Biomedical subjects

R Sinna

Publications and source records attributed to R Sinna.

9 recordsLinked to original sources

PubMed2006

[Bilateral breast reconstruction with the autologous latissimus dorsi flap (a retrospective study of 31 consecutive cases)].

PURPOSE OF THE STUDY: The purpose of this study was to analyse the advantages, disadvantages and results of bilateral breast reconstruction by autologous latissimus dorsi flap. MATERIAL AND METHOD: Thirty-one two-stage consecutive bilateral breast reconstructions were performed by the same operator between 1993 and 2001. All the reconstructions, in immediate or delayed manner, were indicated after radical or skin sparing mastectomy for breast cancer. We used the autologous latissimus dorsi flap for all cases. The reconstruction of the second breast was always delayed of a few months to avoid back's complications. We reviewed the charts of these patients retrospectively. Preoperative data, postoperative complications, dorsal seroma occurrence, morphological results and patient's satisfaction were evaluated. Median follow-up was 22 months. RESULTS: The results confirm the procedure's reliability. Comparative rates of postoperative complications are not significantly different between first and contralateral breast reconstruction. Functional after-effects of bilateral latissimus dorsi harvesting are moderate. The aesthetics results have been judged as very good in 84% of cases and good in 16%. The satisfaction rate of the patients is high: 90,3% are pleased, 6,5% are satisfied and 3,2% are moderately satisfied. CONCLUSION: The autologous latissimus dorsi flap allows a two-stage bilateral breast reconstruction. This procedure is not indicated for simultaneous bilateral breast reconstruction; it is the main drawback of this technique. So we believe that this procedure is an excellent alternative in all the indications of sequential bilateral breast reconstructions.

Adult↗

PubMed2005

[Scientific bases of fat transfer. Critical review of the literature].

Fat grafting is an old technique. Since its first description in 1893, fat was used in a lot of indications. After more then a century of evolution, there is still no commonly accepted standard method of fat transfer by all the authors. On the contrary, many different techniques have been described in the literature with the only aim of reducing resorption of the transferred fat. Today the main inconvenient of fat grafting remains the partial resorption the transferred tissue. After a review of the literature of the various technique of fat transfer presented according to their chronology in the operative procedure, we have observed that the techniques developed by certain authors are the opposite of the techniques developed by others. This shows the lack of rigorous work concerning the fat transfer. Whether they are experimental or clinical, in most of these studies, we can find at least one skew which could have influence the results and the conclusion of these studies. A critical revue of the literature offers the opportunity to reconsider the actual bases of fat transfer. The use of an objective way of quantifying the volumes in clinical practice could permit the comparison of different studies in the future.

Adipose Tissue↗

PubMed2005

[Information of the patient: the characteristics of implant breast augmentation].

Delivering full information and obtaining enlightened assent is an unavoidable stage before each operation. This paper presents the different "rules" that defines this information duty in France. The assimilation of these different elements: sources, contents and the weight of the information can help the surgeon to carry out the consultation before breast augmentation with more efficiency and objectivity. This preoperative consultation can be divided into 10 steps. Each step is submitted to specific directives, which will depend on the scientific, the law, and the jurisprudence evolution. Therefore, in addition to this article, one can find the new information card concerning implant breast augmentation of the French society of plastic reconstructive and aesthetic surgery. This card is the first update of the previous information cards published in 2002. This card guarantees clear, simple and complete information being a base for information duty.

Breast Implants↗

PubMed2005

[Breast implant alternatives].

The use of implants is a basic technique in breast reconstruction after mastectomy, for the correction of breast abnormalities or even more in aesthetic breast augmentation. However, especially in difficult cases, implants can have inconveniences and insufficiencies (poor natural aspect, necessity of replacement, capsular contracture). To mitigate these, numerous alternatives were developed. These autologous techniques use mainly the pedicled or free musculocutaneous flaps, which were at first used in breast reconstruction. Their indications were then widened in surgery of breast abnormalities and in aesthetic surgery of the breast. Main alternatives, described, in the breast implants are envisaged by clarifying their advantages, inconveniences, indications and contraindications. The current place of the fat grafting in breast plastic surgery is defined by taking into account the most recent data.

Breast Implants↗

PubMed2005

[Mammary implants and breast cancer].

Many publications deal with the impact of cosmetic breast implants to increase the breast cancer occurence or to delay its diagnosis. We first try to express the clinical and radiological differences in the implanted breast. The diagnostical and therapeutical difficulties were developped to the different technics of imagery, biopsy and specific management of the treatment. On one hand, the litterature revue does not show any significant difference in tumoral stage and nodal status between augmented and nonaugmented women eventhough the mammography sensibility is not as optimal. On the other hand, the global mortality of the augmented population is higher but it appears that this phenomenon could be link to their way of life and is totally independant of breast cancer. Finally, if the diagnosis and the treatment are more complex, the women survival is not altered by breast augmented surgery.

Adult↗

PubMed2005

[Ways of research for the development of new breast prosthesis].

Despite the improvement of breast implant quality across the last decade, the perfect implant does not exist. Therefore research should manage to improve those implants. In this article we have tried to identify different directions to investigate for better prosthesis: improvement of the shell, the filling and the form. Moreover, other targets as fat transfer or other permanent soft tissue filler also need further experimental and clinical investigation.

Breast Implantation↗

PubMed2005

[How to improve breast implant reconstructions?].

Prosthetic breast reconstruction is a simple procedure that has become a standard of care for breast reconstruction. The technique generally provides satisfactory results, although minor defaults requiring further correction may sometimes be detected. The present study is a systematic review of prosthetic breast reconstruction defaults, which we have classified in different categories: shape too round, disruption of inframammary fold, excessive firmness, wrinkling and rippling, and localized imperfections. Based on this analysis of physical signs, we propose surgical solutions adapted to the needs of each patient. Reconstruction with abdominal advancement flap an intrapectoral fat graft (lipomodeling) appear to be among the most significant current advances of prosthetic breast surgery. The skillful analysis of prosthetic reconstruction defaults will make it possible to contribute to enhancing the quality of prosthesis reconstruction, whereas improving both aesthetic outcome and patient satisfaction.

Breast↗

PubMed2005

[3D evaluation and mammary augmentation surgery].

The medical application of the interferometry is valid now. The breast surgery works on the shape and the volume of the tissue. The Inspeck technology is now available and works well in our medical practice. The measurement tools for the lengths, euclidian or projected on surface are working well with the same precision of a manual measurement. The estimation of the volume needs to follow exactly the same procedure to get some good results. The virtual breast modification doesn't work anymore with a scientific precision and does not allowed yet an office use. A development of the software is necessary to use all these data enclosed in the 3D models.

Adult↗

PubMed2005

[3 D evaluation and breast plastic surgery: preliminary study].

Due to the development of the invasive technique of digital exam, the three-dimensional results are more and more precise, spectacular and helpful. The 3D surfacic model is for a medical approach and non invasive. Early in 2003, we have started a patient evaluation before and after surgery. The most common surgical techniques from the breast reconstruction to the breast augmentation and the lipomodeling have been analyzed. This preliminary study has shown objectively some surgical rules and volumetric results. Those results are the elements of the future development of the 3D surfacic model in plastic surgery.

Breast↗