查看更多>>摘要：An estimated 500,000 women were diagnosed with the debilitating breast cancer-related lymphedema(BCRL)in 2022.Lymphedema is not just fluid,but a complex disease characterized by low-grade inflammation,fat deposition,and fluid accumulation,severely affecting patients'quality of life(QoL).The impact of surgical and adjuvant breast cancer treatment on BCRL has been investigated,and treatments have been modified to maintain a high cancer-free survival while addressing the late effects.In addition,the demand for breast reconstruction has increased in the last two decades,leaving a gap in the understanding of the association between BCRL and breast reconstruction.Early detection and treatment of BCRL is crucial in preventing advancement into an impairing chronic stage,making reliable diagnostic modalities necessary.This review is an updated overview of the various diagnostic tools and the established and evolving treatment approaches for BCRL,providing insight into the research findings published since 2017 on breast reconstruction and BCRL through a systematic literature search.Based on the reviewed literature,the authors could not conclude any sure causality between BCRL and breast reconstruction.Studies suggest that breast reconstruction contributes to lower BCRL rates,but prospective observational studies are recommended for future research.
Nicholas R.RandallLazaro R.PerazaGrant S.Hamilton Ⅲ
19-31页
查看更多>>摘要：Secondary rhinoplasty to address complications from initial surgical intervention is a technically challenging operation.Common aesthetic complications that plague patients after primary rhinoplasty include nasal tip asymmetries,bossae,and alar retraction.These adverse outcomes are usually a result of over-manipulation and/or over-excision of native cartilage and are especially prevalent in patients with thick lower lateral cartilages and thin nasal skin.Techniques to minimize tissue handling,maintain natural nasal anatomic support and structure,and soften sharp edges from cartilage grafts or incisions are all essential in the prevention of nasal tip irregularities.In addition to prevention,there are many operative and procedural interventions to correct tip asymmetries,bossae,and alar retraction.These interventional corrections include varying cartilage and/or fascial grafts,camouflaging of previously performed grafts,and repositioning of the alar cartilage.
查看更多>>摘要：The evolution of autologous breast reconstruction is marked by significant technological advancements aimed at enhancing surgical outcomes.This review explores the current limitations and inherent challenges in standard practices of autologous breast reconstruction and highlights the potential benefits of the latest technological innovations.It addresses key aspects that stand to gain from improvements in surgical training and perioperative patient care,with a particular focus on preoperative planning,intraoperative techniques,and postoperative monitoring.The transformative potential of these technologies is poised to significantly improve patient outcomes,optimize surgical efficiency,and advance surgical education.
查看更多>>摘要：The excessively short nose is a challenging dilemma in rhinoplasty.The variability in patient goals and nasal anatomy prevents a one-size-fits-all approach,yet a collection of commonly employed techniques may be considered when approaching an individual nose.This article discusses the common anatomical abnormalities associated with a short nose and reviews the existing literature on techniques to address these abnormalities and how they may be combined to create a unique surgical plan.Typically,correcting a short nose requires an increase in nasal length and projection,along with a decrease in rotation.Achieving this necessitates a complete release of the soft tissue and ligaments from all bony and cartilaginous attachments to allow for skin redraping,as the mucosa and/or soft tissue envelope often pose limitations.Commonly employed techniques include a septal extension graft,anterior septal reconstruction,lower lateral cartilage repositioning with grafting,tip grafts,and occasionally composite grafts.
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