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
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Usefulness of Radio Frequency Identification Device in Diagnosing Rotation of Motiva SmoothSilk Implants after Augmentation Mammoplasty(2019) MUNHOZ, Alexandre Mendonca; CHALA, Luciano; MELO, Giselle Guedes de; MARQUES FILHO, Ary de Azevedo; TUCUNDUVA, Tatiana; GEMPERLI, RolfBreast implant displacement has been described as a significant risk following augmentation mammoplasty. Magnetic resonance imaging (MRI) is considered the method of choice for diagnosing implant complications, but it has its limits in assessing correct implant position and displacement. Motiva SmoothSilk/SilkSurface (R) Implants (MSS) are the first to incorporate a radio frequency identification device (RFID), which produces an imaging artifact in MRI sequences. Given the frequency of breast augmentation procedures and the recent US Food and Drug Administration prospective trial involving SS with RFID, further analysis of implant stability and diagnostic imaging methods to evaluate implant positioning is necessary. The objective of this study was to assess the use of MRI with this new RFID-containing implant as a new tool to assess correct implant positioning. The authors performed this technique in 5 patients (10 implants) undergoing primary breast augmentation or revision surgery with MSS implants (255-385 cc, mean = 325 cc). The average area and volume of the artifact were 15.7 cm(2) and 31.75 cm(3), respectively. All cases presented satisfactory results, with 1 case of implant displacement. Our clinical and radiological outcome demonstrated that RFID technology is a useful tool for correct visualization of the implant position and diagnosis of complications such as slight displacements or rotation. To our knowledge, this is the first RFID breast implant that has been objectively evaluated for MRI issues.
- Delphi Study Consensus Recommendations: Patient Selection and Preoperative Planning Measurements for Natrelle 410(2015) HEDEN, Per; BROWN, Mitchell H.; LUAN, Jie; MAXWELL, G. Patrick; MUNHOZ, Alexandre Mendonca; CARTER, MollieBackground: There is considerable variation in the planning and implementation process for breast augmentation. Although general guidelines are available, the distinctive characteristics of the Natrelle 410 breast implant warrant surgical guidelines specific to this device. This study aimed to develop consensus recommendations for patient selection and preoperative planning for Natrelle 410 in primary breast augmentation. Methods: Surgeons were invited to participate in this study, which used a modified Delphi method. Participants completed 2 rounds of online surveys, with the second round (Recommendations Survey) based on responses from the first round. Respondents also listed their top priorities for using Natrelle 410 implants. Results: Participants (n = 22) reached consensus on 15 of 18 criteria for patient selection; tuberous breasts, patient preference regarding upper pole shape, and asymmetry of the breasts were the top 3 patient characteristics considered appropriate for the use of Natrelle 410. Consensus was reached on 38 of 51 items related to preoperative planning, with 8 measurements and 6 markings recommended by the participants. Patient-desired outcome was considered the most essential element for Natrelle 410 implant selection; quality of skin envelope and height and width dimension of the breast were selected as the most essential elements for Natrelle 410 implant volume selection. Conclusions: The modified Delphi method resulted in consensus recommendations for patient selection and preoperative planning in primary breast augmentation with the Natrelle 410 breast implant. These recommendations and priorities, used in concert with a surgeon's clinical experience, are designed to optimize surgical outcomes.
- Breast Implant Surfaces and Their Impact on Current Practices: Where We Are Now and Where Are We Going?(2019) MUNHOZ, Alexandre Mendonca; CLEMENS, Mark W.; NAHABEDIAN, Maurice Y.Most commercially available breast implants feature some degree of elastomer surface modifications to increase surface roughness, in part because several clinical series have demonstrated positive outcomes from texturizing. However, the literature shows that textured implants support higher rates of bacterial growth, and there is a clear association between increased bacterial contamination and host response in vivo, such as capsular contracture. Furthermore, the infectious theory related to bacterial contamination has recently been described as a potential cause in the etiology of anaplastic large-cell lymphoma. Recent research has focused on the physiology of breast implant surfaces advances and how they interact with the body, creating new surface technologies which have the potential to affect all aspects of breast surgery. Understanding how surface properties affect inflammatory cell response will be essential in designing implants that can provide an esthetic solution while also minimizing long-term clinical complications. This special topic highlights the current knowledge on silicone implant surfaces, as well as innovations that have shaped and will continue to change the silicone breast implant industry in the future. It also provides an overview of the principal surfaces that exist and may find clinical applications in esthetic and reconstructive breast surgery. As additional advances emerge, objective tools will be required to evaluate the different surfaces available on the market, along with the long-term efficacy of new technologies.
- Delphi Consensus Recommendations: Intraoperative Technique and Postoperative Management of Patients with Natrelle 410 Implants(2015) MAXWELL, G. Patrick; BROWN, Mitchell H.; HEDEN, Per; LUAN, Jie; MUNHOZ, Alexandre Mendonca; CARTER, MollieBackground: Anatomically shaped, form-stable Natrelle 410 breast implants were approved in Europe in 1993 and in the United States in 2013. Although general guidelines for breast augmentation are available, the distinctive characteristics of Natrelle 410 warrant specific guidelines for this device. The goal of this study was to generate consensus recommendations for intraoperative technique and postoperative management with Natrelle 410 in primary breast augmentation. Methods: Surgeons were invited to participate in the study, which used a modified Delphi method. Participants completed 2 rounds of online surveys; the second survey (Recommendations Survey) was generated based on first survey results. Respondents also listed top priorities for use of Natrelle 410. Results: Participants (n = 22) reached consensus on 15 of 18 perioperative and surgical techniques; dual-plane placement, tight pockets, and limiting the boundaries of dissection were among intraoperative techniques considered most important for Natrelle 410. Consensus was reached for 18 of 32 items regarding postoperative management and 6 of 9 open-ended postoperative activity restrictions. Consensus on activity restrictions with specified time limits were similar to consensus recommendations on general restrictions. Top participant-identified intraoperative and postoperative management practices for Natrelle 410 were dual-plane placement of the implant and wearing a bra postoperatively, respectively. Conclusions: The Delphi method identified consensus recommendations on a broad range of intraoperative techniques and postoperative management practices for primary breast augmentation with Natrelle 410. These recommendations and priorities provide surgeons with a framework that, together with the surgeon's experience, will contribute to optimal clinical outcomes with Natrelle 410.
- A Simple and Low-cost Method of Sleeve to Insert Silicone Gel Breast Implants(2019) PANCZEL, Georg; MUNHOZ, Alexandre MendoncaContact between silicone implants and skin/breast parenchyma has been described as an agent of implant contamination and biofilm formation, resulting in implant complications. The no-touch technique was introduced to avoid implant contact and reduce skin/breast contamination. The authors propose an easily available sleeve option using a saline sterile plastic container that provides elastic and transparent protection for inserting silicone implants. These sterile containers can be easily converted into a sleeve by cutting off the narrow end of the container, which then easily fits into the small inframammary, periareolar, and transaxillary incisions. The authors have performed this technique in 10 patients (20 implants) undergoing primary breast augmentation or revision breast surgery, with microtexturized implants ranging in size from 255 to 500 ml (mean, 325 ml) and obtained satisfactory results with no cases of complications. Our clinical outcome shows that this new sleeve does not interact with the implant or the patient's skin and soft tissues and has the added advantage of low cost compared with similar available devices, but further randomized and controlled studies are required to corroborate this effect.
- Analysis of Artifacts on MRI from Electronic Identification Enablement in Silicone Gel Implants(2022) MUNHOZ, Alexandre Mendonca