Commentary on: Breast Explantation With Simultaneous Mastopexy and Volume Restoration: An Analysis of Clinical Outcomes and Prospective Quality of Life
Notice bibliographique
Résumé
Requests for breast explantation surgery have been steadily increasing in recent years.Concerns secondary to risk of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL; with textured devices) as well as breast implant illness along with the changing trends in breast aesthetics have led many patients to request implant removal without replacement.Due to the long-term effects of a breast implant on the breast tissue, implant removal can be a challenging procedure with variable aesthetic results.Capsulectomy can increase the complexity of this procedure and lead to an increased risk of complications.Therefore, when approaching these patients, it is important to have a reliable and safe approach to maximize outcomes while modifying potential risks.In this paper by Messa IV and Messa III entitled "Breast Explantation With Simultaneous Mastopexy and Volume Restoration: An Analysis of Clinical Outcomes and Prospective Quality of Life," the authors present a thorough and thoughtful discussion that summarizes the literature with respect to implant safety and outcomes following explantation. 1They describe their approach for simultaneous mastopexy, explantation, and capsulectomy, utilizing autoaugmentation and/or autologous fat grafting to improve aesthetic outcomes.Their discussion includes important references relating to the improvement of symptoms following explantation along with possible etiologies for this improvement.They assess patient-reported outcomes, in terms of satisfaction (breast shape and size) and quality of life and in relation to the procedure and breast implant illness symptomatology, with an author-generated nonvalidated tool.The authors present 4 cases with very good postoperative aesthetic results; however, it is important to note that these cases all include patients with good quality and quantity of tissue, which is often not the case in this patient population.All patients in this study underwent capsulectomy for various indications, with 51.1% of patients undergoing this procedure because of concerns related to breast implant illness.The authors refer to their approach as a "precise total capsulectomy en masse," and this was performed on all patients.Indications for this procedure included "textured breast implants, ruptured implants, a calcified capsule and patients with symptoms attributed to breast implant illness."Currently, the literature does not support an absolute indication for total capsulectomy in the treatment of breast implant illness.In fact, an important recent paper demonstrated an improvement in patient symptoms following implant removal irrespective of the way in which the capsule was managed. 2 As well, there is controversy regarding the management of capsules when removing textured breast implants due to
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».