RESUMO
Quality of Life (QoL) has become a standard measure in assessing the effectiveness of medical interventions. We compared the differences between QoL and body image scale (BIS) in a group of patients who underwent breast surgery, including lumpectomy or conservative surgery, modified radical mastectomy and radical mastectomy with breast reconstruction. We included patients who underwent breast surgery between August of 2005 and June of 2006 in two tertiary referral centers in Mexico City. Two self-administered questionnaires assessing body image perception, BIS and quality of life (SF-36), were assigned and a physician-conducted interview was done. We stratified patients by age, marital status, and scholar grade. The sample comprised 202 patients. The BIS results yielded: the group with a benign lesion demonstrated favorable body image perception when compared with the malignant lesion group. A confirmed diagnosis of malignancy hinders QoL in older and younger age groups. Conservative surgery and breast reconstruction improves QoL in younger patients without significance in the older group. The most significant variable that hinders the BIS and QoL is the cancer diagnosis. Impact of conservative surgery and breast reconstruction in body image perception and quality of life is influenced by patient age and educational level.
Assuntos
Neoplasias da Mama/psicologia , Neoplasias da Mama/cirurgia , Mastectomia/psicologia , Adulto , Idoso , Imagem Corporal , Feminino , Indicadores Básicos de Saúde , Humanos , Mamoplastia/psicologia , Mastectomia Radical Modificada/psicologia , Mastectomia Segmentar/psicologia , Pessoa de Meia-Idade , Qualidade de Vida , Adulto JovemRESUMO
BACKGROUND: Dorsal nasal contour can be improved by using fragmented or crushed cartilage grafts wrapped with fascia in patients with dorsal nasal deformities. METHODS: The authors obtain cartilage from the ear concha that is fragmented or crushed. Fascia is harvested from the temporal region. Multifragmented cartilage is wrapped with deep temporal fascia, making a roll. After creating a cavity in the nasal dorsum, the bone is rasped and the combined roll graft is introduced, and appropriate modeling of the graft is mandatory. The authors have operated on 115 patients with this procedure, 68 primary operations and 47 secondary operations, over a 13-year period. RESULTS: In the great majority of cases, results were excellent. To avoid deviation of the roll graft, it is important to prepare a straight cavity. Especially in secondary cases, seroma is manifested by swelling and reddish skin color, which is removed with a 2-mm incision made with a no. 15 knife and constant pressure over the nose for some minutes. The authors have observed only five primary cases with seroma and 13 secondary cases. CONCLUSIONS: This procedure in the authors' hands has given magnificent aesthetic long-lasting results and a "natural appearing" outcome.