În ultimul deceniu, lumea jocurilor de noroc s-a schimbat radical în România, în special cu apariția noi cazinourilor online. Această tendință, alimentată de progresul tehnologic și de comoditatea jucătorilor, a transformat complet modul în care românii se bucură de jocurile lor preferate.

Una dintre caracteristicile marcante ale cele mai cazinouri noi 2023 este folosirea tehnologiilor de ultimă oră. Acestea oferă jucătorilor o experiență fluidă și captivantă, cu grafică impresionantă și sunete imersive. De asemenea, varietatea jocurilor disponibile a crescut semnificativ. De la sloturi tradiționale la jocuri de masă și până la cazinouri live cu dealeri reali, opțiunile par nesfârșite. Însă, nu doar diversitatea jocurilor face apel la jucători. Noile cazinouri online aduc o serie de beneficii incontestabile. Jucătorii pot accesa platformele oricând și de oriunde, având nevoie doar de o conexiune la internet. În plus, promoțiile și bonusurile oferite sunt deseori mult mai generoase decât cele din cazinourile tradiționale, oferind oportunități suplimentare de câștig.

Breast Procedures

Pre-Pectoral Implant Breast Reconstruction

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Prepectoral reconstruction is a technique that eliminates dissection of the pectoralis major by placing the prosthesis completely above the muscle with complete acellular dermal matrix coverage.


What Is Tissue Expander Implant Reconstruction Surgery?

What Is Tissue Expander Implant Reconstruction Surgery?

Tissue expander implant reconstruction is a very common method for performing breast reconstruction after mastectomy. Using traditional methods, a tissue expander is placed under the muscle at the time of mastectomy. Sometimes this pocket is reinforced with an acellular dermal matrix, such as Alloderm, to help secure the position of the implant and optimize shape.


Is Tissue Expander Implant Reconstruction Surgery Safe?

Creation of a pocket for the tissue expander under the muscle is a safe and effective way to reconstruct the breast mound. Muscle coverage provides a good blood supply to the overlying skin, which decreases healing risks, and also camouflages the implant. This means that there is less risk of seeing rippling of the subsequent permanent implant or seeing the implant edges, which allows the reconstruction to appear more natural. Conversely, because the implant is under the muscle, patients may notice changes in the appearance of the breast when they contract the chest muscle. This can create animation deformity or change in the appearance at the upper pole of the breast with contraction of the chest muscle, and also pushes the implant down and out towards the armpit. To avoid this issue, tissue expanders are now being placed above the chest muscle, termed pre-pectoral tissue expander breast reconstruction. In this approach, a support material, such as Alloderm, may be used to secure the position of the implant on top of the muscle, or the implant will simply be sutured into place using the attached tabs, but the chest muscle is not lifted off of the chest wall. The tissue expander is placed on top of the muscle, secured into place, and is then filled with air (instead of saline). Expansion with air reduces weight on the skin and, therefore, the risk for healing problems. Because the muscle is not lifted, patients who have this type of reconstruction generally will have less pain after surgery. Placement above the muscle also allows patients to avoid animation deformity associated with traditional tissue expander reconstruction approaches. Despite this benefit, there are also downsides to this approach; patients may have a slightly higher risk for delayed healing after surgery and may find that they are more likely to have visible rippling after permanent implant placement. Regardless of the placement of the tissue expander, expansion will continue as planned.


How Is Tissue Expander Implant Reconstruction Performed?

Patients usually begin expansion 2-4 weeks after tissue expander placement and continue until they reach their desired size. Patients with pre-pectoral reconstruction will initially have the air removed and replaced with saline, and then expansions will continue as they would for traditional tissue expander reconstruction. Exchange to a permanent implant then occurs as an outpatient procedure under sedation that takes maybe 1.5 hours to complete. Patients who have pre-pectoral reconstruction may have a higher need for fat grafting in order to provide more coverage over the implant to decrease visible implant edges and rippling. As is the case with most things, there are pros and cons to both of these approaches to reconstruction. We will discuss your preferences with you at your consult and review these options to make sure you feel we are making the best decision for you. If you have questions about pre-pectoral breast reconstruction, please feel free to reach out to us!



What Our
Patients Say

“Dr. Fine and Dr. Schierle are the most competent and meticulous plastic surgeons. I love their positive attitudes and their ability to make things look as normal as possible after a mastectomy. The entire office staff help in making things go as smoothly and easily as possible after a difficult diagnosis. I highly recommend Northwestern Specialists in Plastic Surgery!”

- Cheryl D.

Contact Us Today!

Northwestern Specialists
in Plastic Surgery

676 N St Clair Street, Suite 1575
Chicago, IL 60611

Monday-Friday: 8a-5p
Saturday & Sunday: Closed

Northwestern Med Spa Streeterville

676 N St Clair Street, Suite 1575
Chicago, IL 60611

Monday: 8a-6p
Tuesday-Thursday: 8a-7p
Friday: 9a-5p
Saturday: 9a-2p
Sunday: Closed

Northwestern Med Spa River North

3 E Huron Street, 3rd Floor
Chicago, IL 60611

Monday-Thursday: 10a-7p
Friday: 9a-5p
Saturday: 9a-2p
Sunday: Closed

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