A radical mastectomy has significant psychological, social and sexual implications. It is important to the patient to return to their normal image as quickly as possible.  Many women request breast implants to obtain their pre surgery figure. Unfortunately with internal tissue expanders it can take months to obtain enough tissue to cover the implant. The Proxiderm quickly creates additional tension free local site skin and sub cutaneous tissue to cover a 300 cc breast implant in a few days.

Case Report  2

Figure 1 Figure 2

Figure 1   A 49 year old patient had a carcinoma of the breast treated by a radical mastectomy 3 years previously. The patient did not want to have TRAM procedure and requested breast implant.

Figure 2   Four Proxiderm model BK 460 were used by the physician.  Tissue hooks of the Proxiderm are extended; one tissue hook is inserted as deep as possible at the inferior mammary fold and the other as far superiorly as possible. Proxiderms are secured to the patient by suture.  In general, like intravenous needles, the tissue hook insertion is uncomfortable, but thereafter discomfort is minimal. However, local anesthesia may be required, perhaps supplemented by a longer acting anesthetic agent. Thereafter oral medications of different strengths can be employed.  Combine pads are placed on top of, between and under the ends of the Proxiderms. Elastoplast dressing is wrapped over the combines and fastened to the skin. Adhesive tape is then placed around the edges of the Elastoplast followed by an ace bandage and a surgical bra.   Appearance at second post expansion day.

Figure 3 Figure 4

Figure 3     The patient returned to the physician daily for three times. At each visit  additional tissue was obtained by another application of Proxiderms. Tissue hooks of the Proxiderm were extended further to grasp more tissue.  On the fourth day there was an abundant amount of extra tissue and a 300 cc breast prosthesis was implanted.  Appearance at 10 days post implantation of prosthesis.

Figure 4   Appearance at 14 days post implantation of prosthesis

Figure 5

Figure 5   Appearance at 20 days post implantation of prosthesis

Case Report  3

Figure 1

Figure 1   A 38 year old patient had carcinoma of the breast treated by a radical mastectomy. Her breast wall was very tight and there was a large painful scar contracture measuring over 3 cm in width. (see arrow)

Figure 2 Figure 3 Figure 4

Figure 2     The physician used Proxiderm model BK 460 to obtain enough additional tension free skin and sub cutaneous tissue for revision of the scar and implantation of a 300 cc breast implant.  Tissue hooks of the Proxiderm are extended; one tissue hook is inserted as deep as possible at the inferior mammary fold and the other as far superiorly as possible.   Appearance at 2 days.

Figure 3   Combine pads are placed on top of, between and under the ends of the Proxiderms. Elastoplast dressing is wrapped over the combines and fastened to the skin. Adhesive tape is then placed around the edges of the Elastoplast followed by an ace bandage and a surgical bra. 

Figure 4   On the second day of Proxiderm tissue expansion, it was decided additional tissue was required, another application of Proxiderms was made and the tissue hooks of the Proxiderm were extended to grasp more tissue. On the fourth day the skin was quite lax and there was an abundant amount of extra tissue for revision of the scar and implantation of a 300 cc breast prosthesis.  Appearance for post surgery.

Figure 5 Figure 6

Figure 5   Appearance at 22 days post surgery

Figure 6   Appearance at one year.

Case Report  4

Figure 1 Figure 2

Figure 1 A 63 year old patient has a modified radical mastectomy with lymph node removal. The patient desired reconstruction with a breast implant.

Figure 2   Four Proxiderm model BK 460 were used by the physician.  Tissue hooks of the Proxiderm are extended; one tissue hook is inserted as deep as possible at the inferior mammary fold and the other as far superiorly as possible. Proxiderms are secured to the patient by suture.

Figure 3 Figure 4

Figure 3   Combine pads are placed on top of, between and under the ends of the Proxiderms. Elastoplast dressing is wrapped over the combines and fastened to the skin. Adhesive tape is then placed around the edges of the Elastoplast followed by an ace bandage and a surgical bra. 

Figure 4   On the second day of Proxiderm tissue expansion, it was decided that additional tissue was required, and another application of Proxiderms was made, the tissue hooks of the Proxiderm being extended further to grasp more tissue. On the fourth day the skin was quite lax and there was an abundant amount of extra tissue for implantation of a 300 cc breast prosthesis.   Appearance at 3 weeks.

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