Hilton Becker

Hilton Becker
Boca Raton Regional Hospital | BRRH · Department of Plastic Surgery

Doctor of Medicine

About

97
Publications
12,971
Reads
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1,678
Citations
Additional affiliations
January 2018 - present
Florida Atlantic University
Position
  • Professor (Associate)

Publications

Publications (97)
Article
Full-text available
Background: A technique of a free nipple graft with an inframammary incision and no vertical incision offers promising postoperative results as a safe and aesthetic alternative. Methods: This was a retrospective chart review of patients who presented to a single surgeon for breast reduction surgery using a free nipple graft with an inframammar...
Poster
Background Platelet-rich plasma (PRP) has been shown to release a multitude of growth factors, but its preparation requires the use of anticoagulants and special equipment. In contrast, platelete-rich fibrin (PRF) is produced by centrifuging whole blood and allowing it to clot. The clot contains the platelets and growth factors, and it is composed...
Poster
Background Breast cancer is the most frequently diagnosed malignancy in women with its rates projected to increase and mastectomy followed by breast reconstruction remains one of the most commonly used treatments for breast cancer. A prepectoral adjustable saline implant initially underfilled with air allows for tissue contraction and thickening of...
Article
Full-text available
Platelet-rich plasma (PRP) has been shown to release a multitude of growth factors, but its preparation requires the use of anticoagulants. In contrast, advanced platelet-rich fibrin (aPRF) is produced by centrifuging whole blood and allowing it to clot. The clot contains the platelets, growth factors, and neutrophils, and it is composed of a fibri...
Article
Full-text available
Background: The Goldilocks technique is a postmastectomy breast reconstruction procedure adopted in 2012, which is performed by preserving and de-epithelializing the residual mastectomy flap to create an autologous tissue breast mound using an anchor, inverted T, or lateral incision. It is utilized in select patients along with the addition of a...
Poster
Full-text available
Mastectomy incisions have evolved from an oblique incision to vertical or inframammary incisions. Oblique incisions can lead to flattening of the breast, while a vertical mastopexy can be performed to enhance projection. We describe a case where the excess skin that is normally excised is used to reconstruct the nipple.
Poster
Full-text available
It has been shown that fat harvested with wider-diameter cannulas can improve fat graft survival and reduce fat graft resorption, which is highly variable. It is also theorized that direct excision of fat may result in increased structural integrity resulting in increased viability of fat grafts. We propose a method for somewhat direct excision of...
Article
Full-text available
Surgical drains placed during breast surgery can become blocked by clots or other debris, which may lead to infection of the prosthetic and seroma or hematoma formation from improper drainage. Current methods involve stripping the drain, which does not clear the pores inside the cavity, or flushing the drain at the opposite end using a syringe with...
Article
Full-text available
Background:. Fat is an active and dynamic tissue composed of adipocytes supported by a structural framework known as the stromal vascular fraction (SVF). SVF is traditionally isolated by enzymatic processing, but new methods are being investigated to isolate it mechanically. Recent studies propose that fat harvested with larger cannulas has a highe...
Chapter
Women seeking improvement of breast ptosis will often accept less of a lift for a reduced scar pattern. Periareolar incisions are at higher risk of scar widening related to excessive tension or suture failure along the areolar edge. The subareolar mastopexy technique can offer a means to reduce tension through dermal plication and provide satisfact...
Article
Full-text available
Complete necrosis of the nipple, areola, or both is a uncommon complication of reduction mammaplasty, especially if it happens bilaterally. This case involving a young, black female illustrates that, in a large open wound of the breast, it would be ideal to leave it to heal by secondary intention as adding a skin graft would only speed up the heali...
Article
Full-text available
The onset of the COVID-19 pandemic has changed the face of the treatment of breast cancer and breast reconstruction globally. Mastectomy with immediate implant-based breast reconstruction was on the rise due to advances in meshes and implants. However, due to the prioritisation of the critically ill and diversion of the work force, breast cancer tr...
Article
Full-text available
Background It is generally believed that trauma to fat grafts is detrimental and affects the survival of the graft. In addition, it has been shown that smaller fat particle size corresponds to better survival; however, smaller cannula openings correspond to slower and more difficult fat graft harvesting. Objectives This study documents the relation...
Chapter
The use of adjustable implants has proven to be of great value in breast reconstruction.
Article
Full-text available
Introduction: Immediate prepectoral breast reconstruction offers excellent aesthetic results with less pain and elimination of animation deformity due to avoidance of pectoralis dissection and subpectoral implant placement. Concerns about the effects of prostheses on flap perfusion have limited use of the technique to highly selected patients. We...
Article
Full-text available
Background: The incidence of breast cancer and immediate breast reconstruction is on the rise particularly in the US and Western Europe. Over the last decade, implant based breast reconstructions have gained popularity. The prepectoral breast reconstruction has emerged as a novel technique, minimally invasive, preserves the chest wall anatomy whil...
Article
Full-text available
Advances in implantable biologic and synthetic products over the last decade have enabled surgeons to replace traditional submuscular implant-based breast reconstruction techniques with a prepectoral or muscle-sparing technique. Prepectoral breast reconstruction is becoming increasingly popular among surgeons and patients due to the preservation of...
Article
Full-text available
Background Skin expansion is commonly needed in order to reconstruct the breast following modified radical mastectomy. With the advent of skin-sparing and nipple-sparing techniques, expansion is no longer necessary. The natural ability of healing tissues to contract can be advantageously used to improve the outcomes of immediate prepectoral breast...
Article
Full-text available
Background The incidence of infection following breast implant reconstruction remains high at the level of 24%. Surgical site irrigation is commonly used for its prevention. However, the lack of evidence-based guidelines for antibiotic prophylaxis in breast implant surgery necessitates research for optimal irrigation technique. Objectives composit...
Article
Full-text available
The Spectrum adjustable saline implant is optimal for prepectoral breast reconstruction as it can be placed virtually empty and thus flat, applying no pressure on the overlying skin flap. However, when saline is added, it tends to pool at the bottom of the implant resulting in its uneven surface and rippling. Air filling results in the uniform dist...
Article
Full-text available
Background Animation deformity after subpectoral breast implant placement has been documented; however, the actual prevalence and effect on patient quality of life has not been studied much. Objectives The purpose of this study was to show that all patients with subpectoral implants experience some degree of animation deformity and that it can aff...
Article
Postoperative swelling following prosthetic implant breast augmentation and reconstruction is not uncommon. Prompt diagnosis and targeted treatment are critical. Current treatment recommendations achieve a diagnosis using specialized equipment with needle-guided imaging and/or surgical modalities. These techniques are expensive and delay diagnosis...
Chapter
Mastectomy has evolved from radical to modified radical, skin sparing, and now nipple sparing mastectomy. With the realization of the safety of less radical procedures, surgeons are leaving thicker skin flaps with impaired viability and more focus is being placed on excision with a suitable margin and ease of examinability of residual tissue. These...
Article
Full-text available
Ideally, breast reconstruction is performed at the time of mastectomy in a single stage with minimal scarring. However, postoperative complications with direct-to-implant subpectoral reconstruction remain significant. These include asymmetry, flap necrosis, animation deformity, and discomfort. We report on a series of patients who have undergone im...
Article
Full-text available
Background One-stage implant-based breast reconstruction with minimal scarring is a highly appealing option to most patients. In fact, expander/implant reconstruction accounts for nearly 70 % of all breast reconstructions. We present our experience with a simplified skin-preserving/reducing excision pattern in association with immediate breast reco...
Article
Full-text available
Nipple-sparing mastectomy (NSM) is gaining acceptance as an oncologically sound and cosmetically superior mastectomy technique. Debate exists over the management of positive margins near the nipple-areola complex. This case report presents a novel approach to the management of margin-positive ductal carcinoma in situ in NSM. A 50-year-old white fem...
Article
Full-text available
Recent evidence suggests that the use of acellular dermal matrices in prosthetic breast reconstruction, revision, or augmentation may be associated with an increased risk of complications. In this article we report our results of a potential alternative, using a new long-term resorbable synthetic matrix in these cases. A retrospective study was per...
Article
Background Recent evidence suggests that the use of acellular dermal matrices in prosthetic breast reconstruction, revision, or augmentation may be associated with an increased risk of complications. In this article we report our results of a potential alternative, using a new long-term resorbable synthetic matrix in these cases.MethodsA retrospect...
Chapter
In choosing a breast implant today, it is no longer simply a matter of volume. The surgeon must consider a wide variety of measurements and factors, including base diameter, height, projection, nipple-to-inframammary distance, volume, breast asymmetry, rib cage projection, and ptosis. The enhanced projection adjustable implant is essentially a gel...
Article
Adjustable breast implants are widely used for both reconstructive and cosmetic breast surgery. They provide unique postoperative versatility and allow for more effective management of numerous conditions that would otherwise require surgical intervention. Findings have shown that in a clinical setting, it often is necessary to overexpand saline im...
Article
For augmentation mastopexy, the authors use adjustable implants that are deflated at the end of the procedure and then inflated to the desired size 5 to 10 days postoperatively using external injection domes. Reported advantages, based on 175 cases, include increased perioperative safety for the nipple areolar complex, the ability to adjust for siz...
Article
The author describes how he augments Endotine Forehead device fixation with a temporary external cortical screw. This prevents the elevated and advanced skin flap from becoming detached from the Endotine, causing a relapse of brow ptosis. This double fixation endobrow technique places initial tension on the cortical screw, allowing tension-free fix...
Article
The author describes the use of implants with exteriorized injection domes for patients undergoing breast augmentation. Domes were exteriorized for 1 to 5 days to allow the implant volume to be altered in the early postoperative period. Thirty-three patients were treated without any infections.
Article
A preliminary report on a new technique for dermal overlap subareolar mastopexy appeared in 2001. This paper reports on a series of 117 patients who underwent subareolar mastopexy and describes several modifications of the original technique. Preoperative markings defined the upper edge of the new areola position, the circumferential outline, and t...
Article
Background: The major disadvantage of the circumareolar mastopexy is the risk of hypertrophic scarring and relapse or widening of the areola. Objective: The author describes a new technique that gives added support to the scar by means of a dermal overlap flap that is buried under the areola. Methods: A doughnut incision is made, with the size of t...
Article
Full-text available
Hilton Becker, MD, Boca Raton, FL , is a board-certified plastic surgeon and an ASAPS member. In the late 1970s and early 1980s, breast reconstruction was popularized with the introduction of the Radovan expander (Heyer-Schulte, Goleta, CA).1 The device was initially used to expand the tissue; this was followed by an operation to remove the expan...
Article
An intra-areolar approach for breast augmentation is described. A circumferential incision is made around the nipple, and the surrounding areola undermined. Although the resultant incision is small, it is possible to insert a tightly folded implant into the submuscular or subglandular plane. The resultant scar is camouflaged at the nipple-areolar j...
Article
Recent anecdotal reports have indicated that a high percentage of saline implants harbor dangerous microbes. These reports have caused considerable alarm and fear to saline implant recipients. Reports in the literature of microbial growth in saline implants are infrequent. The expander implant offers an ideal opportunity to study the internal milie...
Article
The fetal wound healing matrix is exceptionally rich in hyaluronic acid (HA). Fetal wounds heal without scarring or contraction. Noting these observations, we cultured adult dermal explants in the presence of various concentrations of medical-grade HA in vitro. In the presence of HA, fibroblasts migrated from the dermal explant and multiplied more...
Article
This article addresses motivations for and reactions to augmentation mammoplasty and reports on a study of 32 women who were able to be followed for a minimum of 1 year after their surgery. It considers the women's stated motives and objectives, as well as their postsurgery reactions. The positive impact of offering the possibility for postoperativ...
Article
Arguably, women (and men) are willing victims of exploitation by cosmetics makers and advertisers, exchanging dollars and good sense for the hope of rejuvenation. This does not justify, however, lack of regulation, use of potentially harmful ingredients, or exaggerated claims. Consumers of cosmetics deserve safe effective products at reasonable pri...
Article
A new cannula has been designed that facilitates liposuction procedures by increasing the amount of fat tissue breakdown before aspiration. The cannula allows for greater application and opens up new horizons in aspirative surgery.
Article
Through our experience with expansion augmentation, we have been able to develop a technique to quantitatively assess the adequacy of the patient's postoperative breast massage. This has resulted in a consistently low capsular contracture rate
Article
Although Montgomery's tubercles are often prominent structures on the areola, little attention has been paid to their reconstruction. Present techniques for nipple-areola reconstruction result in a flat-appearing surface that is usually not characteristic of a normal areola with its projecting Montgomery's tubercles. We describe a technique for cre...
Article
The major disadvantage of breast ptosis correction using the standard mastopexy procedure is the visible scarring. The use of an implant alone is often inadequate, especially in the more ptotic breast. A technique employing a submuscular expandable mammary prosthesis together with release of the breast tissue from the underlying muscle is described...
Article
A new suction cannula is described that is able to dissect and aspirate breast tissue. The cannula has proven effective in treating gynecomastia without surgical resection of breast tissue.
Article
A new expandable breast implant for use in hypomastia is presented. The ability to manipulate the size of the implant postoperatively greatly enhanced the final results.
Article
A new expandable breast implant for use in hypomastia is presented. The ability to manipulate the size of the implant postoperatively greatly enhanced the final results.
Article
The permanent tissue expander has many advantages over a fixed-volume implant. Chest-wall skin can be expanded, enabling safe reconstruction of an aesthetically pleasing breast without the use of flaps. Excessive pressure on compromised skin flaps is avoided, and larger breasts can be achieved postoperatively by staged expansion. It appears that ea...
Article
An expandable saline-gel implant having a detachable injection dome is described. The implant functions initially as a tissue expander. Once the correct size has been obtained, the injection dome is removed, leaving the implant in position.
Article
We describe a new breast implant that greatly facilitates immediate breast reconstruction after mastectomy. Through a detachable filling reservoir, the implant can be filled with saline by percutaneous injection; this allows the empty implant to be placed in position and filled only after viability of the flaps is assured. Because filling can be co...
Article
The expandable mammary prosthesis that has been successfully used for breast reconstruction has been modified for breast augmentation procedures. A new microreservoir that can be buried subcutaneously for extended periods has been developed. The unique design of this implant allows its size to be adjusted postoperatively as many times as desired, t...
Article
The results of intradermal pigmentation to obtain improved coloring in reconstructed nipples is presented. The technique obviates the need for pigmented skin, thus enabling the surgeon to obtain skin grafts for nipple-areola reconstruction from more desirable donor sites.
Article
An inflatable breast implant having a detachable filling reservoir is described. Once in position, the implant can be filled under controlled conditions postoperatively. The implant functions either as a tissue expander or as a delayed-filling implant in the initial stages of the procedure. Once the desired breast size is achieved, the reservoir is...
Article
Further applications of the rhomboid-to-W principle are discussed. The use of the flap in areas where other local flaps have not been successful is shown, together with an in-depth discussion of the planning and design of this flap.
Article
There has been considerable controversy concerning the capacity of tendons to heal intrinsically without adhesion formation. To help clarify this issue, a tissue culture model was developed to study the potential of tendon fibroblasts to proliferate and migrate. Avian flexor tendons, isolated free of sheath and all synovial components, were maintai...
Article
Modified radical mastectomy has clearly facilitated breast reconstruction after mastectomy. We emphasize preservation of the nerve supply to the pectoralis major muscle and describe a method of breast reconstruction after modified radical mastectomy.
Article
This study examines the potential of tendon cells to participate in tendon repair. Explants were prepared from chicken sublimis tendons and studied in tissue culture. Under defined culture conditions, in the absence of tendon sheath, tendon cells were observed to migrate in a limited concentric fashion around the margin of a 2 mm window in the expl...
Article
We have presented a new method of dynamic splinting that allows a greater range of protected motion under constant tension. The device has been designed for use with newer methods of tendon repair in situtations where early controlled motion is allowed.
Article
A method is descirbed whereby a skin lesion is excised as a rhomboid, and adjacent flaps are then created and transposed to close the defect in a W. A. pleasing scar line results, one which is easily hidden in the natural creases.
Article
In an effort to overcome restrictive adhesions following flexor tendon repair, a technique involving beveling of the tendon ends and fine compressive suturing was used in 50 patients (110 tendons). Free early active motion was allowed. There were 70% good-to-excellent results, with a 10% rupture rate.
Article
The fibromatoses are poorly understood conditions with regard to their etiology, pathology, and management. Pathologically related conditions may occur in different parts of the body and have been classified into specific types. Lesions, however, are still encountered which, although related histologically to the fibromatoses, fail to meet the requ...
Article
We describe a distally-based gluteus maximus muscle flap to cover trochanteric pressure sores. The results in 4 patients have been gratifying.
Article
A new approach to the problem of flexor tendon repair within the fibro-osseous canal is presented. Using a technique of bevelling the tendon ends and suturing with a fine suture material, under magnificaiton, a sufficiently strong junction is obtained, which enables immediate active mobilisation without strangulation of the blood supply. The juncti...
Article
A new method of tendon suture has been designed to eliminate the development of a gap when tension is applied to the repair. It has been demonstrated to resist distraction at relatively high tensions on cadaveric tendon. The possible advantages of the technique are discussed.

Projects

Project (1)