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Biomedical subjects

R V Dowden

Publications and source records attributed to R V Dowden.

At least 37 records · Page 2Linked to original sources
PubMed1990

Expandable breast implant reconstruction of Tikhoff-Linberg shoulder deformity.

Expanding breast implants were used in two patients to reconstruct shoulder contour following a Tikhoff-Linberg resection for cancer. In the first patient, one implant alone was used, and in the second patient, two implants in separate but adjacent pockets. The resulting double contour is more pleasing than that after a single implant, and there also appears to be more flexibility with shoulder motion. This method is suggested as an excellent means of reconstructing the contour of the shoulder area following resection for cancer.

Breast↗
PubMed1988

Mondor's disease in plastic surgery patients.

Thrombophlebitis of the chest wall is a benign, self-limiting condition. When it is recognized, the patient can be confidently reassured that spontaneous resolution is expected. The characteristic cutaneous cords are palpable five to seven weeks postoperatively, and they generally resolve within several months without specific therapy. Mondor's disease appears to be related to injury of the subcutaneous chest veins at the initial surgery rather than at reoperation. There is no apparent relationship between Mondor's disease and silicon implants nor between Mondor's disease and capsule contracture. Mondor's disease may be more common then generally believed.

Adult↗
PubMed1987

The tubular/tuberous breast syndrome.

There are various degrees of expression of the fully developed tubular/tuberous deformity. To develop an adequate treatment plan for this condition, the individual deformities constituting the fully expressed syndrome must be diagnosed. The treatment plan must include maneuvers to correct each deficiency within the syndrome itself. We present the spectrum of abnormalities constituting the tubular/tuberous syndrome and the treatment plan thereof.

Adult↗
PubMed1987

Achieving a natural inframammary fold and ptotic effect in the reconstructed breast.

Achieving a natural inframammary fold in the reconstructed breast is a challenging but essential aspect of the excellent result for which we strive. Just as there are many methods of reconstruction, so too are there many ways to enhance the effect of a distinct fold in the reconstructed breast. Several of these techniques are discussed here, including methods for use with flaps, advancements, and expanders, with particular emphasis on implant reconstructions, both immediate and delayed. Also covered are the contributions of external massage and open capsulotomy toward this objective.

Breast↗
PubMed1987

The current approach to breast reconstruction.

Over the last 30 years, breast reconstruction has become a standard part of the care of the breast cancer patient. While it may take another 30 years for many of the traditional oncologic concerns about reconstruction to be answered, indications are that reconstruction does not alter the patient's prognosis in any way. The increased understanding of breast cancer as a disease which is systemic from early in its course has removed many of the former objections to reconstruction. Reconstruction can be performed after almost any type of mastectomy. Chemotherapy does not interfere with reconstruction, as long as the timing of doses is considered. However, therapeutic radiation does present problems which may preclude reconstruction. Conversely, having had reconstruction does not interfere with later chemo or radiation therapy. The author describes reconstructive options and their relationship to oncological decisions and concerns.

Breast↗
PubMed1987

Munchausen's syndrome and prophylactic mastectomy.

A patient sought bilateral prophylactic mastectomies because of a strongly positive family history of breast cancer. Fortunately, prior to operation, this family history was discovered to be a fabrication by the patient. Few ablative plastic surgical procedures are done without objective criteria. Plastic surgeons relying on a positive family history as sufficient indication for bilateral prophylactic mastectomy need to be aware that such a history may be the contrivance of a patient with Munchausen's syndrome. A high index of suspicion may enable the plastic surgeon to recognize Munchausen's syndrome and thus avoid both contributing to the patient's illness and performing an unwarranted operation.

Adult↗
PubMed1985

Lumbar hernia after latissimus dorsi flap.

The authors present what they believe to be the first recorded case of a lumbar hernia following latissimus dorsi myocutaneous flap procedure. The authors discuss the diagnosis by physical examination and x-ray confirmation, pointing out the importance of not mistaking the hernia for a seroma. Suggestions for avoiding the problem are given, relating primarily to preservation of the fascia underlying the distal latissimus aponeurosis.

Diagnosis, Differential↗
PubMed1985

Plastic surgical considerations for urologic surgeons.

Some of the catastrophic problems involving the abdominal wall that occur after surgery are avoidable. Careful planning of the incision with vascular territories in mind can avoid devascularizing areas of skin. The use of intravenous fluorescein can help the surgeon to predict necrosis and take steps to circumvent the problem. These considerations and timely plastic surgical consultations can aid the urologic surgeon in providing patients with the optimal care.

Abdominal Muscles↗
PubMed1984

Breast reconstruction. State of the art.

Some variant of mastectomy remains the mainstay of the treatment of the primary tumor for the vast majority of the 110,000 new cases of cancer of the breast which will be treated this year in the United States. Reconstruction of the breast after ablation for cancer has become an integral part of the therapeutic regimen of this disease. With the increase in availability and dissemination of information about reconstruction, women expect the opportunity to discuss the options of such surgical rehabilitation after mastectomy. The three major questions arise in regard to reconstruction of the breast: (1) Who should be reconstructed? (2) When should the reconstruction be performed? (3) How should the goals of reconstruction be realized? In answer to these questions, healthy reconstruction is available for any patient, provided she is well enough to undergo the surgical procedure. This may be performed immediately at the time of the ablative mastectomy or delayed for a period of 3 months or more. The nature of the reconstructive procedure is tailored according to the nature of the mastectomy and residual deformity. The authors present their philosophy as to who should be reconstructed, when the optimum time is for this procedure, and their techniques for fulfilling these goals.

Breast↗
PubMed1984

Breast reduction for asymmetrical hypertrophy.

Design details of reduction of asymmetrical hypertrophy of the breasts are discussed. The concepts apply to nearly any breast reduction technique, although here they are presented in the context of the inferior segment method, which we favor. Although most of these points may seem self-evident to the experienced plastic surgeon, there has been little written about the details.

Breast↗
PubMed1984

Breast reconstruction without skin flaps.

The development of reliable flaps has made breast reconstruction possible for virtually any patient who has had a mastectomy. However, most breast reconstructions are performed with implants, without flaps. The authors give examples of the use of implants alone without flaps, in situations usually thought to require flaps.

Breast↗
PubMed1984

Surgical considerations in managing the remaining breast during postmastectomy breast reconstruction.

The age and general condition of the patient, size and shape of the remaining breast, various risk factors such as the histologic type of carcinoma, and family history are all critical in governing the definitive management of the remaining breast during postmastectomy breast reconstruction. The philosophy, timing, and method of dealing with the remaining breast must be discussed carefully with the patient. The psychological, social, and physical status of the patient must be addressed, with special emphasis in regard to her future and the degree of risk involved.

Breast↗