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      Mamoplastia de reducción y medialización del complejo areola-pezón en paciente acondroplásica con gigantomastia. Caso clínico Translated title: Reduction mammoplasty and nipple medialization in achondroplasic patient with gigantomastia. Case report

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          Abstract

          Resumen La acondroplasia es una enfermedad genética rara que representa la forma más común de enanismo de extremidades cortas. Existen pocos casos reportados de gigantomastia y subsecuente cirugía mamaria en esta población. Presentamos el caso de una paciente con acondroplasia, gigantomastia y medialización de pezón que requirió mamoplastia reductora y reposición de complejo areola pezón (CAP). Se utilizó la técnica de T invertida con pedículo inferior. La planeación quirúrgica y el correcto marcaje en pacientes acondroplásicos son pasos importantes para una cirugía exitosa teniendo en cuenta que las referencias anatómicas habituales no son guías confiables para un posicionamiento ideal de la mama en el tórax o del CAP en la mama.

          Translated abstract

          Abstract Achondroplasia is a rare genetic disease representing the most common form of short-limb dwarfism, and there are a few case reports of gigantomastia and subsequent breast surgery in this patient population. We present the case of a patient with achondroplasia, gigantomastia and nipple medialization who required a reduction mammaplasty and reposition of the nipple areola complex (NAC). An inverted T technique with an inferior pedicle was used. Surgical planning and correct marking in achondroplasic patients are important steps for a successful surgery considering that common anatomical landmarks are not a reliable guide for ideally positioning the breast on the thoracic wall or the NAC on the breast.

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          Most cited references8

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          Growth velocity and biological variables during puberty in achondroplasia.

          Achondroplasia is the most common form of inherited disproportionate short stature. Cross-sectional design studies of height show that, during childhood, height standard deviation scores (SDS) declines steadily and reaches a mean adult height at -6.42 and -6.72 SDS. However, there is a lack of knowledge about longitudinal growth and biological variables during puberty for children with achondroplasia. Here we report the growth velocity and biological parameters during puberty in children with achondroplasia.
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            Anaesthesia for the achondroplastic dwarf.

            Over the past three years, 36 anaesthetics were administered to 27 patients with achondroplastic dwarfism. Twenty-four patients underwent craniectomy for foramen magnum stenosis. Sixteen of the operations were undertaken in the sitting position with nine incidents of venous air embolism (VAE), all of which occurred in patients under 12 years of age. Six major complications occurred: two C-1 level spinal cord infarctions, two brachial plexus palsies, one severe macroglossia, and one accidental extubation. Intravenous access in the small child with achondroplastic dwarfism is made difficult because of the excess, lax skin and subcutaneous tissue. Airway management and laryngoscopy were not difficult and we found that endotracheal tube size was best predicted by the patient's weight and not age. Blood loss was 38 +/- 9 mg X kg-1 in the prone position (n = 8) and 18 +/- 4 mg X kg-1 in the sitting position (n = 16), and was related to the surgical procedure rather than to dwarfism. Our data indicate that complications are more likely to occur in the sitting position, and that these complications are of a serious nature, and every precaution should be taken to avoid their occurrence.
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              Lateral breast flap with superomedial pedicle breast lift.

              Single-stage, durable aesthetic contouring of the volume-depleted and ptotic breast remains a challenge for plastic and reconstructive surgeons. These challenges are often even more difficult in the patient who has undergone massive weight loss (MWL).
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                Author and article information

                Journal
                cpil
                Cirugía Plástica Ibero-Latinoamericana
                Cir. plást. iberolatinoam.
                Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE) (Madrid, Madrid, Spain )
                0376-7892
                1989-2055
                June 2023
                : 49
                : 2
                : 173-176
                Affiliations
                [2] Toluca Estado de México orgnameCirugía Plástica y Reconstructiva Centro Médico ISSEMyM México
                [1] orgnameCirugía Plástica y Reconstructiva
                Article
                S0376-78922023000200010 S0376-7892(23)04900200010
                10.4321/s0376-78922023000200010
                0b7be910-3317-431c-bd25-e241863489de

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 15 September 2022
                : 30 March 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 8, Pages: 4
                Product

                SciELO Spain

                Categories
                Estética

                Nipple areola complex,Mammoplasty,Achondroplasia,Gigantomastia,Reducción mamaria,Mamoplastia,Acondroplasia,Complejo areola pezón,Breast Reduction

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