neck defects, especially in cases that lack a reliable recipient vessel due to radiation.
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The Superiorly Based Partial Rectus Abdominis and External Oblique Flap: A New Technique for Breast Asymmetry Reconstruction. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 5:e1580. [PMID: 29632763 PMCID: PMC5889460 DOI: 10.1097/gox.0000000000001580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 09/29/2017] [Indexed: 12/05/2022]
Abstract
Breast asymmetry has a wide spectrum of presentations with several employable strategies for surgical correction. Historically, the external oblique muscle has proven to be a versatile flap option for the reconstruction of both local and distant defects. It has also been described for use in breast reconstruction for coverage of the lower pole of implant prostheses. The external oblique muscle flap can be harvested in several ways to capture overlying fat and skin. In this study, we describe the use of a superiorly based partial rectus and external oblique flap for surgical correction of lower pole breast hypoplasia. This flap provides vascularized autologous volume to the lower pole of the breast with minimal donor morbidity. Other advantages of this flap are that it can increase the nipple to inframammary fold distance and lower the inframammary fold. This technique represents an evolution of an under-utilized flap and is the first study describing the use of the external oblique flap in the management of breast asymmetry.
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De Silva NK. Breast development and disorders in the adolescent female. Best Pract Res Clin Obstet Gynaecol 2018; 48:40-50. [DOI: 10.1016/j.bpobgyn.2017.08.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/29/2017] [Accepted: 08/29/2017] [Indexed: 11/25/2022]
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A Nonsurgical Approach to Adolescent Breast Asymmetry Using External Prostheses. J Adolesc Health 2017; 61:240-245. [PMID: 28455130 DOI: 10.1016/j.jadohealth.2017.02.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 02/23/2017] [Accepted: 02/24/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Currently, there are few nonsurgical treatment options for pediatric patients with developmental breast asymmetry. Our group established a partnership with a prosthetic unit within a local oncology center to provide custom-fit breast prostheses for young women with breast asymmetry. The purpose of this study was to describe the effect of this experience on patients' self-esteem and body image. METHODS Patients were administered an anonymous satisfaction survey at least 1 month after their first fitting at the prosthetic unit. The survey was designed to evaluate body image, self-esteem, as well as social and emotional well-being before and after treatment. Thematic analysis was used to assess their experiences. RESULTS Seventeen patients, aged 12-19 years, visited the prosthetic unit and subsequently completed the retrospective survey. After using the breast prostheses, 14 (82.4%) patients reported an improvement in body image and 12 (70.6%) patients reported an improvement in self-esteem. Benefits pertaining to three emergent themes were revealed: "body wholeness/symmetry," "body image and psychological well-being," and "esthetic outcome." CONCLUSIONS Results from the survey demonstrate the ease and efficacy of a form of nonsurgical treatment for adolescent breast asymmetry. Our partnership with an adult oncology center can serve as a national model to support the development of similar treatment programs. Existing resources that have been previously used only for adult breast cancer survivors can be effectively applied to the adolescent population to ameliorate the negative psychological effects of breast asymmetry.
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Ellart J, François C, Calibre C, Guerreschi P, Duquennoy-Martinot V. Asymétrie mammaire de l’adolescente et de la jeune adulte. Stabilité du résultat dans le temps. À propos de 144 patientes. ANN CHIR PLAST ESTH 2016; 61:665-679. [DOI: 10.1016/j.anplas.2016.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 10/21/2022]
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Bruant-Rodier C, Dissaux C, Baratte A, Francois Fiquet C, Bodin F. [The breast of the adolescent girl]. ANN CHIR PLAST ESTH 2016; 61:629-639. [PMID: 27318639 DOI: 10.1016/j.anplas.2016.05.006] [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: 04/25/2016] [Accepted: 05/02/2016] [Indexed: 10/21/2022]
Abstract
During adolescence, psychological and physical changes occur and breast takes a major place in the young woman body image. Except rare malign tumors, breast pathologies at this age are mainly benign or malformative. Malformative issues are revealed during breast growth, as isolated asymmetry or associated to other regional anomalies, with abnormal shape or volume of the breast, or even supernumerary breast. Therapeutic solutions will not differ from the ones used for adults. Breast lipofilling, recently admitted by plastic surgery community is an interesting tool that can be used on young women. Choosing the right technic depends on the initial problem. It comes at an early stage to offset hypoplasia resulting in a problem of asymmetry. It waits for breast stability in case of hypertrophy and for legal majority in case of breast augmentation using implants. Psychological impairment stays however a central issue and forces the surgeon to adapt to the individual and to his body change over time.
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Affiliation(s)
- C Bruant-Rodier
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie B, hôpitaux universitaires, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
| | - C Dissaux
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie B, hôpitaux universitaires, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - A Baratte
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie B, hôpitaux universitaires, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - C Francois Fiquet
- Service de chirurgie plastique, centre hospitalier de Reims, 45, rue Cognacq Jay, 51100 Reims, France
| | - F Bodin
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie B, hôpitaux universitaires, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
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Yin Z, Wang D, Ma Y, Hao S, Ren H, Zhang T, Chen W, Fan J. Self-esteem, Self-efficacy, and Appearance Assessment of Young Female Patients Undergoing Facial Cosmetic Surgery: A Comparative Study of the Chinese Population. JAMA FACIAL PLAST SU 2016; 18:20-6. [PMID: 26469879 DOI: 10.1001/jamafacial.2015.1381] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE The psychological traits of cosmetic surgery patients (CSP) are important for selecting patients and postoperative patient satisfaction. A patient's self-esteem, self-efficacy, and self-assessment affect his or her motivation for cosmetic surgery, but the association among these traits remains unclear, especially in the Asian population. OBJECTIVE To clarify the association of a patient's psychological traits, decision to undergo cosmetic surgery, and the effectiveness of facial cosmetic surgery on the psychological conditions of young, female Chinese patients. DESIGN, SETTING, AND PARTICIPANTS Three different groups of young women (aged 18-30 years) from the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and 7 universities were enrolled from January 1, 2012, through December 31, 2014: CSPs (n = 161), general population controls (GPCs) (n = 355), and facial appearance raters (FARs) (n = 268). The last date of follow-up was January 20, 2015. Patient data from questionnaires were obtained preoperatively and 6 months postoperatively, and the data from the control groups were obtained immediately after enrollment. Front-view facial images of the study participants were taken and then shown to independent raters to assess the participants' facial appearances on a rating scale. MAIN OUTCOMES AND MEASURES Evaluation of self-esteem and self-efficacy, subjective and objective assessment of facial appearance, and structural equation models. RESULTS A total of 163 CSPs and 387 GPCs were recruited for the study, and complete and valid data were obtained from 161 CSPs and 355 GPCs. All responses from the 268 FARs met the criteria for subsequent analysis. Of the questionnaires issued to the CSPs 6 months postoperatively, 126 valid responses were returned (response rate, 78.3%). Self-esteem and self-efficacy decreased significantly in preoperative patients compared with controls (P < .001) (mean [SD] scores, 22.60 [1.80] for CSPs and 27.39 [2.11] for GPCs for self-esteem and 21.50 [2.40] for CSPs and 28.59 [4.23] for GPCs for self-efficacy) and were found to be at nearly normal levels 6 months postoperatively (mean [SD] scores, 25.88 [3.65] and 26.38 [2.45] for self-esteem and self-efficacy, respectively). The patients' objective assessments of facial appearance did not differ significantly from those of the control group participants (mean [SD] scores, 4.51 [0.77] and 4.55 [0.74] for CSPs and GPCs, respectively; P = .86); however, a significant decrease in patient self-assessment was noted (mean [SD scores], 6.45 [1.15] and 7.31 [1.42] for CSPs and GPCs, respectively; P = .01). Moreover, the structural equation models revealed a path from low self-esteem and self-efficacy after decreased self-assessment to decision for cosmetic surgery. CONCLUSIONS AND RELEVANCE Self-esteem and self-efficacy mediate the negative effects of self-assessment on the decision of young women to undergo facial cosmetic surgery. The impairment of self-esteem and self-efficacy may indicate the need for preoperative psychological intervention. Facial cosmetic surgery can have positive effects on self-esteem and self-efficacy. LEVEL OF EVIDENCE 2.
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Affiliation(s)
- Zhuming Yin
- Ninth Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dafang Wang
- Ninth Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Ma
- Department of Medical Psychology, Institute of Medical Humanities, Peking University Health Science Center, Beijing, China
| | - Shuwei Hao
- Department of Medical Psychology, Institute of Medical Humanities, Peking University Health Science Center, Beijing, China
| | - Huiwen Ren
- Department of Pharmacology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Tingting Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders , Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Wenlin Chen
- Ninth Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jincai Fan
- Ninth Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Glicksman CA, Ferenz SE. The Etiologies of Chest Wall and Breast Asymmetry and Improvement in Breast Augmentation. Clin Plast Surg 2015; 42:519-30. [PMID: 26408441 DOI: 10.1016/j.cps.2015.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Patients presenting for correction of breast and chest wall asymmetries may have undergone numerous thoracic procedures in early childhood and may have suffered profound psychosocial effects. Complex congenital syndromes as well as mild breast asymmetries should be carefully documented using objective measurements, photography, and 3-dimensional simulations when available. Shaped highly cohesive breast implants offer plastic surgeons more possibilities and precision by fine-tuning the gel distribution and specific volumes required to correct the hypoplastic elements. Long-lasting correction of asymmetry can be obtained when patients are not oversized, and care is taken to avoid visibility, palpability, and malposition problems.
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Affiliation(s)
- Caroline A Glicksman
- Glicksman Plastic Surgery, Sea Girt, NJ, USA; Department of Surgery, Jersey Shore University Medical Center, Neptune, NJ, USA.
| | - Sarah E Ferenz
- Department of Biology, Cornell University, Ithaca, NY 14853, USA
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Reply: Psychological Impact of Breast Asymmetry on Adolescents: A Prospective Cohort. Plast Reconstr Surg 2015; 136:109e-110e. [PMID: 25803163 DOI: 10.1097/prs.0000000000001342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Forgotten Functionality. Plast Reconstr Surg 2015; 136:108e-109e. [PMID: 25803157 DOI: 10.1097/prs.0000000000001352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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