2024
Smooth versus Textured Tissue Expanders: Comparison of Outcomes and Complications in 536 Implants
Allam O, Dinis J, Almeida M, Junn A, Mozaffari M, Shah R, Chong L, Olawoyin O, Mehta S, Park K, Avraham T, Alperovich M. Smooth versus Textured Tissue Expanders: Comparison of Outcomes and Complications in 536 Implants. Archives Of Plastic Surgery 2024, 51: 042-051. PMID: 38425846, PMCID: PMC10901592, DOI: 10.1055/s-0043-1775592.Peer-Reviewed Original ResearchTextured tissue expandersPain scoresTissue expanderTwo-stage breast reconstructionTextured surface implantsExpander fill volumeStudy evaluated outcomesAssociated with ageComparison of outcomesRegression analysisBilateral reconstructionPrepectoral placementComplication rateTextured implantsNo significant differenceBreast reconstructionPerioperative informationSurface implantsOperative timeTE exchangeComplicationsLinear regression analysisSignificant differencePainChi-square
2020
Worse overall health status negatively impacts satisfaction with breast reconstruction
Mehta SK, Olawoyin O, Chouairi F, Duy PQ, Mets EJ, Gabrick KS, Le NK, Avraham T, Alperovich M. Worse overall health status negatively impacts satisfaction with breast reconstruction. Journal Of Plastic Reconstructive & Aesthetic Surgery 2020, 73: 2056-2062. PMID: 32972879, DOI: 10.1016/j.bjps.2020.08.093.Peer-Reviewed Original ResearchConceptsBREAST-Q scoresPatient-reported outcomesOverall health statusBreast reconstructionOverall healthASA classificationHealth statusGeneral linear modelAnesthesiologists physical status classificationYale-New Haven HospitalWorse overall health statusBREAST-Q outcomesHealth-related qualityPhysical status classificationNew Haven HospitalEffect of ASAASA 1Independent predictorsPatient factorsPostoperative satisfactionBreast surgeryPatient satisfactionASA 2PatientsRelevant covariatesManagement of recurrent bilateral multifocal pseudoangiomatous stromal hyperplasia (PASH)
Xu X, Persing SM, Allam O, Park KE, Mozaffari MA, Lannin DR, Bossuyt V, Alperovich M. Management of recurrent bilateral multifocal pseudoangiomatous stromal hyperplasia (PASH). The Breast Journal 2020, 26: 1814-1817. PMID: 32562297, DOI: 10.1111/tbj.13950.Peer-Reviewed Original ResearchConceptsPseudoangiomatous stromal hyperplasiaStromal hyperplasiaBilateral mastectomyReduction mammoplastyTwo-stage implant-based breast reconstructionImplant-based breast reconstructionExcellent aesthetic outcomesPain reliefBreast enlargementStandard treatmentBreast reconstructionFocal excisionReconstructive surgeryRare caseConservative optionsAesthetic outcomeHyperplastic conditionsMastectomyHyperplasiaMammoplastyMacromastiaPatientsSurgeryExcisionBreastPatients with psychiatric illness report worse patient‐reported outcomes and receive lower rates of autologous breast reconstruction
Mehta SK, Sheth AH, Olawoyin O, Chouairi F, Gabrick KS, Allam O, Park KE, Avraham T, Alperovich M. Patients with psychiatric illness report worse patient‐reported outcomes and receive lower rates of autologous breast reconstruction. The Breast Journal 2020, 26: 1931-1936. PMID: 32529691, DOI: 10.1111/tbj.13936.Peer-Reviewed Original ResearchConceptsPatient-reported outcomesPsychiatric diagnosisBreast reconstructionBinary logistic regressionAutologous reconstructionReconstructive modalityWorse patient-reported outcomesLogistic regressionBREAST-Q surveysBREAST-Q scoresAutologous breast reconstructionGeneral linear modelQuality of lifeModalities of reconstructionChi-squared testPsychiatric wellASA classificationIndependent predictorsTertiary hospitalInsurance statusImplant reconstructionRisk populationsPatientsDiagnosisModule scoresImpact of socioeconomic status on psychological functioning in survivorship following breast cancer and reconstruction
Le NK, Gabrick KS, Chouairi F, Mets EJ, Avraham T, Alperovich M. Impact of socioeconomic status on psychological functioning in survivorship following breast cancer and reconstruction. The Breast Journal 2020, 26: 1695-1701. PMID: 32337778, DOI: 10.1111/tbj.13849.Peer-Reviewed Original ResearchConceptsPatients' socioeconomic statusQuality of lifeBreast reconstructionBreast cancerSocioeconomic statusCancer treatmentPatient-reported outcome measuresSingle academic centerInitial cancer treatmentBreast cancer treatmentPopulation health risk factorsHealth risk factorsLow socioeconomic statusHigher socioeconomic statusStudy time periodBaseline comorbiditiesCancer stageRisk factorsOutcome measuresAnalysis of covariancePatient experienceAcademic centersPatientsSignificant positive correlationSatisfaction domainsImpact of Insurance Payer on Type of Breast Reconstruction Performed.
Chouairi F, Mets EJ, Gabrick KS, Dinis J, Avraham T, Alperovich M. Impact of Insurance Payer on Type of Breast Reconstruction Performed. Plastic & Reconstructive Surgery 2020, 145: 1e-8e. PMID: 31881596, DOI: 10.1097/prs.0000000000006315.Peer-Reviewed Original ResearchConceptsBreast reconstructionBreast reconstruction modalityAcademic medical centerOdds ratioMedical CenterMuscle-sparing transverse rectus abdominis myocutaneous flapPerforator flapTissue expander/implant breast reconstructionExpander/implant breast reconstructionMicrovascular autologous breast reconstructionTransverse rectus abdominis myocutaneous flapPerforator flap breast reconstructionIncome quartileCLINICAL QUESTION/LEVELReconstruction modalitiesSame academic medical centerRectus abdominis myocutaneous flapAutologous breast reconstructionFlap breast reconstructionImplant breast reconstructionHighest income quartileLowest income quartileInsurance typeMicrovascular reconstructionChi-square analysis
2019
Breast reconstruction patterns and outcomes in academic and community practices within a single institution
Gabrick K, Alperovich M, Chouari F, Mets EJ, Reinhart M, Dinis J, Avraham T. Breast reconstruction patterns and outcomes in academic and community practices within a single institution. The Breast Journal 2019, 26: 924-930. PMID: 31788914, DOI: 10.1111/tbj.13693.Peer-Reviewed Original ResearchConceptsYale-New Haven HospitalBreast reconstructionMore patientsSingle institutionPlastic surgeonsCommercial insuranceHigh rateRetrospective chart reviewPrevalence of diabetesSimilar complication ratesNipple-sparing mastectomyHigher infection rateAP cohortChart reviewComplication rateCP cohortPostoperative outcomesPreoperative historySurgery ratesPsychiatric comorbidityInsurance statusAutologous reconstructionPractice patternsMedicaid patientsGreater prevalenceComplication Profiles by Mastectomy Indication in Tissue Expander Breast Reconstruction
Chouairi F, Gabrick KS, Avraham T, Markov NP, Alperovich M. Complication Profiles by Mastectomy Indication in Tissue Expander Breast Reconstruction. Plastic & Reconstructive Surgery 2019, Publish Ahead of Print: &na;. PMID: 30730496, DOI: 10.1097/prs.0000000000005423.Peer-Reviewed Original ResearchConceptsMastectomy flap necrosisTwo-stage implant breast reconstructionImplant breast reconstructionFlap necrosisBreast reconstructionHigh riskProphylactic mastectomyTherapeutic mastectomyMastectomy indicationExact testTissue expander breast reconstructionCLINICAL QUESTION/LEVELYale-New Haven HospitalPermanent implant reconstructionExpander breast reconstructionTimes higher riskFisher's exact testNew Haven HospitalSignificant differencesBreast reconstruction proceduresBinary logistic regressionReconstructive complicationsBreast groupPerioperative complicationsComplication rate
2018
Impact of incidental findings in preoperative CTA imaging for autologous breast reconstruction
Gabrick KS, Godier-Furnemont A, Chouairi F, Avraham T, Alperovich M. Impact of incidental findings in preoperative CTA imaging for autologous breast reconstruction. Journal Of Plastic Reconstructive & Aesthetic Surgery 2018, 72: 789-794. PMID: 30501967, DOI: 10.1016/j.bjps.2018.11.015.Peer-Reviewed Original ResearchConceptsAutologous breast reconstructionCTA findingsCT angiographyIncidental findingBreast reconstructionPatient careYale-New Haven HospitalPreoperative CT angiographyNew Haven HospitalMetastatic diseaseMedical managementFurther imagingAdditional imagingGynecologic proceduresReconstructive microsurgeonsPatientsImaging reportsPerforator mappingCareBiopsyImagingFindingsReportMastectomyAngiographyA Predictive Model for Determining Permanent Implant Size During 2-Stage Implant Breast Reconstruction
Gabrick KS, Markov NP, Chouairi F, Wu R, Persing SM, Abraham P, Avraham T, Alperovich M. A Predictive Model for Determining Permanent Implant Size During 2-Stage Implant Breast Reconstruction. Plastic & Reconstructive Surgery Global Open 2018, 6: e1790. PMID: 29922567, PMCID: PMC5999420, DOI: 10.1097/gox.0000000000001790.Peer-Reviewed Original ResearchImplant breast reconstructionBreast reconstructionPreoperative radiationPreoperative variablesPI sizeSignificant preoperative variablesFill volumeRange of implantsTissue expanderSilicone implantsMultivariate analysisImplant sizeStudy periodSurgical planningSignificant variablesRoom workflowPatientsRegression analysisTE volumeTE sizeImplantsEvolution in Monitoring of Free Flap Autologous Breast Reconstruction after Nipple-Sparing Mastectomy
Frey JD, Stranix JT, Chiodo MV, Alperovich M, Ahn CY, Allen RJ, Choi M, Karp NS, Levine JP. Evolution in Monitoring of Free Flap Autologous Breast Reconstruction after Nipple-Sparing Mastectomy. Plastic & Reconstructive Surgery 2018, 141: 1086-1093. PMID: 29659449, DOI: 10.1097/prs.0000000000004271.Peer-Reviewed Original ResearchMeSH KeywordsAdultBreastBreast NeoplasmsFemaleFree Tissue FlapsHumansMammaplastyMastectomy, SubcutaneousMiddle AgedNipplesPatient SatisfactionPerforator FlapPostoperative CarePostoperative ComplicationsReoperationRetrospective StudiesTransplantation, AutologousTreatment OutcomeUltrasonography, DopplerConceptsNipple-sparing mastectomyFree flap reconstructionSkin paddleFlap reconstructionAutologous reconstructionRevision proceduresMuscle-sparing transverse rectus abdominis myocutaneous flapFree flap autologous breast reconstructionAutologous free flap reconstructionTransverse rectus abdominis myocutaneous flapGreater body mass indexCLINICAL QUESTION/LEVELPercentage of flapsProfunda artery perforatorRectus abdominis myocutaneous flapAutologous breast reconstructionBody mass indexInferior epigastric perforatorGreater mean numberMass indexFlap weightMastectomy weightComparing outcomesBreast reconstructionMastectomy reconstruction
2015
Nipple‐sparing Mastectomy and Sub‐areolar Biopsy: To Freeze or not to Freeze? Evaluating the Role of Sub‐areolar Intraoperative Frozen Section
Alperovich M, Choi M, Karp NS, Singh B, Ayo D, Frey JD, Roses DF, Schnabel FR, Axelrod DM, Shapiro RL, Guth AA. Nipple‐sparing Mastectomy and Sub‐areolar Biopsy: To Freeze or not to Freeze? Evaluating the Role of Sub‐areolar Intraoperative Frozen Section. The Breast Journal 2015, 22: 18-23. PMID: 26510917, DOI: 10.1111/tbj.12517.Peer-Reviewed Original ResearchConceptsNipple-sparing mastectomyIntraoperative frozen sectionNipple-sparing mastectomiesNipple-areolar complexPermanent paraffin sectionsFrozen sectionsParaffin sectionsBreast cancer resectionRecords of patientsFrozen section resultsCancer resectionDuctal carcinomaProphylactic mastectomyResidual pathologyBreast reconstructionPermanent biopsyMastectomyBiopsyReconstructive planningSeparate proceduresResectionPatientsCarcinomaBreastBreast Reconstruction Using Contour Fenestrated AlloDerm
Frey JD, Alperovich M, Weichman KE, Wilson SC, Hazen A, Saadeh PB, Levine JP, Choi M, Karp NS. Breast Reconstruction Using Contour Fenestrated AlloDerm. Plastic & Reconstructive Surgery Global Open 2015, 3: e505. PMID: 26495218, PMCID: PMC4596430, DOI: 10.1097/gox.0000000000000482.Peer-Reviewed Original ResearchMinor mastectomy flap necrosisMastectomy flap necrosisBreast reconstructionAcellular dermal matrixFlap necrosisReconstructive outcomesInfection outcomesInfection rateSignificant independent risk factorsDermal matrixImplant-based breast reconstructionPermanent implant reconstructionIndependent risk factorNipple-sparing mastectomyLow infection rateUse AlloDermIntravenous antibioticsImplant coverageRisk factorsImplant reconstructionPatientsAlloDermOutcomesNecrosisInfection
2013
Microsurgical Breast Reconstruction for Nipple-Sparing Mastectomy
Tanna N, Broer PN, Weichman KE, Alperovich M, Ahn CY, Allen RJ, Choi M, Karp NS, Saadeh PB, Levine JP. Microsurgical Breast Reconstruction for Nipple-Sparing Mastectomy. Plastic & Reconstructive Surgery 2013, 131: 139e-147e. PMID: 23358009, DOI: 10.1097/prs.0b013e3182789b51.Peer-Reviewed Original ResearchConceptsNipple-sparing mastectomyMicrosurgical breast reconstructionBreast reconstructionNipple necrosisMastectomy skin flap necrosisFree flap breast reconstructionNew York University Medical CenterCLINICAL QUESTION/LEVELSuperior gluteal artery perforator flapThorough preoperative evaluationGluteal artery perforator flapImmediate breast reconstructionLow complication rateNipple-sparing mastectomiesProfunda artery perforatorSkin flap necrosisBody mass indexFlap breast reconstructionMastectomy specimen weightBreast cancer historyHigh patient satisfactionMajority of flapsChoice of incisionArtery perforator flapMastectomy skin flaps