RESUMO
BACKGROUND: Breast implant displacement or rupture can cause aesthetic problems and serious medical complications. Activities with prone positioning and loading of the anterior chest wall, such as massage, chiropractic or osteopathic therapies may increase the risk of implant failure and can also cause discomfort in women with natural breast tissue. Here we test the effectiveness of a newly developed orthosis on pain, mechanical pressure and displacement of breast tissue in women with cosmetic augmentation, post-mastectomy reconstruction, lactating or natural breast tissue. METHODS: Thirty-two females volunteers, aged 25-56 years with augmented, reconstructed, natural or lactating breast tissue and cup sizes B-F, participated in this open-label clinical trial. We measured pain perception, peak pressure, maximum force, and breast tissue displacement using different sizes of the orthosis compared to no orthosis. Different densities of the orthosis were also tested in a subgroup of women (n = 7). Pain perception was rated using a validated 11-point visual-analogue scale. Peak pressure and maximum force were assessed using a bilateral set of capacitance-pliance® sensor strips whilst participants were load bearing in a prone position, and breast displacement was measured by magnetic-resonance-imaging. RESULTS: The orthosis significantly reduced pain, breast displacement and mechanical pressures in women with natural and augmented breast tissue in prone position. Greater relief of pain and greater reduction in mechanical forces were found with increased size and density of the orthosis. Use of the orthosis improved overall comfort by 64-100%, lowered peak pressure by up to 85% and maximum force by up to 96%. Medio-lateral displacement of breast tissue was reduced by 16%, resulting in a 51% desirable increase of breast tissue height. CONCLUSION: Our study demonstrated that the newly developed orthosis significantly reduced pain, mechanical pressure and breast tissue displacement in women with augmented and natural breast tissue when lying prone. Our findings are of clinical significance, potentially reducing the risk of complication from prone activities in women with breast augmentation or reconstruction, as well as improving comfort whilst undergoing prone procedures. TRIAL REGISTRATION: Australia and New Zealand Clinical Trials Register, ACTRN12613000541707.
RESUMO
BACKGROUND: Breast augmentation, post-mastectomy patients as well as some women with natural breast tissue, and lactating, women often experience discomfort in prone activities. Our study, for the first time, examines pain levels, mechanical force and peak pressure in natural, reconstructed and augmented breast tissues with and without a new orthosis designed for reduction of displacement, compression and loading forces through the breast tissue during prone activities. METHODS: Twelve females with natural, lactating or augmented breast tissue, and cup-sizes C-F volunteered for the study. Pain perception was measured using an 11-point visual-analogue-scale without and with different sizes/textures of the orthosis. Magnetic-Resonance-Imaging captured segmental transverse and para-sagittal mid-breast views, and provided linear measurements of breast tissue displacement and deformation. Capacitance-pliance® sensorstrips were used to measure force and pressure between the breast tissue and the surface of a standard treatment table. Measurements were taken whilst the participants were load bearing in prone positions with and without the orthosis. RESULTS: The new orthosis significantly reduced pain and mechanical forces in participants with natural or augmented breast tissue with cup-sizes C-F. Larger orthotic sizes were correlated with greater reduction in pain and mechanical forces, with all participants reporting no pain with the largest size orthotic. A size-3 orthotic decreased load on the breast tissue by 82% and reduced peak pressure by 42%. The same orthotic decreased medio-lateral spread of breast tissue and implant whilst increasing height. CONCLUSIONS: The new orthosis significantly reduced pain and mechanical forces in all women with natural or augmented tissues. Results are of clinical significance, as reduced mechanical forces are associated with greater comfort and reduced pressure and displacement which may lower the probability of breast implant complication. In clinical settings the orthosis is recommended for all augmentation patients when undergoing prone treatment by therapists and clinicians for improved comfort and safety.
