Reconstructive and esthetic breast surgery after solid organ transplantation - a systematic review, proposal of a novel protocol and case presentations.

INTRODUCTION: Great advancements in solid organ transplantation (SOT) have allowed patients to have better chances to survive longer and enjoy a quality life after surgery. This increasing number of SOTs and improved long-term survival rates lead to an increasing demand for plastic, esthetic and reconstructive breast procedures. MATERIAL AND METHODS: A literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and using searching terms related to esthetic and reconstructive breast surgery was conducted across three databases: PubMed, Scopus and Google Scholar. Included articles were analyzed to extract data points of interest including patient age, type of surgery, organ transplanted, underlying conditions associated with organ transplantation, follow-up, immunosuppressive drugs and their side effects, perioperative management and complications related to the breast plastic procedures in SOT recipients. RESULTS: A total of 1,298 articles were retrieved from the mentioned electronic databases. Eight full articles were finally included in this systematic review. In these articles, a total of 41 cases of breast plastic surgery after solid organ transplantation were reported. Procedures were esthetic in nature in 26.83% of cases (11 of 41 cases) and reconstructive in 73.17% of them (30 of 41 cases). No deaths were reported. CONCLUSIONS: Although esthetic and reconstructive breast surgery could be performed safely in SOT recipients, the dosage of immunosuppression and patient's overall health status with regard to the length and extent of the planned procedure should always be taken into account. From the literature data analysis, it is not possible to draw a statistical conclusion that the complication rate of surgery in immunosuppressed post-transplant patients is the same as in normal, not immunosuppressed population. Further and more valid clinical studies are warranted.

Dismorfia de genitales externos en la población pediátrica / Dysmorphia external genitalia in the pediatric population

El procedimiento estético más común de los genitales femeninos es la reducción de los labios menores (labioplastía). Cada vez son más las niñas y mujeres jóvenes que prestan especial atención a la apariencia estética de sus genitales externos. La causa más común de hipertrofia es probablemente la congénita. Las mujeres afectadas habitualmente sufren vergüenza social y preocupación estética. Existen numerosas técnicas para la corrección quirúrgica en la literatura médica, aunque ningún método es superior a otro. Se presentan dos casos de dismorfia de labios menores en adolescentes. En un caso, de dismorfia congénita, se utilizó la técnica de reducción en ancho y en largo mediante desepitelización y resección en cuña inferior. Esta asociación proporciona un cierre libre de tensión y asegura una vascularización adecuada del borde del colgajo superior, lo que disminuiría el riesgo de dehiscencia de herida. En el otro caso, secuela de trauma, se reimplantó el labio afectado con resección del tercio distal del mismo. En ambas pacientes los resultados estéticos fueron satisfactorios...

The most common cosmetic procedure of the female genitalia is the labia minora reduction (labiaplasty). There are more and more girls and young women, with special attention to the aesthetic appearance of their external genitalia. The most common cause of hypertrophy is likely to congenital. Affected women usually suffer social shame and aesthetic concerns. There are numerous techniques for surgical correction in the medical literature, although no method is superior to another. Two cases of a minor dysmorphic teen lips are presented. In one case, a congenital dysmorphic, we used the reduction technique in width and in length by epithelialization and lower wedge resection. This partnership provides tension-free closure and ensures proper vascularization of the upper edge flap, which would reduce the risk wound dehiscence. In the other case, sequel to trauma, the affected lip were treated with resection of the distal portion. In both patients the aesthetic results were satisfactory...

Dismorfia de genitales externos en la población pediátrica / Genital dysmorphia external in the population pediatric

El procedimiento estético más común de los genitales femeninos es la reducción de los labios menores (labioplastia). Cada vez son más las niñas y mujeres jóvenes que prestan especial atención a la apariencia estética de sus genitales externos. La causa más común de hipertrofi a es probablemente la congénita. Las mujeres afectadas habitualmente sufren vergüenza social y preocupación estética. Existen numerosas técnicas para la corrección quirúrgica en la literatura médica, aunque ningún método es superior a otro. Se presentan dos casos de dismorfi a de labios menores en adolescentes. En un caso, de dismorfi a congénita, se utilizó la técnica de reducción en ancho y en largo mediante desepitelización y resección en cuña inferior. Esta asociación proporciona un cierre libre de tensión y asegura una vascularización adecuada del borde del colgajo superior, lo que disminuiría el riesgo de dehiscencia de herida. En el otro caso, secuela de trauma, se reimplantó el labio afectado con resección del tercio distal del mismo. En ambas pacientes los resultados estéticos fueron satisfactorios

The most common cosmetic procedure of the female genitalia is the labia minora reduction ( labiaplasty ). There are more and more girls and young women, with special attention to the aesthetic appearance of their external genitalia. The most common cause of hypertrophy is likely to congenital. Aff ected women usually suff er social shame and aesthetic concerns. There are numerous techniques for surgical correction in the medical literature, although no method is superior to another. Two cases of a minor dysmorphic teen lips are presented. In one case, a congenital dysmorphic, we used the reduction technique in width and in length by epithelialization and lower wedge resection. This partnership provides tension-free closure and ensures proper vascularization of the upper edge fl ap, which would reduce the risk wound dehiscence . In the other case, sequel to trauma, the aff ected lip were treated with resection of the distal portion. In both patients the aesthetic results were satisfactory.