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Breast Reconstruction 3D Mohamed 15,355 Views • 2 years ago

Breast reconstruction 3D Animation
on Friday, December 17, 2010

The primary part of the procedure can often be carried out immediately following the mastectomy. As with many other surgeries, patients with significant medical comorbidities (high blood pressure, obesity, diabetes) and smokers are higher-risk candidates. Surgeons may choose to perform delayed reconstruction to decrease this risk. Patients expected to receive external beam radiation as part of their adjuvant treatment are also commonly considered for delayed autologous reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients. Breast reconstruction is a large undertaking that usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revisional surgeries. Outcomes based research on quality of life improvements and psychosocial benefits associated with breast reconstruction served as the stimulus in the United States for the 1998 Women's Health and Cancer Rights Act which mandated health care payer coverage for breast and nipple reconstruction, contralateral procedures to achieve symmetry, and treatment for the sequelae of mastectomy. This was followed in 2001 by additional legislation imposing penalties on noncompliant insurers. Similar provisions for coverage exist in most countries worldwide through national health care programs. There are many methods for breast reconstruction. The two most common are: * Tissue Expander - Breast implants This is the most common technique used in worldwide. The surgeon inserts a tissue expander, a temporary silastic implant, beneath a pocket under the pectoralis major muscle of the chest wall. The pectoral muscles may be released along its inferior edge to allow a larger, more supple pocket for the expander at the expense of thinner lower pole soft tissue coverage. The use of acellular human or animal dermal grafts have been described as an onlay patch to increase coverage of the implant when the pectoral muscle is released, which purports to improve both functional and aesthtic outcomes of implant-expander breast reconstruction. o In a process that can take weeks or months, saline solution is percutaneously injected to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a more permanent implant. Reconstruction of the areola and nipple are usually performed in a separate operation after the skin has stretched to its final size. * Flap reconstruction The second most common procedure uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen. This procedure may be performed by leaving the donor tissue connected to the original site to retain its blood supply (the vessels are tunnelled beneath the skin surface to the new site) or it may be cut off and new blood supply may be connected. o The latissimus dorsi muscle flap is the donor tissue available on the back. It is a large flat muscle which can be employed without significant loss of function. It can be moved into the breast defect still attached to its blood supply under the arm pit (axilla). A latissimus flap is usually used to recruit soft-tissue coverage over an underlying implant. Enough volume can be recruited occasionally to reconstruct small breasts without an implant. o Abdominal flaps The abdominal flap for breast reconstruction is the TRAM flap or its technically distinct variants of microvascular "perforator flaps" like the DIEP/SIEP flaps. Both use the abdominal tissue between the umbilicus and the

Hair Transplant Techniques: Difference between FUE vs FUT Alicia Berger 3,138 Views • 2 years ago

Today, hair transplant physicians are able to make use of different techniques to extract and transplant large numbers of hair follicles (follicular units). There are two primary techniques for hair transplantation currently in use. The FUE (Follicular Unit Extraction) and the FUT (Follicular Unit Transplantation) methods. They differ primarily in the way hair follicles are extracted from the donor area. Follicular Unit Transplantation (FUT) The FUT process involves removing a small strip of tissue from the back of the head, from which the donor hair follicles will be extracted. The hair follicles are harvested from the strip by a skilled clinical team before being individually transplanted to the recipient areas. In most cases, and especially cases of advanced hair loss, FUT is the preferred method because it allows the physician to fully utilize the scalp area to deliver results consistent with patient expectations. FUT typically allows for the greatest number of grafts to be transplanted in a single session. Pain Management Some patients report higher levels of discomfort with FUT procedures compared to FUE due the potential swelling in the area where the strip of tissue was removed, but both methods have a very manageable recovery period and pain medication can be prescribed by your physician if needed. Both techniques of hair transplantation are relatively simple. Hair transplantation procedures are outpatient surgeries with some patients going back to work as soon as the very next day. Scarring The FUT strip extraction method typically results in a very narrow linear scar in the back of the head (typically 1mm in diameter or less in size). Since the scar is very thin, it’s easily concealed by all but the shortest of haircut styles. A short to moderate crop setting on most clippers is sufficient to conceal the scar for the majority of patients, and over time the scar will become less noticeable as it fades. Costs The industry norm for pricing is on a per-graft basis. This allows each individual to pay for only what they need and receive in number of grafts, and not a flat rate that in the end may cost you more. The per-graft cost of a FUT procedure is generally lower than that of a FUE procedure. Lately however, in response to the rising popularity of the FUE technique, many hair transplantation clinics have started lowering the per graft cost on FUE procedures, so that the cost difference between the two types of procedure are not as much as most people think. The costs of medical procedures always vary by patients’ conditions, needs and objectives. For the most accurate assessment of your hair loss and the associated cost of your hair restoration, you will need to speak to a physician. Follicular Unit Extraction (FUE) In an FUE hair transplantation, each follicular unit is individually taken directly from the scalp with no strip of tissue being removed. Hair follicles are removed in a random fashion and the result is less density in the donor area that many say is not even noticeable. This is the main difference between FUE & FUT. Since follicles are removed one at a time, fewer follicles can be harvested during a typical session, making FUE a better option to restore hair in smaller cases (number of grafts) compared to the traditional FUT method. FUE is constantly evolving and what was once utilized for only smaller cases is now being utilized for larger and larger cases. Some people that prefer the FUE method may have the option of splitting their procedure into two days in order to complete their recommended transplantation goals. Pain Management With no stitches required and no linear scar left to heal, FUE procedures do have a faster healing time and less post-procedure discomfort compared to the traditional FUT procedure. Scarring Since FUE procedures involve removing hairs individually from the scalp, there is no linear scar left behind. However, there will be tiny 1mm in diameter or less puncture marks that tend to heal by themselves after scabbing-over in the days following the procedure. These tiny wounds typically heal within three to seven days. Costs Since the physician must remove each hair follicle individually, the time-sensitive nature of an FUE procedure typically makes it more expensive than an FUT procedure. As stated earlier, FUE technology is improving as well as gaining popularity and many hair restoration practices (including Bosley) have started to lower the cost per graft price for FUE procedures. Nowadays, the cost difference between a FUE and a FUT procedures is less disparate.

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