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Biomedical subjects

M J Pelay

Publications and source records attributed to M J Pelay.

6 recordsLinked to original sources

[Breast reconstruction with expander prostheses].

Breast reconstruction with tissue expanders is a technique that has been known to clinical practice since 1978. The authors present their clinical experience in the Plastic and Reconstructive Surgery Service of the Virgen del Camino Hospital from 1980 to 2005. They describe breast reconstruction using tissue expanders and the evolution towards immediate breast reconstruction with durable expanders prostheses, which resemble conventional breast prostheses and try to emulate the extirpated breast. They provide an historical review of the repercussion of mastectomy and breast reconstructive surgery in the different professional and social areas, as well as the change in mentality of society and health professionals that has benefited patients. The characteristics of post-mastectomy breast reconstruction, using expanders prostheses, are set out, as well as its advantages and drawbacks.

Breast Implantation↗

[Breast reconstruction with latissimus dorsi musculocutaneous flap].

In breast reconstruction we try to achieve the greatest possible symmetry with the contralateral breast, with the smallest number of interventions, the least possible sequel and the greatest safety. When we find poor cutaneous quality in the thorax we must use techniques that provide a well vascularised tissue of good quality, which we obtain at a certain distance instead of using the thorax tissues themselves. This article reviews the latissimus dorsi musculocutaneous flap, the technique of elevation, variations of the flap, and the advantages and drawbacks involved. This is a very safe and versatile technique, with few sequels in the donor area, with a relatively short surgery time and with good aesthetic results.

Female↗

[Reconstruction of the tuberous breast].

The tuberous breast is a malformation that affects adolescent women uni- or bilaterally, becoming apparent at puberty with the growth of the breast. It is characterised by an alteration of the vertical and horizontal dimensions of the breast, which is translated into a lack of development of the breast and into the herniation of the glandular tissue within the areola with hypertrophy of the latter. Numerous terms have been employed to describe this deformity, besides that of tuberous breast: tubular breast, caprine breast, areolar hernia, hypoplasia of the lower pole or constricted breast. At its most developed degree it is a serious deformity, which affects the emotional stability of the patient in an important way, altering their relational life. Surgical treatment varies depending on the degree and severity of the deformity and includes procedures such as: glandular remodelling, augmentation mammoplasty, mastopexy or a combination of both.

Breast↗

[Gynecomastia. Surgical treatment].

Gynecomastia is an increase in the size of the mammary gland of the male. It has a varied etiology, mainly associated with hyperestrogenism, although in many cases it is idiopathic. This anomaly produces a deformity of an aesthetic character that provokes alterations of a psychological order in the patient. The aim of surgical treatment is to achieve a normal appearance of the masculine thorax, with the smallest possible scar. Surgical technique will mainly depend on the degree of the gynecomastia, and on the distribution and proportion of the different components (fat and parenchyma) of the breast. There are several alternatives: simple surgical exeresis; simple liposuction; surgical exeresis plus liposuction; and surgical exeresis plus cutaneous resection. Liposuction has emerged as one of the most important techniques applied in this pathology, either alone or in combination with other procedures. This paper describes the indications and different forms of surgical treatment.

Gynecomastia↗

[Reconstruction of a breast following mastectomy].

Breast reconstruction has become an available option for most patients undergoing mastectomy. Breast reconstruction has been shown to lessen the psychological disturbances associated with mastectomy. Reconstruction with a silicone breast prosthesis is selected when the preserved tissues after subcutaneous mastectomy, total mastectomy or modified radical mastectomy, have an adequate quantity and quality for insertion of the prosthesis. Frequently these tissues are quantitatively deficient. In these cases the use of tissue expanders allows the expansion of deficient soft tissues. Anatomically shaped expanders produce breasts with a natural appearance, adequate ptosis and a well-defined submammary fold. When the skin has poor quality or has been irradiated, or when a radical mastectomy has been performed, additional autogenous tissue needs to be brought to the breast area with a flap. The two most commonly used musculocutaneous flaps are the latissimus dorsi and the transverse rectus abdominis flap (TRAM). To get a good result nipple-areola reconstruction is necessary, and it is often necessary to modify the contralateral breast.

English Abstract↗