Maxine Schurter

The effects of mammary hypertrophy on the skeletal system.

Women with mammary hypertrophy usually have a number of complaints relating to the skeletal system. Nech strain, headache, aching shoulders, heavy anterior chest, and paresthesias of the little fingers disappear after reduction mammaplasty. Low back pain is either completely eliminated or dramatically improved. Posture may or may not be corrected. It is suggested that muscle reeducation be institued in patients who do not show spontaneous improvement. Deep brassiere strap jurrows may vanish after a long postoperative period, or they may be permanent. In any case, they become asymptomatic. The effects of hypertrophic breasts on the skeletal system are many and varied. A few such problems are illustrated. Many more exist.

HEMANGIOMAS IN PREGNANCY.

Washington, D. C. T H I s IS a report of a series of unusual experiences with cutaneous and mucosal hemangiomas which developed or became symptomatic during pregnancy. A hemangioma may be defined as a benign blood vessel tumor with its components somewhat apart from the general circulatory system. In pregnancy, these vascular tumors first appear during the middle trimester, gradually increase in size until term, and then usually regress in the puerperium. They may disappear completely after pregnancy or they remain permanently. In some instances, in which no treatment of the lesion had been instituted during a previous pregnancy, the tumor recurred or enlarged during subsequent pregnancies. There are many different classifications of hemangiomas. Some are clinical, while others are based on microscopic findings. Winer and Levin’ consider the acquired cutaneous hemangiomas of pregnancy to be eruptive angiomas. The involved capillaries may be arterial or venous. Arterial capillary angiomas may represent an overgrowth of an end artery of the skin or a thickened coiled artery of the cutis. The venous capillary angioma usually overlies a vein or venule which has become obstructed.

A Sitting Position for Mammaplasty with General Anesthesia

The final cosmetic result achieved by a mammaplasty is judged primarily upon the size, shape, and position the breasts assume with the individual in the erect position. For the past thirty-five years we have used the sitting position for certain mammaplasty procedures. It has proved especially advantageous and indeed mandatory for those mam-maplasties in which the new nipple-areolar site has not been determined before operation.When we first used this position, complications were encountered. This finding prompted an analysis of the entire problem and the institution of measures to prevent compli-cations. With time, a simple routine for positioning the patient evolved. Special measures are used to ensure the integrity of the cardiovascular, respiratory, and musculoskeletal systems. The peripheral nerves and peripheral soft tissue structures must be protected. If the proper care is taken, the sitting position for mammaplasty is safe, and it can be of real value to the surgeon.

Suggested nomenclature for aesthetic and reconstructive surgery of the breast. Part III: Gynecomastia

The more recent studies of the Committee on Nomenclature of the American Society for Aesthetic Plastic Surgery have concerned the breast. Part l (1983) dealt with the anatomic, diagnostic, and surgical terms used in female breast reduction [7]. Part II (1984) suggested terms to be used for augmentation mammoplasty and mastopexy [8]. Part Ill (1985) of this series concerns the male breast and gynecomastia. The nomenclature pertaining to gynecomastia has been prepared. Current literature available to plastic surgeons in the United States has been reviewed. Anatomic, diagnostic, and surgical procedural terms in common usage have been listed. The International Classification of Diseases (I.C.D.) and Physicians Current Procedural Terminology (C.P.T.) have been compared for coding purposes. Nomenclature previously defined and discussed in Parts I and II are not repeated in this article.

Suggested nomenclature for aesthetic and reconstructive surgery of the breasts. IV: Congenital anomalies of the breast

A nomenclature for the definition, diagnosis, and surgical management of the congenital anomalies of the breast is suggested. The International Classification of Diseases (ICD) and the Current Procedural Terminology (CPT) code numbers pertaining to these anomalies have been tabulated.A nomenclature for the definition, diagnosis, and surgical management of the congenital anomalies of the breast is suggested. The International Classification of Diseases (ICD) and the Current Procedural Terminology (CPT) code numbers pertaining to these anomalies have been tabulated.

A suggested English nomenclature for aesthetic surgery of the abdominal wall

Our knowledge of plastic surgery has been greatly enhanced by our ability to share old and new concepts with each other. If we are to continue to learn from current medical literature, we must try to adopt a method of writing that can be understood by the greatest possible number of people. It seems clear that when an anatomical term is used, it should conform to the listings found in Nomina Anatomica [ 1]. When discussing diagnoses and surgical procedures, however, the problem becomes more complex. We have tried to standardize the terms that relale to aesthetic and plastic surgery of the abdomen. Several hundred articles were reviewed in 7 languages. Each term was checked against the International Classification o f Diseases, 9th edition [2], and all those not found were discarded. The remaining terms were checked for their root origin in Latin or Greek, and those that did not have such a root origin were discarded. The final terminology was divided into diagnosis and surgery, each on an anatomical basis: skin, subcutaneous tissue, and muscle and fascia. Almost all of these terms had a comparable word in Spanish, Portuguese, Italian, and French. Very few had a similar word in German. In the following table, we present a simple, anatomically based terminology that we hope can be used by all.