The "dermal cage": a modification of the inferior pedicle breast reduction

In spite of more recent techniques for breast reduction, the inferior pedicle technique has proven to be enduring and still a very popular option in the plastic surgeon's armamentarium despite certain shortcomings. This technique is especially important for treating large breasts with a long sternal notch-to-nipple distance. The modifications we describe in this article overcome some of the main drawbacks of the standard inferior pedicle technique and make the procedure particularly effective when used on appropriately selected patients. This is achieved principally by the creation of a strong, durable, and internalized "dermal cage" that remains fixed to the chest wall in the upper part, as well as on both sides, to support the majority of the remaining breast tissue. This serves several purposes, including narrowing the breast thereby giving good projection and reduction of the N-IMF length of the inferior pedicle. Through suspension and fixation of the inferior pedicle to the chest wall, one can mitigate the effects of gravity on the inferior pedicle. The benefits of this include reduced tension on the T junction, thereby reducing the incidence of wound dehiscence in the immediate postoperative period, while reduction of tension on the nipple-areola complex reduces "bottoming" out over the long term. This process has been the main shortcoming of the inferior pedicle technique to date. The technique was used on 26 patients over a 7-year period with a mean long-term follow-up of 41 months. The results demonstrate the short- and long-term effectiveness of our own particular combination of modifications to previously described techniques and modifications of the inferior pedicle breast reduction. ----- LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

A simple analytical method for residual stress measurement on suspended MEM structures using surface profilometry

This paper presents an analytical method to calculate residual stress and Young’s modulus in clamped-clamped beams. These types of structures are a typical building block of many MEMS devices, and this guarantees an accurate transferability of the measured parameters. The method is based on the determination of beam bending as a function of applied load by means of a surface profiler, and as a function of beam length. By modeling analytically both the elastic and the stress contribution to beam bending, it is possible to obtain both the stress value and the Young’s modulus by a simple fitting of the experimental data. Results are presented for electrodeposited gold beam arrays of different width, but the method is in principle exploitable for every type of suspended film where the residual stress strongly influences the material properties. Accuracy and limitations of the method are also discussed