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Biomedical subjects

V R Pennisi

Publications and source records attributed to V R Pennisi.

At least 19 recordsLinked to original sources
PubMed1990

Long-term use of polyurethane breast prostheses: a 14-year experience.

I have used polyurethane prostheses for the past 14 years, implanting 220 implants into 130 patients who desired breast reconstruction after subcutaneous mastectomy or cancer ablation or simply breast augmentation. I theorize that a polyurethane-covered implant resists contracture, retaining its compressibility because the fibroblasts proliferate into the polyurethane in many different directions. When the fibrils contract, the forces of contracture counterbalance one another, resisting contracture. However, when smooth prostheses are implanted, fibrils are directed in a circular fashion around the implant and naturally contract, leading to firmer breasts. There were 115 prostheses inserted following subcutaneous mastectomy, and 22 percent developed contracted capsules. Seven implants became exposed because of skin necroses; one was removed because of a Staphylococcus infection; and two patients developed a combination of polyurethane and silicone granulomas. These developed only with the earlier implant, where there was shedding of the polyurethane sponge layer and silicone bled from the low-viscosity silicone used in the earlier implants. No granulomas were noted with the currently used Surgitek Replicon implant. Eighty-five breasts were reconstructed after cancer ablation with polyurethane implants, and the contracture rate was 2.3 percent. Other complications were minimal. A smaller group of patients had augmentation mammaplasty, and 20 prostheses were placed in 10 patients. A 15 percent contracture rate was noted in this group. In this study, 82 percent of patients were followed for up to 14 years. Capsular contractures occurred in 30 implants between 1 and 11 years, for an average recurrence at 6.3 years. The overall contracture rate was 13 percent. Other complications were minimal. All implants were placed subcutaneously or subglandularly, and all were drained.

Breast↗
PubMed1989

Subcutaneous mastectomy data: a final statistical analysis of 1500 patients.

A statistical analysis of 1500 patients who underwent subcutaneous mastectomy is presented. Their data suggest that most patients who were treated by subcutaneous mastectomy had proliferative fibrocystic disease or macrocystic disease, among other high risk factors. The data also suggest that a thoroughly performed subcutaneous mastectomy is an effective means of providing prophylaxis in women who are at high risk for breast cancer. Conclusions were confirmed by many unsolicited comments of patients who underwent the procedure and were grateful to their doctors who performed it.

Adult↗
PubMed1988

The scalp as a donor site in burns.

The scalp can be used as a donor site in the extensively burned patient. A series of 21 patients in whom this procedure has been performed, including up to 12 occasions in the same patient, is reviewed. No associated complications were encountered. The technique of harvesting the split-thickness skin grafts in this area requires the use of Pitkin's syringe and Brown air dermatome. The advantages include the availability of a large donor site that is well concealed and heals rapidly. The anatomic basis of the advantageous characteristics of the scalp and the need for subgaleal injections of fluid to stabilize the scalp are reviewed. The occasionally more pressing need to use this area in the extensively burned child because of relative body surface area distributions is also noted. Excessive blood loss, hypertrophic scarring, and the need for hair transplantation have not been noted. Complete hair regrowth has been experienced in nearly all cases.

Adolescent↗
PubMed1986

Redefined indications for subcutaneous mastectomy in patients with benign breast disease.

The indications for subcutaneous mastectomy have been redefined as a result of more recent and more conclusive data. This information has provided us with specific biological markers that define more clearly the high-risk woman for breast cancer. Proliferative disease, with and without atypia, should replace the previous criterion of moderate to severe fibrocystic disease or non-specific mammary dysplasia.

Biopsy↗
PubMed1985

Polyurethane-covered silicone gel mammary prosthesis for successful breast reconstruction.

A polyurethane-covered silicone gel implant has been used by the author in 150 breast reconstructions and augmentations in the past 9 years. The results have been most gratifying with regard to breast softness, breast compressibility, and esthetics. Only 4 patients have developed a unilateral capsule contracture and firm breast. The reasons are postulated for these satisfying results. Complications have been few and very minor.

Adult↗
PubMed1984

Subcutaneous mastectomy: an interim report on 1,244 patients.

Data are presented on 1,244 patients who had subcutaneous mastectomies during the past fourteen years with an average follow-up of seven years. Obscure lobular carcinoma in situ was found in 4.3% of patients and obscure ductal or intraductal carcinoma was found in 5.1%, for a total of 9.4%. Breast cancer developed in only 6 patients after subcutaneous mastectomy, an incidence of 0.5%, indicating that subcutaneous mastectomy is effective in preventing breast cancer. Where obscure breast cancer was found, the prevalent associated benign fibrocystic diseases were microcystic and macrocystic and lobular hyperplasia. Where obscure ductal or intraductal carcinoma was found, the prevalent associated benign diseases were microcysts, macrocysts, intraductal hyperplasia, and sclerosing adenosis.

Adult↗
PubMed1984

Obscure carcinoma encountered in subcutaneous mastectomy in silicone- and paraffin-injected breasts: two patients.

Two patients are presented whose breasts were injected directly or indirectly with paraffin and silicone, respectively. Both patients had breast cancer that was obscured by the overwhelming granulomatous resection produced by both these foreign substances. It is suggested that paraffin could have been a causative agent in the development of cancer. The role of injected silicone in breast cancer is questionable.

Adult↗
PubMed1978

Distant migration of silicone gel from a ruptured breast implant. Case report.

A complication of augmentation mammaplasty is presented in which the bag of a gel-filled implant ruptured and the thin gel migrated through subcutaneous planes as far as the groin. We feel that when a rupture of a gel-filled prosthesis becomes evident, it should be replaced as soon as possible if such migration is to be prevented (particularly if the gel is of the thinner and less-cohesive variety).

Adolescent↗
PubMed1977

Subcutaneous mastectomy data: a preliminary report.

This is a preliminary report on data accumulated in the first 12 months by the Subcutaneous Mastectomy Data Evaluation Center at Saint Francis Memorial Hospital in San Francisco, California. We present some statistics on 419 subcutaneous mastectomies performed by 105 plastic surgeons.

Adenocarcinoma↗
PubMed1976

Subcutaneous mastectomy and fibrocystic disease of the breast.

There has been a considerable amount of data presented to implicate moderate to severe fibrocystic disease as a strong precursor of breast cancer. When a premenopausal woman with nodular breasts presents a biopsy examination characterized by sclerosing adenosis, intraductal hyperplasia and/or papillomatosis, microcystic disease, macrocystic disease, or lobular neoplasia, her malignant potential will be much greater than when these disease processes are absent. As a result, a prophylactic subcutaneous mastectomy is indicated and breast reconstruction with either an immediate or a delayed mammary prosthesis implantation should be performed.

Adult↗