Breast Reconstruction in Connecticut
Breast Reconstruction in Connecticut section, includes general infrmation about Breast Reconstruction Procedure, Breast Reconstruction Connecticut Local News, Breast Reconstruction Connecticut Surgeon Locator and other Breast Reconstruction related material.
Breast Reconstruction Procedure
This procedure is designed for women who underwent breast amputation after breast cancer or other conditions. Newer techniques allow the surgeon to create a breast which is very similar to the natural one. The reconstruction can be done during the amputation procedure, or a few months or even a year afterwards.
There are a number of implants: the most widely used are silicon implants which have silicon surface and filling. They come in different sizes and shapes.
Becker implants are made of a thick silicon surface (35%-50%) and a solution filling. The advantage of this implant is the ability to adjust its shape to the woman's body. It can also serve as a skin stretcher. There are also implants with a thin silicon surface and a solution filling, which are less used.
The operation can be divided into 2 main categories: (a) a stretcher is inserted, then replaced with an implant; (b) the reconstruction is made from another body tissue.
The most common reconstruction is performed with a stretcher and an implant. After amputation a balloon (stretcher) is inserted under the skin and chest muscles. It has a special valve which can be filled from outside. The implant is being filled gradually with a special solution, until the skin has sufficiently stretched for inserting the implant. It takes another 3-6 months until the breast has acquired its final shape, then the nipple can be reconstructed as well.
Becker implants: sometimes during amputation the skin can be preserved. That would eliminate the need for a stretcher, and a permanent implant (Becker) can be inserted right away.
The breast can also be reconstructed with body tissue from areas with extra skin and fat, like the tummy, buttocks and back. The tissue being removed is called "a flap". Common sites to acquire the flap are the lower tummy and the lotissimus dorsi muscle from the back.
This procedure can be complicated due to implant infection, a contraction of a surface of an implant, silicon leaks and anesthetic complications.
You'll need to stay in hospital 2-7 days after the surgery, while you may feel pain and weakness for a week or two. Complete recovery may take up to 6 weeks, depending on the surgery. You may have an unusual sensation in the breast that would usually disappear over time. In most cases there could be a slight asymmetry between the breasts, however, most women report a significant improvement in their social life and self esteem.
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Plastic Surgery News...
- The Royal Pharmaceutical Society of Great Britain (RPSGB) has published its updated 1997 Report of the Working Party on the prevention of HIV/AIDS, hepatitis B and C and sexually transmitted diseases – a document which examines the place of pharmacists in the fight against these illnesses (see link above). It discusses and updates the main recommendations made in 1997, covering the following:
• Display of information in community pharmacies relating to prevention of HIV/AIDS, hepatitis B and C and sexually transmitted diseases, and to the risks associated with intravenous drug use
• Signposting to other services – e.g. sexual health services, addiction and substance misuse services, written and internet-based information
• Clean needles and syringes exchange schemes (PNEX)
• Supply of water for injection by pharmacists
• Self-administration of methadone in pharmacies
• Education and training for pharmacists and pharmacy technicians on social skills and on the non-medical use of drugs
• Role of local pharmaceutical committee (LPC) and Area Pharmaceutical Committee (APC), Area Pharmacy Contractor’s Committees (APCC) in facilitating pharmacists’ involvement in the prevention of HIV/AIDS and other related conditions
• Improving liaison between prescribers and community pharmacists – e.g. appointment of drug liaison pharmacist
• Promotion of pharmacists’ role in this field and encouragement of research projects which might show the benefits
The need for future recommendations in other areas is discussed, and will be considered in any future updated version of the report.
- Research published early online in the European Heart Journal suggests that percutaneous coronary intervention (PCI) is safe even if performed during uninterrupted anticoagulation (UAC).
According to the researchers, a common consensus is to postpone PCI until international normalised ratio (INR) levels of < 1.5–1.8 are reached. Therefore, the safety and efficacy of various periprocedural antithrombotic strategies in patients on long-term oral anticoagulation with warfarin was investigated.
The study involved a retrospective analysis of all consecutive patients (n=523) on warfarin therapy referred for PCI in four centres with a policy to interrupt anticoagulation (IAC) before PCI and in three centres with UAC during PCI.
Major bleeding, access-site complications, and major adverse cardiac events (death, myocardial infarction, target vessel revascularisation, and stent thrombosis) were recorded during hospitalisation. A total of 241 patients underwent PCI without pauses in warfarin therapy (the UAC group; mean INR = 2.2), and in 254 patients (IAC group), oral anticoagulation treatment with warfarin was stopped before the procedure (mean 3.0 days, range 1–30 days). Furthermore, a total of 28 patients underwent PCI when warfarin treatment was interrupted on the day of the index procedure.
The following results were reported:
• Glycoprotein IIb/IIIa (GP) inhibitors (P < 0.001) and low-molecular-weight heparins (P < 0.001) were more often used in the IAC group.
• Major bleeding and access-site complications were more common in the IAC group (5.0% vs. 1.2%, P = 0.02 and 11.3% vs. 5.0%, P = 0.01, respectively) than in the UAC group.
• After adjusting for propensity score, the group difference in access-site complications remained significant [OR (odds ratio) 2.8, 95% CI (confidence interval) 1.3–6.1, P = 0.008], but did not remain significant in major bleeding (OR 3.9, 95% CI 1.0–15.3, P = 0.05).