Breast Tissue Expanders with Magnetic Ports: Clinical Experience at 1.5 T.

BACKGROUND: The purpose of this study was to evaluate breast tissue expanders with magnetic ports for safety in patients undergoing abdominal/pelvic magnetic resonance angiography before autologous breast reconstruction. METHODS: Magnetic resonance angiography of the abdomen and pelvis at 1.5 T was performed in 71 patients in prone position with tissue expanders with magnetic ports labeled "MR Unsafe" from July of 2012 to May of 2014. Patients were monitored during magnetic resonance angiography for tissue expander-related symptoms, and the chest wall tissue adjacent to the tissue expander was examined for injury at the time of tissue expander removal for breast reconstruction. Retrospective review of these patients' clinical records was performed. T2-weighted fast spin echo, steady-state free precession and gadolinium-enhanced spoiled gradient echo sequences were assessed for image artifacts. RESULTS: No patient had tissue expander or magnetic port migration during the magnetic resonance examination and none reported pain during scanning. On tissue expander removal (71 patients, 112 implants), the surgeons reported no evidence of tissue damage, and there were no operative complications at those sites of breast reconstruction. CONCLUSION: Magnetic resonance angiography of the abdomen and pelvis in patients with certain breast tissue expanders containing magnetic ports can be performed safely at 1.5 T for pre-autologous flap breast reconstruction perforator vessel mapping. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Assessment of biomechanical skin properties: is cellulitic skin different?

BACKGROUND: An objective in vivo measurement of viscoelastic skin properties is difficult. Consequently, the clinician's ability to evaluate the effectiveness of therapies that may affect skin pliability and skin surface characteristics is limited. OBJECTIVE: The purpose of this study was to evaluate the usefulness of the Biomechanical Tissue Characterization BTC-2000 System for objective, noninvasive assessment of viscoelastic skin properties, specifically by testing the hypothesis that cellulite-affected skin may have different biomechanical characteristics than skin without a cellulitic appearance. METHODS: A prospective study comparing 2 closely matched, nonrandomized groups of 15 women with and without cellulite in cellulite-prone areas was conducted. Biomechanical parameters including skin laxity, elastic and viscoelastic deformation, stiffness, energy absorption depicting overall tissue compliance, and elasticity were measured in an area prone to cellulite (the lateral thigh) and one not prone to cellulite (the posterior shoulder). RESULTS: The degree of the elastic deformation on the maximum pressure, stiffness, and elasticity was similar for all areas in both groups (P > .05). Comparisons of individual parameters showed decreased elastic deformity and laxity of skin among individuals with no cellulite in the cellulite-prone area (P < .05), whereas there was no significant difference between the groups in the cellulite-nonprone area (P > .05). In addition, in volunteers with cellulite, lateral thigh and posterior shoulder skin was remarkably softer, as reflected by energy absorption, than in those without cellulite (P < .05). CONCLUSIONS: An assessment of volunteers with and without cellulite in cellulite-prone and non-prone areas demonstrated that BMT-2000 technology allows noninvasive, reproducible measurements of selected biomechanical skin properties. Such measurements will be useful in assessing changes in skin laxity and elasticity in aesthetic surgical and nonsurgical treatments, and in evaluating skin, skin care programs, and cosmeceutical agents. (Aesthetic Surg J 2002;22:260-266.).