I just returned this last weekend from the Atlanta Breast Symposium, one of the annual major meetings in Plastic Surgery. Atlanta is one of the places where many milestone advances in Plastic Surgery came from including flap based reconstructive surgery, the TRAM flap & latissimus breast reconstruction procedures, and endoscopic plastic surgery. At one point in the early-mid 1970's there existed a cadre of talent at Emory University's Plastic Surgery department that will never be rivaled.
A few observations from the meeting:
- the form-stable shaped "gummy bear" implants from Inamed (Inamed 410 implant), Mentor (Mentor CPG implant), & others (Silimed, Euro-Silicone) are going to dramatically affect our results for the better in breast reconstruction surgery. A number of international presenters showed results that cannot be achieved with round "normal" silicone implants as were just approved by the FDA.
- the silicone-istas are ready to pounce on any failure of compliance with the FDA instructions to demand that approval be withdrawn for silicone implants.
- we're struggling with how to address the increasing use of radiation in breast cancer patients when we plan reconstruction. There continues to be wide variability in different cities in who gets radiated and how much the side affects are.
- subglandular implant placement seems poised for a comeback. Contemporary "low bleed" implants appear to have significantly lower chance of capsular contracture as compared to older implants when placed above the muscle.
- using smaller implants continues to be identified as the single most important factor in reducing complications and reoperations.
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