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Article ; Online: Hybridrekonstruktion der Brust nach Mastektomie.

Momeni, Arash

Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...

2022 Volume 54, Issue 4, Page(s) 297–304

Abstract: The challenge following mastectomy is to safely reconstruct breasts of adequate size, shape, symmetry, softness, and sensation ("6 S"). Historically, patients have been offered two reconstructive modalities, namely either implant-based or autologous ... ...

Title translation	Hybrid Breast Reconstruction Following Mastectomy.
Abstract	The challenge following mastectomy is to safely reconstruct breasts of adequate size, shape, symmetry, softness, and sensation ("6 S"). Historically, patients have been offered two reconstructive modalities, namely either implant-based or autologous reconstruction. While this binary approach is appropriate for most patients, there remain a subset of patients for whom this simplistic approach is not suitable. For these, hybrid reconstruction, i. e., the combination of an implant with microsurgical tissue transfer, offers the possibility of individualised reconstruction, which avoids some of the limitations of traditional approaches. Hybrid breast reconstruction, thus expands the indications for microsurgical reconstruction and offers the advantages of this reconstructive modality to a larger patient population. In this article, the surgical technique of hybrid breast reconstruction is described, along with a discussion of important parameters related to this reconstructive modality, including plane and timing of implant placement, and the issue of radiotherapy.
MeSH term(s)	Breast Implants ; Breast Neoplasms/surgery ; Female ; Humans ; Mammaplasty/methods ; Mastectomy/methods ; Retrospective Studies
Language	German
Publishing date	2022-06-22
Publishing country	Germany
Document type	Journal Article
ZDB-ID	392414-2
ISSN	1439-3980 ; 0722-1819
ISSN (online)	1439-3980
ISSN	0722-1819
DOI	10.1055/a-1808-6779
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Article: A plastic surgery perspective on the choice between breast conserving surgery with radiotherapy versus mastectomy and reconstruction.

Silverstein, Max L / Momeni, Arash

Gland surgery

2024 Volume 13, Issue 3, Page(s) 449–451

Language	English
Publishing date	2024-03-14
Publishing country	China (Republic : 1949- )
Document type	Editorial ; Comment
ZDB-ID	3016969-0
ISSN	2227-8575 ; 2227-684X
ISSN (online)	2227-8575
ISSN	2227-684X
DOI	10.21037/gs-23-506
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Article: Hybridrekonstruktion der Brust nach Mastektomie

Momeni, Arash

Handchirurgie · Mikrochirurgie · Plastische Chirurgie

2022 Volume 54, Issue 04, Page(s) 297–304

Abstract: Die Herausforderung nach Mastektomie ist die sichere Rekonstruktion der Brust von adäquater Größe und Form, welche weich, symmetrisch und sensibel ist („6 S“: size, shape, symmetry, softness, ... ...

Abstract	Die Herausforderung nach Mastektomie ist die sichere Rekonstruktion der Brust von adäquater Größe und Form, welche weich, symmetrisch und sensibel ist („6 S“: size, shape, symmetry, softness, sensation, safety). Traditionell wurden Patientinnen zwei rekonstruktive Verfahren angeboten, nämlich die Implantat-basierte vs. autologe Brustrekonstruktion. Obgleich dieses binäre Vorgehen für die Mehrzahl der Patientinnen adäquat ist, so verbleibt ein Anteil, für welche dieser recht einfache Entscheidungsalgorithmus keine optimale Lösung darstellt. Hier bietet die Hybdridrekonstruktion, d. h. die Kombination von Implantat und mikrochirurgischer Lappenplastik, die Möglichkeit Patientinnen eine individualisierte Rekonstruktion anzubieten, welche die einzelnen Limitationen der traditionellen Verfahren durch Kombination vermeidet. Insofern erweitert die Hybridrekonstruktion das Indikationsspektrum der mikrochirurgischen Brustrekonstruktion und stellt die Vorteile der autologen Brustrekonstruktion einer größeren Patientenpopulation zur Verfügung. In diesem Beitrag wird das operative Vorgehen der Hybridrekonstruktion vorgestellt mitsamt einer Diskussion wichtiger Parameter, inklusive der Implantatloge, Zeitpunkt der Implantatplatzierung, sowie Einfluss der Radiatio.
Keywords	Brustrekonstruktion ; Hybridrekonstruktion ; Mikrochirurgie ; Implantat ; freie Lappenplastiken, Mikrochirurgie ; Breast reconstruction ; Hybrid reconstruction ; microsurgery ; breast implant ; free flaps
Language	German
Publishing date	2022-06-22
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	392414-2
ISSN	1439-3980 ; 0722-1819
ISSN (online)	1439-3980
ISSN	0722-1819
DOI	10.1055/a-1808-6779
Database	Thieme publisher's database

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Article ; Online: Long-Term Outcomes Following Hybrid Breast Reconstruction.

Silverstein, Max L / Momeni, Arash

Plastic and reconstructive surgery

2023

Abstract: Background: Hybrid breast reconstruction combines free tissue transfer with implant placement. Various mesh products have been successfully used to secure the implant position in these reconstructions. In this study, the authors investigate the impact ... ...

Abstract	Background: Hybrid breast reconstruction combines free tissue transfer with implant placement. Various mesh products have been successfully used to secure the implant position in these reconstructions. In this study, the authors investigate the impact of mesh type on long-term outcomes following hybrid breast reconstruction. Methods: A retrospective analysis of all patients with at least 24 months of follow-up after immediate bilateral prepectoral hybrid breast reconstruction was performed. Univariate and multivariable regression analyses were used to evaluate long-term outcomes and compare breasts reconstructed with polyglactin mesh versus acellular dermal matrix (ADM). Results: Thirty-nine patients (78 breasts) who underwent hybrid breast reconstruction with an average follow-up period of 50.4 months (range, 27 to 73 months) were included in the study. Post-operative complications included hematoma [n = 2 (2.6 percent)], mastectomy skin necrosis [n = 12 (15.4 percent)], and fat necrosis [n = 6 (7.7%)]. There were no instances of implant infection, implant exposure, or flap failure. Polyglactin mesh and ADM were used in 24 breasts and 54 breasts, respectively. Implant malposition and capsular contracture occurred more frequently in the polyglactin cohort leading to 10 (41.7 percent) instances of re-operation for implant replacement compared to only 1 (1.9 percent) in the ADM cohort (p < 0.001). On multivariable regression analysis, polyglactin mesh was associated with a 36-fold greater probability of requiring implant replacement compared to ADM (p = 0.006). Conclusions: ADM (vs. polyglactin mesh) is associated with lower rates of capsular contracture and implant malposition in the context of hybrid breast reconstruction.
Language	English
Publishing date	2023-08-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	208012-6
ISSN	1529-4242 ; 0032-1052 ; 0096-8501
ISSN (online)	1529-4242
ISSN	0032-1052 ; 0096-8501
DOI	10.1097/PRS.0000000000010987
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Uk I Zs.142: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article: Reconsidering the Standard of Care for Peripheral Nerve Reconstruction.

Safa, Bauback / Momeni, Arash

Plastic and reconstructive surgery. Global open

2023 Volume 11, Issue 11, Page(s) e5320

Language	English
Publishing date	2023-11-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2851682-5
ISSN	2169-7574 ; 2169-7574
ISSN (online)	2169-7574
ISSN	2169-7574
DOI	10.1097/GOX.0000000000005320
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Article: Managing Postoperative Infection following Breast Reconstruction with the Sientra AlloX2 Tissue Expander.

Momeni, Arash

Plastic and reconstructive surgery. Global open

2018 Volume 6, Issue 12, Page(s) e2046

Abstract: Background: Implant-based breast reconstruction is the most common reconstructive modality in the United States. Significant advances in surgical technique and technology have resulted in improvement of clinical outcomes. A recent innovation has been ... ...

Abstract	Background: Implant-based breast reconstruction is the most common reconstructive modality in the United States. Significant advances in surgical technique and technology have resulted in improvement of clinical outcomes. A recent innovation has been the introduction of a tissue expander with an integral drain that permits access to the periprosthetic space. A new use for this drain port is presented in patients with postoperative surgical-site infection. Methods: Patients who underwent staged implant-based breast reconstruction with the Sientra AlloX2 tissue expander and experienced postoperative infection that warranted inpatient management with intravenous antibiotics were included in the study. The integral drain port was used in these patients to perform washout of the periprosthetic space at the bedside. The ability to salvage the tissue expander in the setting of infection without the need for surgical revision in the operating room was determined. Results: Of 31 patients who underwent a total of 52 staged breast reconstructions with the Sientra AlloX2 tissue expander, 3 patients (8.7%) with a mean age of 50.3 years (range, 34-76 years) and mean body mass index of 23.3 kg/m Conclusion: Using the integral drain port of the AlloX2 tissue expander has the potential for device salvage in a subset of patients with surgical-site infection without the need for surgical revision.
Language	English
Publishing date	2018-12-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2851682-5
ISSN	2169-7574 ; 2169-7574
ISSN (online)	2169-7574
ISSN	2169-7574
DOI	10.1097/GOX.0000000000002046
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Article: Nationwide Trends in Contralateral Prophylactic Mastectomies: An Analysis of 55,060 Unilateral Breast Cancer Patients.

Shaheen, Mohammed S / Momeni, Arash

Plastic and reconstructive surgery. Global open

2022 Volume 10, Issue 5, Page(s) e4344

Abstract: Background: The effects of recent initiatives to better educate unilateral breast cancer (UBC) patients about contralateral prophylactic mastectomy (CPM) have not been fully examined. The purpose of this study was to update and examine recent annual CPM ...

Abstract	Background: The effects of recent initiatives to better educate unilateral breast cancer (UBC) patients about contralateral prophylactic mastectomy (CPM) have not been fully examined. The purpose of this study was to update and examine recent annual CPM trends by evaluating 2015-2020 data from a large administrative claims database. We also sought to determine if there were any variations in trends among different age groups and reconstructive modalities. Methods: Patients diagnosed with UBC between 2015 and 2019 were identified in Optum Clinformatics DataMart. Patients were then categorized by age group, whether they underwent CPM, whether they underwent breast reconstruction (BR), timing of any BR (immediate or delayed), and type of BR (implant-based or autologous). Results: Of 55,060 patients who were diagnosed with UBC, 2625 (4.8%) underwent CPM. After a slight decline from 2015 to 2016, the CPM rate among UBC patients increased significantly from 3.4% in 2016 to 6.8% in 2019. Although this upward trend remained consistent across all age groups examined, younger UBC patients represented a significantly higher and faster growing percentage of those undergoing CPM. BR rates among those who underwent CPM also increased between 2015 and 2019, with implant-based and immediate BR becoming more heavily favored over autologous and delayed BR. Conclusions: CPM rates continued to rise between 2016 and 2019 and younger women represented a substantially higher and faster growing percentage of UBC patients undergoing CPM than older women. In addition, implant-based and immediate BR are becoming more heavily favored over autologous and delayed BR.
Language	English
Publishing date	2022-05-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2851682-5
ISSN	2169-7574 ; 2169-7574
ISSN (online)	2169-7574
ISSN	2169-7574
DOI	10.1097/GOX.0000000000004344
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Article ; Online: Brustrekonstruktion bei Mammakarzinom.

Momeni, Arash / Giunta, Riccardo E

2022 Volume 54, Issue 4, Page(s) 268

Title translation	Breast Reconstruction in Breast Cancer.
MeSH term(s)	Breast Neoplasms/surgery ; Female ; Humans ; Mammaplasty
Language	German
Publishing date	2022-08-09
Publishing country	Germany
Document type	Journal Article
ZDB-ID	392414-2
ISSN	1439-3980 ; 0722-1819
ISSN (online)	1439-3980
ISSN	0722-1819
DOI	10.1055/a-1817-2493
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Article ; Online: Complication Rates in Therapeutic Versus Prophylactic Bilateral Mastectomies: Insights From a National Database.

Shaheen, Mohammed S / Wan, Derrick / Momeni, Arash

Annals of plastic surgery

2023 Volume 91, Issue 4, Page(s) 422–427

Abstract: Background: The "Jolie effect" and other media focus on prophylactic treatments have resulted in unilateral breast cancer patients increasingly undergoing contralateral prophylactic mastectomy. Little is known, however, regarding outcomes following ... ...

Abstract	Background: The "Jolie effect" and other media focus on prophylactic treatments have resulted in unilateral breast cancer patients increasingly undergoing contralateral prophylactic mastectomy. Little is known, however, regarding outcomes following therapeutic versus prophylactic mastectomy. In this study, we compared complication rates of unilateral breast cancer patients undergoing contralateral prophylactic mastectomy (BM-TP) to patients undergoing bilateral prophylactic mastectomy (BM-P). Methods: The BM-TP and BM-P patients from 2015 to 2019 were identified in Optum Clinformatics DataMart. Six-month outcomes were assessed and included wound complications, infection, hematoma/seroma, breast pain, fat necrosis, flap failure, implant failure/removal, other flap/implant complications, and other complications. Multivariable regression models adjusted for age, residence, insurance, race, and Charlson Comorbidity Index score. Results: Of 9319 women, 7114 (76.3%) underwent BM-TP, and 2205 (23.7%) underwent BM-P. In multivariable analysis, BM-TP had higher odds of overall complications (adjusted odds ratio [aOR], 1.35; P < 0.0001), but no difference was observed among patients who had autologous ( P = 0.1448) or no breast reconstruction ( P = 0.1530). Higher odds of overall complications persisted even after controlling for radiation therapy (aOR, 1.25; P = 0.0048) and chemotherapy (aOR, 1.28; P = 0.0047), but not after controlling for lymph node surgery ( P = 0.7765). Conclusion: The BM-TP (vs BM-P) patients face higher odds of overall complications but without any difference in certain reconstructive modalities or after controlling for lymph node surgery.
MeSH term(s)	Humans ; Female ; Prophylactic Mastectomy ; Mastectomy/methods ; Breast Neoplasms/complications ; Unilateral Breast Neoplasms/complications ; Mammaplasty/methods ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Retrospective Studies
Language	English
Publishing date	2023-08-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	423835-7
ISSN	1536-3708 ; 0148-7043
ISSN (online)	1536-3708
ISSN	0148-7043
DOI	10.1097/SAP.0000000000003648
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Zs.A 1419: Show issues

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Article ; Online: The Impact of Reconstructive Modality and Postoperative Complications on Decision Regret and Patient-Reported Outcomes following Breast Reconstruction.

Cai, Lawrence / Momeni, Arash

Aesthetic plastic surgery

2021 Volume 46, Issue 2, Page(s) 655–660

Abstract: Shared decision-making gives patients greater autonomy in their healthcare decisions; however, decisions that result in negative outcomes may lead to decision regret. The complexity of reconstructive options makes post-mastectomy breast reconstruction ... ...

Abstract	Shared decision-making gives patients greater autonomy in their healthcare decisions; however, decisions that result in negative outcomes may lead to decision regret. The complexity of reconstructive options makes post-mastectomy breast reconstruction particularly prone to decision regret. This study's purpose was to explore the relationship between breast reconstruction modalities and degree of postoperative decision regret. Patients who had undergone either implant-based or autologous breast reconstruction with a minimum of 12 months of follow-up were invited to complete the Decision Regret Scale and the BREAST-Q Satisfaction with Breasts module. The impact of reconstructive modality and occurrence of postoperative complications on decision regret and satisfaction with breasts was examined. Sixty-three patients completed the questionnaires-25 patients with implant-based reconstruction and 38 patients with autologous reconstruction. The average Decision Regret score was 84.6 ± 23.6; thirty-one patients experienced no decision regret. The average score for the BREAST-Q module was 81.9 ± 18.8. Neither satisfaction with breasts nor decision regret were impacted by the reconstructive modality. The occurrence of postoperative complications was strongly correlated with lower Decision Regret scores (91.6 vs. 74.6, p=0.004) but was not correlated with lower Satisfaction with Breasts scores (84.6 vs. 78.2, p=0.18). Patients had relatively low levels of decision regret and relatively high levels of satisfaction with breasts, irrespective of reconstructive modality. Having a postoperative complication led to significantly greater levels of decision regret without impacting satisfaction with breasts. Patients may benefit from additional preoperative education on possible complications to mitigate decision regret. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
MeSH term(s)	Breast Neoplasms/surgery ; Emotions ; Female ; Humans ; Mammaplasty/adverse effects ; Mastectomy ; Patient Reported Outcome Measures ; Postoperative Complications/epidemiology ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-11-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	532791-x
ISSN	1432-5241 ; 0364-216X
ISSN (online)	1432-5241
ISSN	0364-216X
DOI	10.1007/s00266-021-02660-2
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