Egidio Riggio

Fondazione IRCCS Istituto Nazionale dei Tumori di Milano | Istituto Tumori di Milano · Dipartimento di Chirurgia

Background The literature that has explored differences between direct-to-implant (DTI) and expander-based (EB) breast reconstruction has mainly focused on complications, with results not always unambiguous. Moreover, there are limited data 1) comparing DTI and EB breast reconstruction after nipple-sparing mastectomy (NSM) and 2) from the patient’s...

The annual congress of the Italian Association of Plastic Aesthetic Surgery (AICPE) is one of the most relevant conference meetings in Europe concerning aesthetic plastic surgery due to the number of participants and as parterre of invited speakers chosen for their renowned scientific value [...]

EDITORIAL In lieu of an abstract, this is an excerpt from the first page. Surgical Techniques Development is an Open Access peer-reviewed journal focusing on minimally invasive surgical techniques, technical innovations such as new instruments, new technologies, new robotics applications, and other new ideas, and is open to suggestions coming from...

Local relapse after mastectomy is sporadic for early breast cancer (stage 1 or 2) adequately treated [...]

Introduction: After mastectomy, immediate breast reconstruction is paramount. With the growing number of nipple-sparing mastectomies, the chances of successful one-stage reconstruction with implants are also increasing. Local safety is one of the main issues. This study investigated the factors that could lead to major or minor complications after...

Background: The regenerative effectiveness of lipoaspirate procedures relies on the presence of mesenchymal stem cells, but the stromal microenvironment and hormonal secretions of the adipose tissue may be involved in cancer growth. Only few oncological outcome studies of fat grafting at the surgical site of malignant neoplasms of mesenchymal orig...

Background Preoperative implant planning for breast reconstruction is often at risk of being changed perioperatively. This study examined which factors are associated with a change of implant selection. Methods Women who had unilateral two-stage breast reconstruction between 2002 and 2007 were studied. Inclusion criteria were photographic evidence...

Background: Nipple-areola complex-sparing mastectomy (NSM), extending the concept of skin-sparing mastectomy, allows for the provision of a better cosmetic result. Large operable T2-T3 breast cancer might theoretically appear suitable for this surgical option as an alternative to conventional mastectomy or breast-conserving surgery, when a good re...

The anatomy of the pectoral region is described in relation with the medial and pectoral nerves, recently also classified in three distinct nerves (superior, middle and inferior), with a special stress on the oncological and reconstructive surgery of the breast. The chapter focuses on the different anatomical, functional, and surgical aspects of th...

Introduction: TiLOOP(®) Bra is a permanent titanium-coated polypropylene mesh currently used in post-mastectomy breast reconstruction with implants. This mesh is generally presented as inducing low-grade inflammatory reactions, but only few reports focused on its possible side effects. In the case described here, the use of the mesh led to minor c...

Acellular dermal matrix and similar meshes are used in breast reconstruction to cover the inferior implant pocket. We considered whether using a modified dual-plane technique in immediate breast reconstruction could improve the outcome when compared with mesh reconstruction. The paper presents a case of a patient who underwent one-stage bilateral i...

Acellular dermal matrix and similar meshes are used in breast reconstruction to cover the inferior implant pocket. We considered whether using a modified dual-plane technique in immediate breast reconstruction could improve the outcome when compared with mesh reconstruction. The paper presents a case of a patient who underwent one-stage bilateral i...

The regenerative effects of fat injections are based on the same hormones, growth factors, and stem cells that stimulate neoplastic angiogenesis and cancer progression in basic research. Few studies have analyzed the oncologic risk. No report has covered 5 years of oncologic surveillance, and no long-term risk has been estimated. The in vivo relati...

Extra-projected Natrelle 510 belongs to a new generation of silicone breast implants. A single-surgeon prospective study set out to investigate the device's features, outcomes, and complications, and devise a proper measurement method based on the zenith system. From December 2004 to June 2010, 75 subjects (150 implants) were enrolled in four cohor...

The Authors present a novel technique of immediate breast reconstruction with definite implants after mastectomy conserving the nip-ple-areola complex and, less frequently, in skin-sparing mastectomy. The increase of indi-cations for both oncologic and prophylactic nipple-sparing mastectomy has induced the research for a single-stage technique that...

The greatest technical challenges in reconstruction of a breast relate to reproduction of projection, ptosis, and the inframammary fold. The newer biodimensional prostheses (Figs. 3 and 4) have helped achieve better projection and ptosis and the latter is aided by a degree of overexpansion and subsequent replacement of the tissue expander with a de...

In 2005 a new-concept implant was introduced for breast surgery by Allergan Inc, “Natrelle 510“, which shows characteristics that implants by other manufacturers do not have. Basic innovations are: the envelope contour and silicone dual gel in one single lumen. Original features are: a) anterior surface composed by smoothly thin borders and contour...

Outcome evaluation in cosmetic and reconstructive surgery of the breast is commonly performed visually or employing bi-dimensional photography. The reconstructive process in the era of anatomical implants requires excellent survey capabilities that mainly rely on surgeon experience. In this paper we present a set of parameters to unambiguously esti...

The transabdominal (transumbilical [TUBA]) procedure for breast implant insertion is known for aesthetic aims, but cosmetic and psychosocial improvements reported in aesthetic surgery should be transferred to breast reconstruction patients. Surgical and psychological aspects were analyzed in four cases through clinical evaluation and psychosocial a...

Coverage of facial defects is frequently challenging. Despite the numerous flaps described, the search for additional flaps with good color match and minimal donor-site morbidity continues and attempts to find valid options to free flaps perhaps overused in the last two decades, in particular for soft tissue replacement of the moderate-to-large per...

The authors propose a combined flap technique to reconstruct large and medium-sized ptotic breasts in a single-stage operation by use of anatomical permanent implants. The authors enrolled 28 patients fulfilling criteria for skin-sparing mastectomy and presenting with ptotic breasts whose areola-to-inframammary fold distance was more than 8 cm. All...

The subcutaneous fascial system of the breast was investigated. The aim was to demonstrate splitting of the superficial fascia and the existence of an inframammary ligament. The inframammary region was studied in six cadavers (12 breast dissections) and in 21 patients during breast surgery (12 surgical and nine histological investigations). The sup...

Sleeve anastomosis is an end-to-end variant (i.e., end in end) that makes it possible to suture two vessels quickly and with few stitches. Various methods have been described in the literature concerning experimental surgery (microsurgery and transplantation) and clinical microsurgery. The authors tested for a method that would eliminate narrowing...

Anterior craniofacial resection is now recognized as the best treatment for ethmoid tumors involving the cribriform plate with or without invasion of anterior cranial fossa. Ninety-one patients underwent an anterior craniofacial resection for ethmoid malignant tumors at the Milan Cancer Institute between 1987 and 1994. The patient population was di...

Background Anterior craniofacial resection is now recognized as the best treatment for ethmoid tumors involving the cribriform plate with or without invasion of anterior cranial fossa.Methods Ninety-one patients underwent an anterior craniofacial resection for ethmoid malignant tumors at the Milan Cancer Institute between 1987 and 1994. The patient...

A wide variety of osseomyocutaneous free flaps for mandibular reconstruction has been described. The flap made up of latissimus dorsi, serratus anterior and rib (LSRF), , can provide vascularized skin, muscle, bone and cartilage on a single thoracodorsal vascular pedicle and is useful in some circumstances, i.e., large soft tissues defects. In this...

Anatomists and surgeons have underestimated the importance of understanding the anatomic connective frame of the inframammary region. The submammary fold does not originate as a self-governing unit but depends on breast mould and on a fine superficial fascial system suspension. The authors investigated the inframammary fold anatomy and subcutaneous...

Progressive hemifacial atrophy, described initially by Parry and Romberg, is reviewed in terms of etiopathogenesis and clinical features. The purpose is to clarify the variegated nature of this syndrome and to distinguish it from other forms of atrophy affecting the face, principally the soft tissues. The authors propose a new general classificatio...

This is a single case report describing a young woman with progressive facial atrophy that began at age 15. After she underwent commissuroplasty and collagen injection at age 29, her symptoms continued to progress, and she was ultimately shown to have serologic evidence of systemic lupus. She had a "remission of symptoms" after commencement of medi...

We critically review 13 patients with progressive hemifacial atrophy treated with three basic surgical procedures (free flap transplantation, alloplastic implants, micro-fat injections 'lipofilling') and further ancillary techniques. In spite of the satisfactory results achieved with the procedures, with the exception of alloplasts, we feel that li...

Parry-Romberg syndrome is an uncommon self-limiting condition principally affecting the adipose tissue of the face. Six patients have undergone the microfat injection technique. The follow-up of 18 months confirms the usefulness of microlipoinjection in the treatment of the soft tissue deformity of the face.