Abnormal placentation is a noncommon but life-threatening obstetric condition that requires a multidisciplinary approach. It is a spectrum of disorders that seems to parallel the increasing rate of cesarean sections. Imaging findings have a crucial role in detecting this abnormality early in the pregnancy and subsequently guiding and alerting the surgeon. Between accreta and percreta, the difference is huge; thus, they are managed with a different degree of radicality. The surgeon tends to treat more radically cases of placenta percreta with cesarean hysterectomy and needs to have special expertise in pelvic surgery, inter alia, and gynecologic oncology. While extrapolation does not find its way in every case of abnormally invasive placenta, a new inspired technique from gynecologic oncology surgeries and adapted to percreta cases seems to be applied safely and effectively in all circumstances of percreta. Conservative treatment is also an alternative but is limited to selected cases of placenta accreta.
Part of the book: Placenta
Oncoplastic surgery is an emerging approach which combines breast-conserving surgery and plastic surgery techniques. It aims to provide wider volume resection with oncologically clear margins and at the same time to maintain the breast shape and optimize cosmetic outcomes. Inspired from esthetic breast surgery techniques, oncoplasty consists of breast volume displacement to fill the defect of large resections and optimize the cosmetic outcomes without interfering with the oncoplastic safety. In this chapter, the concept, indications, and principles of oncoplastic techniques used in conservative breast surgeries will be exposed. A photo-based atlas for oncoplastic incisions will concern seven cases starting with the preoperative planning and marking and ending up with the long-term postoperative outcomes.
Part of the book: Breast Cancer and Breast Reconstruction