A case of extracapsular silicone gel implant rupture with contralateral gel migration.

Symmastia is a rare complication of augmentation mammaplasty that occurs when a breast implant crosses the midline and connects with the contralateral implant pocket. We present a case of implant rupture, migration to the contralateral breast, and ultimate symmastia following a traumatic fall in a patient with prior breast augmentation.

Urinary bladder matrix for lower extremity split-thickness skin graft donor site.

Split-thickness skin grafts (STSG) are commonly used to treat soft-tissue defects. Harvesting a STSG creates an additional partial thickness wound at the donor site which must be managed. Many dressings are commercially available for the management of STSG donor sites; however, there is no evidence-based consensus on optimal dressing for site management. Urinary bladder matrix (UBM) is an extracellular matrix that acts as a structural support for tissue remodeling and provides molecular components for repair. Common clinical applications of UBM include coverage of deep wounds, burns, and irradiated skin. Skin grafting from the lower extremities poses a challenge due to the increased dermal tension. UBM-based reconstruction is an alternative method of managing lower extremity skin graft donor sites. This case study demonstrates the use of UBM in the reconstruction of a STSG donor site of the anterolateral thigh, which resulted in satisfactory healing, no pain, and excellent cosmetic and functional outcomes.

Nipple Reconstruction with the Biodesign Nipple Reconstruction Cylinder: A Prospective Clinical Study.

BACKGROUND: Nipple reconstruction is the last stage in cosmetic reconstruction of the breast after mastectomy, but no method produces reliable and consistent aesthetic results. This study examined the use of the Biodesign Nipple Reconstruction Cylinder (NRC) during reconstruction of the nipple after mastectomy. METHODS: Patients with a history of breast cancer and mastectomy desiring nipple reconstruction were invited to participate. After obtaining consent, unilateral or bilateral nipple reconstruction was performed. Skin flaps were raised, the NRC was placed beneath the flaps as a stent, and the site was protected for up to 4 weeks with a nipple shield. Nipple projection was measured for 12 months after surgery. Patient satisfaction was measured and adverse events were recorded. Follow-up examinations were performed at 1 week, and then at 1, 3, 6, and 12 months after surgery. RESULTS: Eighty-two nipple reconstructions were performed in 50 patients. Related postoperative adverse events were minor, but reported in 8 reconstructions (9.8%) representing 7 patients (14.0%). Average projection at 6 and 12 months was 4.1 ± 1.6 mm and 3.8 ± 1.5 mm, respectively, compared with 10.5 ± 2.2 mm 1 week after surgery. Of patients completing the satisfaction questionnaire at 12 months, 70/75 (93.3%) of reconstructions were rated "pleased" or "very pleased" with the overall outcome. Overall, 45/46 (97.8%) patients would recommend nipple reconstruction to other women. CONCLUSIONS: The Biodesign NRC offers a safe alternative to nipple reconstruction, resulting in stable projection and a high level of patient satisfaction for 12 months after placement.