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  1. Plastic Surgeon
  2. Problems in Breast Surgery. A Repair - eRef, Thieme
  3. Breast Reduction Plastic Surgeon Upper East Side Manhattan NY
  4. Dr. Brian D. Peterson's CV
  5. Search form

Plastic Surgeon

In a single-group study, 17 healthy women aged 18—40 years wore a brassiere-like vacuum system that applied a mmHg vacuum controlled, mechanical, distraction force to each breast for 10—12 hours daily for 10 weeks. Pre- and post-procedure, the breast volume size was periodically measured; likewise, a magnetic resonance image MRI of the breast-tissue architecture and water density was taken during the same phase of the patient's menstrual cycle ; of the woman study group, 12 completed the study, and 5 withdrew, because of non-compliance with the clinical trial protocol.

Incidences of partial recoil occurred at 1-week post-procedure, with no further, significant, breast volume decrease afterwards, nor at the follow-up treatment at weeks post-procedure. The MRI visualizations of the breasts showed no edema , and confirmed the proportionate enlargement of the adipose and glandular components of the breast-tissue matrices.


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Furthermore, a statistically significant decrease in body weight occurred during the study, and self-esteem questionnaire scores improved from the initial-measure scores. The long-term, volume maintenance data reported in Breast Augmentation using Pre-expansion and Autologous Fat Transplantation: a Clinical Radiological Study indicate the technical effectiveness of external tissue expansion of the recipient site for a patient study group, who had 46 breasts augmented with fat grafts.

The indications included micromastia underdevelopment , explantation deformity empty implant pocket , and congenital defects tuberous breast deformity , Poland's syndrome. Pre-procedure, every patient used external vacuum expansion of the recipient-site tissues to create a breast tissue matrix to be injected with autologous fat grafts of adipocyte tissue, refined via low G-force centrifugation. Pre- and post-procedure, the breast volumes were measured; the patients underwent pre-procedure and 6-month post-procedure MRI and 3-D volumetric imaging examinations. The size, form, and feel of the breasts was natural; post-procedure MRI examinations revealed no oil cysts or abnormality neoplasm in the fat-augmented breasts.

Surgical post-mastectomy breast reconstruction requires general anaesthesia, cuts the chest muscles, produces new scars, and requires a long post-surgical recovery for the patient. The surgical emplacement of breast implant devices saline or silicone introduces a foreign object to the patient's body see capsular contracture.

The TRAM flap Transverse Rectus Abdominis Myocutaneous flap procedure reconstructs the breast using an autologous flap of abdominal, cutaneous, and muscle tissues.

Problems in Breast Surgery. A Repair - eRef, Thieme

The latissimus myocutaneous flap employs skin fat and muscle harvested from the back, and a breast implant. The breast is reconstructed by first applying external tissue expansion to the recipient-site tissues adipose , glandular to create a breast-tissue matrix that can be injected with autologous fat grafts adipocyte tissue ; the reconstructed breast has a natural form, look, and feel, and is generally sensate throughout and in the nipple-areola complex NAC.

The autologous breast-filler fat is harvested by liposuction from the patient's body buttocks, thighs, abdomen , is refined and then is injected grafted to the breast-tissue matrices recipient sites , where the fat will thrive. One method of non-implant breast reconstruction is initiated at the concluding steps of the breast cancer surgery, wherein the oncological surgeon is joined by the reconstructive plastic surgeon, who immediately begins harvesting, refining, and seeding injecting fat grafts to the post-mastectomy recipient site.

After that initial post-mastectomy fat-graft seeding in the operating room, the patient leaves hospital with a slight breast mound that has been seeded to become the foundation tissue matrix for the breast reconstruction. The external vacuum expansion of the breast mound created an adequate, vascularised , breast-tissue matrix to which the autologous fat is injected; and, per the patient, such reconstruction affords almost-normal sensation throughout the breast and the nipple-areola complex.

Patient recovery from non-surgical fat graft breast reconstruction permits her to resume normal life activities at 3-days post-procedure. The breast-tissue matrix consists of engineered tissues of complex, implanted, biocompatible scaffolds seeded with the appropriate cells. The in-situ creation of a tissue matrix in the breast mound is begun with the external vacuum expansion of the mastectomy defect tissues recipient site , for subsequent seeding injecting with autologous fat grafts of adipocyte tissue.

A study, reported that serial fat-grafting to a pre-expanded recipient site achieved with a few 2-mm incisions and minimally invasive blunt-cannula injection procedures , a non-implant outcome equivalent to a surgical breast reconstruction by autologous-flap procedure. The fat graft breast reconstructions for 33 women 47 breasts, 14 irradiated , whose clinical statuses ranged from zero days to 30 years post-mastectomy, began with the pre-expansion of the breast mound recipient site with an external vacuum tissue-expander for 10 hours daily, for 10—30 days before the first grafting of autologous fat.

At one week post-procedure, the patients resumed using the external vacuum tissue-expander for 10 hours daily, until the next fat grafting session; 2—5 outpatient procedures, 6—16 weeks apart, were required until the plastic surgeon and the patient were satisfied with the volume, form, and feel of the reconstructed breasts. The follow-up mammogram and MRI examinations found neither defects necrosis nor abnormalities neoplasms. The post-procedure mammographies indicated normal, fatty breasts with well-vascularized fat, and few, scattered, benign oil cysts. The occurred complications included pneumothorax and transient cysts.

The autologous fat graft replacement of breast implants saline and silicone resolves medical complications such as: capsular contracture , implant shell rupture, filler leakage silent rupture , device deflation, and silicone-induced granulomas , which are medical conditions usually requiring re-operation and explantation breast implant removal.

The patient then has the option of surgical or non-implant breast corrections, either replacement of the explanted breast implants or fat-graft breast augmentation. The outcome of a breast augmentation with fat-graft injections depends upon proper patient selection, preparation, and correct technique for recipient site expansion, and the harvesting, refining, and injecting of the autologous breast filler fat. The refined breast filler then was injected to the pre-expanded recipient site; post-procedure, the patient resumed continual vacuum expansion therapy upon the injected breast, until the next fat grafting session.

The mean operating room OR time was 2-hours, and there occurred no incidences of infection , cysts, seroma , hematoma , or tissue necrosis. In a two-year period, 25 patients underwent breast augmentation by fat graft injection; at three weeks pre-procedure, before the fat grafting to the breast-tissue matrix recipient site , the patients were photographed, and examined via intravenous contrast MRI or 3-D volumetric imaging , or both.

At six months post-procedure, the follow-up treatment included photographs, intravenous contrast MRI or 3-D volumetric imaging, or both.

Breast Reduction Plastic Surgeon Upper East Side Manhattan NY

The mean increase in breast volume was 1. In , the Thai government endorsed a regimen of self-massage exercises as an alternative to surgical breast augmentation with breast implants. The Thai government enrolled more than 20 women in publicly funded courses for the teaching of the technique; nonetheless, beyond Thailand, the technique is not endorsed by the mainstream medical community.

Despite the promising results of a six-month study of the therapeutic effectiveness of the technique, the research physician recommended to the participant women that they also contribute to augmenting their busts by gaining weight. In every surgical and nonsurgical procedure, the risk of medical complications exists before, during, and after a procedure, and, given the sensitive biological nature of breast tissues adipocyte, glandular , this is especially true in the case of fat graft breast augmentation. The complications occurred to the patient group were identified and located with 3-D volumetric and MRI visualizations of the breast tissues and of any sclerotic lesions and abnormal tissue masses malignant neoplasm.

The complications associated with injecting fat grafts to augment the breasts are like, but less severe, than the medical complications associated with other types of breast procedure. Technically, the use of minuscule 2-mm incisions and blunt- cannula injection much reduce the incidence of damaging the underlying breast structures milk ducts, blood vessels, nerves.

Nevertheless, a contoured abdomen for the patient is an additional benefit derived from the liposuction harvesting of the adipocyte tissue injected to the breasts. When the patient's body has insufficient adipocyte tissue to harvest as injectable breast filler, a combination of fat grafting and breast implants might provide the desired outcome. Although non-surgical breast augmentation with fat graft injections is not associated with implant-related medical complications filler leakage, deflation, visibility, palpability, capsular contracture , the achievable breast volumes are physically limited; the large-volume, global bust augmentations realised with breast implants are not possible with the method of structural fat grafting.

Oncoplastic Breast Surgery

Global breast augmentation contrasts with the controlled breast augmentation of fat-graft injection, in the degree of control that the plastic surgeon has in achieving the desired breast contour and volume. The controlled augmentation is realised by infiltrating and diffusing the fat grafts throughout the breast; and it is feather-layered into the adjacent pectoral areas until achieving the desired outcome of breast volume and contour. A contemporary woman's lifetime probability of developing breast cancer is approximately one in seven; [] yet there is no causal evidence that fat grafting to the breast might be more conducive to breast cancer than are other breast procedures; because incidences of fat tissue necrosis and calcification occur in every such procedure: breast biopsy , implantation, radiation therapy , breast reduction , breast reconstruction , and liposuction of the breast.

Nonetheless, detecting breast cancer is primary, and calcification incidence is secondary; thus, the patient is counselled to learn self-palpation of the breast and to undergo periodic mammographic examinations. Although the mammogram is the superior diagnostic technique for distinguishing among cancerous and benign lesions to the breast, any questionable lesion can be visualized ultrasonically and magnetically MRI ; biopsy follows any clinically suspicious lesion or indeterminate abnormality appeared in a radiograph.

Breast augmentation via autologous fat grafts allows the oncological breast surgeon to consider conservative breast surgery procedures that usually are precluded by the presence of alloplastic breast implants , e. In previously augmented patients, aesthetic outcomes cannot be ensured without removing the implant and performing mastectomy. After mastectomy, surgical breast reconstruction with autogenous skin flaps and with breast implants can produce subtle deformities and deficiencies resultant from such global breast augmentation, thus the breast reconstruction is incomplete.

In which case, fat graft injection can provide the missing coverage and fullness, and might relax the breast capsule. The fat can be injected as either large grafts or as small grafts, as required to correct difficult axillary deficiencies, improper breast contour, visible implant edges, capsular contracture, and tissue damage consequent to radiation therapy. From Wikipedia, the free encyclopedia. Further information: Body dysmorphic disorder , Body image , and Beauty.

Main article: Capsular contracture. Aesthetic Plastic Surgery.

July Plastic Reconstructive Surgery. Plastic and Reconstructive Surgery. American Journal of Cosmetic Surgery. Excerpta Medica International Congress Series. Environ Health Perspect. Clinical Plastic Surgery. Annals of Plastic Surgery. Clinics in Plastic Surgery. Retrieved 2 December American Society of Plastic Surgeons. Introduction to the Human Body , Fifth Edition.

Dr. Brian D. Peterson's CV

Journal of Anatomy. February , Volume 15, Number 3, pp. Inorganic Milk: Can Kendra Wilkinson breast-feed her baby even though she has implants? Archived at the Wayback Machine , Slate. Archives of Internal Medicine. Plastic Surgical Nursing. Archived from the original PDF on Retrieved USA Today. June American Journal of Epidemiology. Retrieved on Archived from the original on 19 August Art has always been there. Approaching my senior year at Wake, while I still planned on attending med school, I felt that graduate school would be better for me first.

Because of what I was able to study simultaneously at Wake Forest, I had much of the science and art requirements for a medical illustration graduate program. I was following my academic interests somewhat independently of one another and they sort of converged in front of me. Medical illustration made perfect sense at that time, but I was not letting go of medical school. By the end of graduate school, I realized that through illustrating medicine, I was working with my favorite parts of medicine.

I also came to understand the great responsibility of working with patients and their lives and deaths. What I dreamed that medicine would be, fueled me through the roughest parts of preparation, but this dream was the vehicle that brought me to where I am now in my lifework.


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JG: Maybe just luck. Following grad school, my job as a breast prosthesis designer came at a time when the company happened to be looking for another designer.

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The idea was that this custom fit worked to disperse the weight of the prosthesis similar to the way that natural breast weight is distributed across the chest and to which minimized the amount of force on the shoulder from the bra strap and helped to prevent imbalance and back injury over time. HC: What was your favorite part about working in that industry? What was fulfilling about it? JG: I love the part about solving a problem for someone and offering a solution that serves their needs and brings happiness or satisfaction.

I met many inspirational women who could laugh despite tragedy. I sat, listened, and cried with many women. Although these were some of the hardest parts, it made me happy to give them something that helped fill a need, to provide a little more balance both physically and perhaps, emotionally. Fisher and Handel.

Then the second portion of the chapter features a variety of solutions from different experts for treating the problem. These experts provide case examples of similar problems with a step-by-step explanation of how they solved these problems and why they took the approach that they used. The book covers both aesthetic and reconstructive breast surgery. The goal of this text is not to judge which solution is the best that decision is left to the reader. Rather, it is designed to provide a detailed road map explaining how to move from point A, the problem, to point B, the solution.