ALEXANDRE MENDONCA MUNHOZ
Índice h a partir de 2011
15
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Response to: Nano-Surface Implants: Indications and Limitations(2021) SFORZA, Marcos; BOTTI, Giovanni; HEDEN, Per; ZACHEDDU, Renato; MUNHOZ, Alexandre Mendonca; MAYO, Federico; KINNEY, Brian M.; HAMMOND, Dennis C.; CORDUFF, Niamh; MORELLI, Humberto Uribe; STAVROU, Demetris; CENTENO, Jesus
- Response to ""Clarification About 'Expert Consensus on the Use of a New Bioengineered, Cell-Friendly, Smooth Surface Breast Implant'""(2019) SFORZA, Marcos; HAMMOND, Dennis C.; BOTTI, Giovanni; HEDEN, Per; QUIROS, Manuel Chacon; MUNHOZ, Alexandre Mendonca; KINNEY, Brian M.; CORDUFF, Niamh
- Single-Stage Augmentation Mastopexy With Composite Reverse Inferior Muscle Sling Technique for Autologous Reinforcement of the Inferior Pole: Technical Refinements and Outcomes(2020) MUNHOZ, Alexandre Mendonca; NETO, Ary Marques; FERRARI, OrlandoBackground: Single-stage augmentation mastopexy (SAM) is a common procedure, but revision rates are high. Muscle slings have been used in SAM, but despite satisfactory outcomes, most studies do not include objective or accurate measurements of implant/breast position. This article describes a surgical technique for SAM employing a composite reverse inferior muscle sling (CRIMS). Objectives: The authors sought to assess outcomes from primary SAM procedures utilizing the CRIMS technique in a cohort of patients operated on by a single surgeon. Methods: Thirty-two patients (60 breasts) aged a mean of 43.1 +/- 6.8 years underwent primary CRIMS mastopexy to treat severe ptosis (grade III-IV) in 25 patients (78.1%). The average implant volume was 255 cc (range, 215-335 cc). Three-dimensional imaging obtained from the Divina scanner system was employed to evaluate lower pole stretch and lower pole arc and to determine long-term ptosis. Results: Four cases of complications were observed in 3 patients (9.3%), minor dehiscence in 2 and capsular contraction in 1, during a mean follow-up of 42 months. The value for lower pole stretch was 5.5% (P < 0.0001) between 10 days and 1 year, with the majority occurring early in the first 6 months, indicating that lower pole arc remained steady during the last months of follow-up. Conclusions: Advances in techniques have led to improvements in aesthetic outcomes following SAM, and CRIMS can play a helpful role. Our results show this procedure is suitable for patients with breast ptosis, with acceptable complication rates and the added bonus of implant stabilization within the pocket.
- Reoperative Transaxillary Approach Algorithm: Extending the Surgical Alternatives for Secondary Breast Augmentation in the Era of Scarless Surgery(2020) MUNHOZ, Alexandre MendoncaBackground: Although the transaxillary approach (TAA) is useful in primary breast augmentation (BA) surgery, drawbacks of this technique include the need to correct complications arising from reuse of the axillary incision. Objectives: The purpose of this study was to assess the outcomes of secondary BA procedures performed via the TAA in a cohort of patients operated on by a single surgeon and to provide an algorithm for reoperative TAA technique selection. Methods: Sixty-two patients (122 breasts) underwent secondary TAA BA, which was indicated for capsular contracture (CC) in 35 patients (56.4%). Periods for analysis included less than 10 days, 1, 3, 6, and 12 months, and then at 2-year intervals postprocedure. Results: Forty-three patients (69.3%) had a previous premuscular (PM) pocket; in 35 (81.3%) of these patients the new pocket was kept in the same position. Nineteen patients (30.7%) had a previous submuscular pocket, and 15 patients (78.9%) had the new pocket transferred to the PM plane. Ten cases of complications were observed in 8 patients (16.1%), Baker grade II/III CC in 3 (4.8%), and axillary banding in 2 (3.2%), during a mean follow-up of 72 months (range, 6-170 months). Fifty-nine patients (95.1%) were either very satisfied or satisfied with their aesthetic result. Conclusions: Recent progress in surgical techniques has led to significant improvements in aesthetic outcomes following BA. The TAA can play a useful role in secondary BA cases and our results show this procedure to be useful, with acceptable complication rates, and the added bonus of avoiding additional scarring on the breast.
- Hybrid Breast Augmentation: A Reliable Formula for Preoperative Assessment of Fat Graft Volume Based on Implant Volume and Projection(2020) MAXIMILIANO, Joao; MUNHOZ, Alexandre Mendonca; PEDRON, Mirian; OLIVEIRA, Antonio Carlos Pinto de; DUARTE, Daniele Walter; NETO, Rafael; PORTINHO, Ciro Paz; COLLARES, Marcos Vinicius MartinsBackground: Autogenous fat grafting (AFG) is an established technique used as an adjunct to breast augmentation (BA) to redesign breast shape. Surgeons often use experience and intuition to estimate AFG volume, which can result in incorrect assessment of donor areas and unnecessary fat removal. Objectives: This aim of this study was to develop a method based on a mathematical formula, which utilizes implant volume and projection to predict AFG volume. Methods: Thirty patients (60 breasts) underwent primary hybrid BA. A software package (SketchUp) was used to simulate 3-dimensional AFG and implant volumes, which in turn were used to develop an equation for estimating AFG volume according to 3 different implant projections. The results for each group were compared, via Pearson's correlation coefficient, with the results of the clinical series. Results: All patients received Motiva Ergonomix SmoothSilk/SilkSurface implants, ranging in volume from 175 to 355 cc (mean, 265 cc), as well as an average AFG volume of 79.2 cc/breast (range, 50-110 cc). Twenty-nine patients (96.6%) were either very satisfied or satisfied during a mean follow-up of 18 months (range, 6-28 months). A high correlation was observed between the AFG performed in the cohort and predictions obtained from the formula (r = 0.938, P < 0.001). Conclusions: The AFG volume in hybrid BA procedures can be estimated utilizing measurements based on implant volume/ projection. This low-cost method can be applied to guide surgical decision-making in patients who are candidates for BA.
- Expert Consensus on the Use of a New Bioengineered, Cell-Friendly, Smooth Surface Breast Implant(2019) SFORZA, Marcos; HAMMOND, Dennis C.; BOTTI, Giovanni; HEDEN, Per; QUIROS, Manuel Chacon; MUNHOZ, Alexandre Mendonca; KINNEY, Brian M.; CORDUFF, NiamhBackground Although general guidelines are available for established silicone gel breast implants, the unique characteristics of the latest Motiva implants warrant specific guidelines. Objectives This study aimed to generate consensus recommendations and summarize expert-based advice to better understand current surgical practices and to establish guidelines for surgeons transitioning from other implant devices to the Motiva implants. Methods A survey was compiled by 12 plastic surgeon experts in aesthetic and reconstructive breast surgery and 1 biotechnology scientist, and distributed to 36 plastic surgeons to establish a consensus on the use of these devices. Surgical techniques, complication rates, and implant selection were among the topics discussed. Results The experts agreed on 3 core principles regarding the use of Motiva Round and Ergonomix implants. Firstly, the dissected pocket needs to be close fitting and steps must be taken to prevent expansion of the pocket. Secondly, implant selection must be individualized. Finally, surgical planning and technique must be carefully considered. When questioned about problems they had ecountered, 84.6% of the experts agreed that they experienced fewer overall complications and 76.9% confirmed reduced capsular contracture rates with these devices. Overall, 84.6% of the experts favored selecting Motiva Ergonomix implants over Round implants to achieve a more natural look. In addition, 92.3% of the experts agreed that Motiva implants, due to their innovative technology, reduce the risk of anaplastic large-cell lymphoma. Conclusions This international consensus of leading practitioners will assist plastic surgeons with patient selection, preoperative planning, and surgical technique. These recommendations are designed to optimize surgical outcomes, resulting in lower overall complication rates, more natural-looking breasts, and highly satisfied patients.
- Additional Thoughts on Banning Textured Implants to Prevent Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)(2020) MUNHOZ, Alexandre Mendonca