Summary: Nipple-sparing mastectomy continues to grow in popularity as oncologic indications for preserving the nipple areolar complex have become less stringent and more patients with genetic predispositions to breast cancer seek aesthetically superior prophylactic mastectomy reconstructions. Nonetheless, nipple malposition remains a common and disturbing complication. This article proposes several anatomic variations that predispose to nipple malposition and a strategy to avoid it through a reliable, easily reproducible method of preoperative marking and intraoperative stabilization.
Dr. Blanchet serves on the editorial board of PRSGO and has recently won an award for the quality of her reviews for both PRS and PRSGO which are the official journals of the American Society of Plastic Surgeons.
Check out her publications under “Publications “!
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To date she has reviewed over 70 papers for Plastic and Reconstructive Surgery and Plastic and Reconstructive Surgery Global Online , the online version . These are the official plastic surgery journals of the American society of plastic surgeons, ASPS.
Summary: Burns to breast reconstructions, both autologous and implant-based, are well described in the plastic surgery literature. The mechanism has often been contact; however, burns secondary to sun exposure have also been reported. With the increasing number of prepectoral breast reconstructions, including irradiated prepectoral reconstructions, we would like to highlight the increased susceptibility of these reconstructions to thermal and ultraviolet injury. We present the case of a patient who underwent prepectoral implant-based breast reconstruction years after irradiation, who subsequently developed full-thickness injury to her mastectomy flap after minor sun exposure. After weeks of daily wound care and hyperbaric oxygen treatments, the patient eventually reepithelialized over her exposed acellular dermal matrix tissue layer, allowing for implant salvage. Postmastectomy flaps overlying implants in the prepectoral plane are delicate; major burns can develop from minor thermal injury, even months after surgery. Irradiated prepectoral reconstruction patients should be educated about the susceptibility of their breast flaps to even minor burn injury and should maintain vigilance beyond the immediate postoperative period. It remains to be seen whether prepectoral reconstruction in an irradiated breast can be a viable, long-term option.
Dear Dr. Blanchet,
At the most recent Plastic and Reconstructive Surgery- Global Open (PRS Global Open) Managing Committee and Editorial Board meetings held in October 2017 in Orlando, Florida, you were nominated and elected as an Associate Editor to the Editorial Board of PRS Global Open. Your nomination and election has been subsequently forwarded to the ASPS Executive Committee. They have approved your selection, and you are now an official member of the Editorial Board of PRS Global Open. Congratulations! Your term will begin and your name will appear on the masthead on January 1, 2018.
Plastic and Reconstructive Surgery ? Global Open is the international open access journal of the American Society of Plastic Surgeons, aiming to improve patient safety, care, and outcomes one open access article at a time. The journal is an online-only open access publication, aimed at improving patient safety, outcomes, and care one open access article at a time; it launched in April 2013 and has surpassed all of our expectations. PRS Global Open has won several national publishing awards and is indexed by ESCI, a new edition of Web of Science, as well as SCOPUS. This is already a fast-growing, increasingly impactful, global platform for plastic surgery; and we ?re only just beginning.
Your term as Associate Editor will last 3 years. At the end of your term, depending upon your willingness, performance as a reviewer, and the needs of the Journal, you can be re-elected to a second 3-year term. As an Editorial Board member, your responsibilities will include:
- Service as a high-volume peer reviewer for PRS Global Open (and PRS as well)
- Approximately 1 ? 3 per month as discussed;
- Agree to review no less than 70% of the articles I invite you to complete;
- Complete approximately 90% of the articles you agree to review;
- Aim to submit each review on or before the deadline; be no more than 5 days late;
- Keep your personal classifications up to date in www.editorialmanager.com/gox
- we cannot properly invite you to review manuscripts in your areas of expertise without up-to-date classifications
- Optional attendance at the Editorial Board meetings, held at the ASPS Annual Meeting;
- Participation in Ad Hoc Committees which conduct studies and implement new initiatives for the Journal;
- Become a ?PRS Global Open ? ambassador: read and share articles via social networks, promote the Journal;
- An ?ambassador kit ? will be provided to aid in your understanding and promotion of the journal;
- Provide assistance with special projects upon request, such as building collections or generating article topics;
- Read, Share, Download, Email, Watch, and Engage with PRS Global Open content on PRSGlobalOpen.com;
- Help promote the journal and journal articles via social media (especially Facebook, Instagram, and Twitter);
- Let me know your ?handle ? as soon as possible
- Use ?#PRSGlobalOpen ? on Twitter or Instagram
- A Social Media Digest is prepared and sent weekly to Editorial Board Members to make the process easier
- Consider submitting manuscripts to PRS Global Open if you have not already done so.
We do not anticipate these responsibilities to become burdensome upon you. We, along with the entire Board, are pleased to greet you as a member, and we look forward to working with you more closely on Journal-related issues in the years to come. Please let us know if you do not accept this position.
Rod J. Rohrich, M.D.
James M. Stuzin, M.D.
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Summary: Although much has been written about breast aesthetics, the literature lacks a simple yet systematic and comprehensive approach for pre-operative breast assessment. With use of the mnemonic BFACE, the breast surgeon will analyze the bony skeleton and the breast footprint, areola, conus, and envelope. The authors present a thorough review of the important parameters that define the ideal breast, and several techniques for perceiving asymmetries more clearly. Strategic surgical planning is enabled by accurate perception.
(Plast. Reconstr. Surg. 140: 287e, 2017.)
WEDNESDAY, July 19, 2017 (HealthDay News) — Surgeons performing mastectomies can offer a form of the procedure that allows women to retain the nipple for use in breast reconstruction.
Now, a reassuring study finds that this type of mastectomy doesn’t raise a woman’s risk for breast cancer recurrence.
“More women are requesting nipple-sparing mastectomy because of the superior cosmetic results. But doctors don’t want to take any chances with breast cancer patients’ safety for the sake of cosmetic improvement,” explained lead researcher Dr. Barbara Smith. She’s a surgical oncologist and director of the breast program at Massachusetts General Hospital in Boston.
“Our study, which has one of the longest reported follow-ups after therapeutic nipple-sparing mastectomy in the United States, provides additional support that it’s safe to leave the nipple intact during mastectomy with only a few exceptions,” she said in a news release from the Journal of the American College of Surgeons. It published the findings online July 17.
Most breast cancer patients are eligible for nipple-sparing mastectomy, which leaves the natural nipple in place. That’s different from a standard mastectomy, where the whole breast and breast skin, including the nipple, are removed.
Nipple-sparing mastectomy has several advantages over standard mastectomy, Smith said.
“Often, a woman feels more whole when she keeps her nipple,” she said. “Not only does the breast look more natural after [the surgery], a woman who still has fully intact breast skin can often choose to have a single-stage breast reconstruction with an implant, rather than needing a tissue expander (an inflatable breast implant) to stretch the skin over several months.”
In the new study, Smith’s team tracked outcomes for 297 women who underwent nipple-sparing mastectomy from June 2007 through 2012. Fourteen had cancer in both breasts and underwent nipple-sparing mastectomy on both sides, so the total number of surgeries was 311.
After a median follow-up of more than four years, there was a 5.5 percent breast cancer recurrence rate. None of the recurrences involved nipples retained during mastectomies, the findings showed.
The cancer recurrence rate among patients in this study was comparable to rates seen after standard mastectomy, Smith said.
Two breast cancer surgeons said the new findings should help women feel good about nipple-sparing mastectomy.
The study “encourages those of us who have been waiting for long-term results to now incorporate the procedure into our practices,” said Dr. Virginia Maurer, who directs breast surgery at NYU Winthrop Hospital in Mineola, N.Y. She said the hospital has already been offering women these surgeries “for five years with good results.”
Dr. Lauren Cassell is chief of breast surgery at Lenox Hill Hospital in New York City. She agreed that “nipple-sparing mastectomies offer our patients a cosmetic approach which allows them to look most like themselves, not to mention avoiding an additional procedure to recreate a nipple.”
However, “patients as well as physicians have been wary about the possible increased risk of local recurrence in the nipple areola complex,” Cassell said. But the Boston study appears to have laid those fears to rest, she noted.
The American Cancer Society has more on breast cancer surgery.
SOURCES: Virginia Maurer, M.D., chief, division of breast surgery, NYU Winthrop Hospital, Mineola, N.Y.; Lauren Cassell, M.D., chief of breast surgery, Lenox Hill Hospital, New York City; Journal of the American College of Surgeons, news release, July 17, 2017