ROME BREAST SURGERY SYMPOSIUM - RECONSTRUCTION AND AESTHETIC: OBTAINING SAFETY AND RESULTS
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ROME BREAST SURGERY SYMPOSIUM
RECONSTRUCTION AND AESTHETIC: OBTAINING SAFETY AND RESULTS
Roy de Vita, M.D. Stefano Pompei, M.D.
Rome, Sheraton Golf Parco de’ Medici
June 4-5-6, 2014
Under the Patronage of SICPRE
Organizing Secretariat and CME Provider
Organizing Secretariat
Event Manager: Michela Scarani - 0039 06 87757099
Project Manager: Patrizia Serenella - 0039 06 87756028
info@alfafcm.com www.alfafcm.com
Italian CME ACCREDITATION INFORMATION
Nr. 3282 - 93162
Nr. 10,5 CME Credits
The Congress is intended for the following figures (maximum 200 registrations)
MEDICAL DOCTORS
Disciplines: General Surgery; Oncology; Radiotherapist; Plastic and Reconstructive Surgery;
Obstetrics & Gynecology; Thoracic Surgery; Dermatology and Venereology.
NURSES
In order to obtain CME Credits, participants must:
• Attend 100 % of the Sessions indicated in the Program
• Fill in the personal data form, the form evaluating the event, and the learning questionnaire, and
give them back to the Organizing Secretariat at the end of the Congress
The CME certificate will be sent by certified e-mail after the Congress to the e-mail address given on
the personal data form
CONTENTS Faculty5 Pre-Congress Courses Program 6 Congress Program 8 Practical Information 28 Useful Numbers 29 Visit Rome 30 Sponsor36
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Scientific Program
ROME BREAST SURGERY SYMPOSIUM
RECONSTRUCTION AND AESTHETIC:
OBTAINING SAFETY AND RESULTS
Scientific Committee
Roy de Vita, M.D.
Stefano Pompei, M.D.
Scientific Secretariat
Ornella Abate
Alfredo Altieri
Floriana Arelli
Ernesto Buccheri
Guido Caravelli
Maurizio Costantini
Maria Chiara Drago
Stefano Feliciano
Lara Labardi
Pierpaolo Gullo
Fabio Marcasciano
Massimo Panimolle
Marcello Pozzi
Antonio Varanese
Giovanni Zoccali
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Dear Friends,
Restoration of breast shape and morphology has been integrated in the breast cancer treatment
regimens since many decades.
Since breast reconstruction is considered to be an important therapeutic intervention as radiother-
apy, chemotherapy, and tumor excision therapy the evolution of this field was inevitable.
The continuous improvement of breast reconstruction guidelines and surgical techniques, as well
as the increasing availability of different types of implants and biological or synthetic aids, justifiably
resulted in various combinations of instructions and opinions on Breast Reconstruction.
There is, however, a shared consensus: The “multidisciplinary approach” ensures the best results in
breast cancer treatment as well as breast reconstruction.
A successful breast reconstruction includes, of course, the aesthetic result, and the parameters of an
aesthetically appealing breast remain the same as in Cosmetic Surgery.
We believe the benefit of knowledge sharing is tremendous and therefore International Opinion
Leaders in the field of “Senology” are gathered in this meeting to present their experience and re-
search results.
This Symposium includes not only presentations but also constructive discussions and videoconfer-
ences from experts around the globe about indications, results and complications.
Attention is equally given to reconstructive as well as aesthetic breast surgery since the two fields
are interdependent. Opinion-leaders will participate in special “boxe-ring” sessions that will consist
in debates and critical discussion of crucial topics.
We would like to welcome you here and we hope you enjoy the conference as much as you enjoy
Rome in June.
Roy de Vita Stefano Pompei
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FACULTY
Scientific Committee
Roy de Vita
Stefano Pompei
International Faculty Italian Faculty
Claudia Albornoz, New York - USA Pietro Berrino, Genoa
Eric Auclair, Paris - France Luigi Cataliotti, Florence
Ricardo Baroudi, Campinas - Brasil Valerio Cervelli, Rome
Antonio Roberto Bozola, San José de Rio Preto - Brasil Flori Degrassi, Rome
Karl Heinz Breuing, Essen - Germany Franco Di Filippo, Rome
Mitch Brown, Toronto - Canada Stefano Drago, Rome
Peter Gabriel Cordeiro, New York - USA Lucio Fortunato, Rome
José Luis MartÍn Del Yerro Coca, Madrid - Spain Giovanni Battista Grassi, Rome
Michael Douek, Londra - UK Andrea Grisotti, Milan
Jian Farhadi, Londra - UK Riccardo Masetti, Rome
Luiz Fernando Frascino, San José de Rio Preto - Brasil Paolo Persichetti, Rome
Clifford Hudis, New York - USA Enrico Robotti, Bergamo
Steven Kronowitz, Houston - USA Marzia Salgarello, Rome
Douglas Macmillan, Nottingham - UK Pierluigi Santi, Genoa
Patrick Mallucci, London - UK Maurizio Valeriani, Rome
Ricardo Marujo, São Paulo - Brasil Michele Zocchi, Milan
Jaume Masià, Barcelona - Spain
Colleen McCarthy, New York - USA
Stephen McCulley, Nottingham - UK
Babak J. Mehara, New York - USA
José Mendes Junior, Sorocaba - Brasil
Virgilio Sacchini, New York - USA
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PRE-CONGRESS COURSES PROGRAM
June 4th
08.00 - 08.30
REGISTRATION
08.30 - 10.30
NEW TRENDS AND REFINEMENTS IN BR
Discussants: M. Douek, J. Masià
• Prevention and management of early complications in BR - J. Farhadi
• Autologous or implant based immediate BR? - D. Macmillan
• ADM + implant based reconstruction - M. Brown
• Actual role of two stages reconstruction - P. Cordeiro
• Reshaping of residual breasts after BCT - D. Macmillan
• Impact of RT on implant based and autologour reconstruction - S. Kronowitz
Discussion and “take home concepts”
10.30 - 11.00
COFFEE BREAK
11.00 - 13.00
HOT TOPICS IN BREAST ENLARGEMENT
Discussants: E. Robotti, J. Mendes
• Fat and/or implant for breast enlargement - E. Auclair
• The access choice - L.F. Frascino
• The choice of the implant shape: my personal criteria for different cases - J.L. M. Del Yerro Coca;
P. Mallucci
• Revisional breast augmentation - R. Marujo
Discussion and “take home concepts”
7 YOUR NOTES
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CONGRESS PROGRAM
June 4th
13.00 - 13.45
REGISTRATION
13.45 - 14.00
OPENING AND WELCOME - R. DE VITA, S. POMPEI
GREETING SESSION - R. MAZZOLA
14.00 - 15.15
VIDEOCONFERENCE SESSION FROM MEMORIAL SLOAN KETTERING
CANCER CENTER, NEW YORK
Coordinator in Rome: P. Cordeiro
• Current State of Breast Surgery - V. Sacchini
• New developments in adjuvant therapy - C. Hudis
• Understanding lymphedema: what is the best approach to treatment? - B. Mehrara
• Quality of life and patient satisfaction after breast reconstruction-what do our patients really
think? - C. McCarthy
• Do high volume breast centers provide better outcome in autologous reconstruction? - C. Albornoz
Discussion and “take home concepts”
15.15 - 15.40
OPENING LECTURES
• Quality control in breast cancer surgery - L. Cataliotti
• Local treatment of Breast Cancer: where are we today? - R. Masetti
• The role of the “Breast Unit” and volunteer associations - F. Degrassi9 YOUR NOTES
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June 4th
15.40 - 16.40
FOCUS ON BCS WITH PARTIAL RESECTIONS
Discussants: S. Kronowitz, P. Persichetti
• Oncological features in BCT - M. Douek
• Consideration of the outcome in BCS - D. Macmillan
• Superior and inferior pedicle flaps after BCS - S. McCulley
• Local perforator flaps for partial defect in BR - J. Masià
Discussion and “take home concepts”
16.40 - 17.10
COFFEE BREAK
17.10 - 18.10
CRITICAL CHOICES IN BR
Discussants: G.B. Grassi, M. Salgarello
• Risk factors for mastectomy flap necrosis and strategies to manage them - L. Fortunato
• Optimal incisions in SSM and NSM for implant breast reconstruction - F. Di Filippo
• Choosing the right prosthesis in one stage implant reconstruction - K. Breuing
• Treatment proposals in breast carcinoma in genetically predisposed patients - S. Drago
• Therapeutic Mammaplasty for BCS in smaller breasts - D. Macmillan
Discussion and “take home concepts”11 YOUR NOTES
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June 4th
18.10 - 19.00
BR AND RT
Discussants: M.Douek , J. Farhadi
• “Immediate-delayed” BR and RT - S. Kronowitz
• Polyurethane implants: defining their role and their long term outcome in BR with and no RT
S. Pompei
• Effect of RT on autologous tissue - S. McCulley
• ADM and implant reconstruction with RT - M. Brown
Discussion and “take home concepts”
19.00 - 19.15
CLOSING REMARKS13 YOUR NOTES
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June 5th
08.30 - 09.30
THE ADM ERA
Discussants: S. McCulley, P. Santi
• The learning curve in ADM use - J. Farhadi
• The M.D. Anderson experience with ADM - S. Kronowitz
• Alloplastic Meshes: an effective alternative to ADM ? - K. Breuing
• Experience with different kinds of ADM - M. Douek
• ADM and Meshes: do they have a future? - R. de Vita
Discussion and “take home concepts”
09.30 - 10.20
BR: PRESENT AND FUTURE TRENDS
Discussants: M. Douek, A. Grisotti
• The fat grafting in BR : technique and outcome - P.L. Santi
• Oncoplastic approach in extremes ages - G.B. Grassi
• Adipose-derived Stem Cell (ADSC): present and future - V. Cervelli
• Management of breast edema: limphonode transfer - J. Masià
Discussion and “take home concepts”
10.20 - 11.00
COFFEE BREAK15 YOUR NOTES
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June 5th
11.00 - 12.00
AUTOLOGOUS BR: DEFINING A REALISTIC ROLE
Discussants: P. Cordeiro, P. Santi
• Indications for non abdominal free flaps - J. Masià
• Tips and tricks for DIEP flap reconstruction - S. McCulley
• Impact of RT on immediate autologous BR - S. Kronowitz
• Extended LD flap: a realistic alternative to implants - E. Robotti
Discussion and “take home concepts”
12.00 - 12.55
THE BOXING RING
CONTROVERSIAL TOPICS ON RECONSTRUCTIVE SURGERY
Referees: D. Macmillan, S. Kronowitz
• BR with ADM: Does it have a realistic future? - J. Farhadi vs P. Cordeiro
• Fat grafting and oncological safety - P. Cordeiro vs M. Zocchi
Discussion and “take home concepts”
12.55 - 14.00
LUNCH17 YOUR NOTES
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June 5th
14.00 - 15.00
THE ABSTRACTS’ CHALLENGE
RESULTS AND STABILITY OVER TIME HAVING THE COMMON
DENOMINATOR OF BR AND AESTHETIC SURGERY
Judges: J.L.M. Del Yerro Coca, L.F. Frascino, E. Robotti
Discussion and “take home concepts”
15.00 - 16.15
VIDEOCONFERENCE SESSION FROM SÃO PAULO, BRAZIL
Coordinators in Rome: E. Auclair, L.F. Frascino
Faculty from São Paulo: R. Baroudi, A.R. Bozola
• Preferences of pedice
• Long term results regarding types of scars: myths and reality
• Mammoplasties after extreme weight loss
• Mastopexy with no implants: upper pole fullness
• How to avoid recurrence of ptosis
• Hypomastia and high degrees of ptosis: how to manage them
Discussion and “take home concepts”
16.15 - 16.45
COFFEE BREAK19 YOUR NOTES
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June 5th
16.45 - 18.30
THE BOXING RING
CONTROVERSIAL TOPICS ON BREAST AUGMENTATION
Referees: J. Farhadi, L.F. Frascino
• Round vs shaped implants - J.L.M. Del Yerro Coca vs J. Mendes
• The accesses: periareolar/fold vs axilla - M. Brown vs R. Marujo
• Textured vs micropolyurethane - R. de Vita vs S. Pompei
• Lipoaugmentation: fat alone vs fat and implants - E. Auclair vs M. Zocchi
Discussion and “take home concepts”
18.30 - 18.45
CLOSING REMARKS21 YOUR NOTES
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June 6th
08.30 - 10.00
REVISIONAL AESTHETIC BREAST SURGERY
Discussants: L.F. Frascino, R. Marujo, M. Valeriani
• How to avoid rotation and malposition deformities in breast augmentation with anatomical im-
plants - J.L.M. Del Yerro Coca
• Defects and restoring the IMF - M. Brown
• The role of ADM in revisional breast surgery - J. Farhadi
• The use of fat in revisional breast surgery - E. Auclair
• Capsular contracture: how to manage it - A. Grisotti
• Explantation of implants: tips and tricks - P. Mallucci
• Unusual complications: how one solves them - J. Mendes
Discussion and “take home concepts”
10.00 - 10.30
COFFEE BREAK
10.30 - 11.40
CORE TOPICS IN MASTOPEXY/REDUCTION MAMMOPLASTY
Discussants: J.L.M. Del Yerro Coca, M. Brown
• Preference of superior pedicles - L.F. Frascino
• The Periareolar approach - P. Berrino
• Inverted T and vertical scar: why and when - R. Marujo
• Mastopexy and fat grafting - A. Grisotti
• Tuberous breast and other challenging deformities - P. Mallucci
Discussion and “take home concepts”23 YOUR NOTES
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June 6th
11.40 - 13.00
ROUND TABLE
COMPLICATIONS IN AESTHETIC BREAST SURGERY:
HOW ONE TRIES TO PREVENT AND SOLVE THEM
Discussants: E. Auclair, J. Mendes
Speakers: P. Berrino, K. Breuing, J.L.M. Del Yerro Coca, L.F. Frascino, P. Mallucci, M. Salgarello
Discussion and “take home concepts”
13.00 - 13.10
CLOSING REMARKS - R. DE VITA, S. POMPEI25 YOUR NOTES
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YOUR NOTES27 YOUR NOTES
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PRACTICAL INFORMATION
Organizing Secretariat
Alfa FCM Srl
Headquarters: Via Paolo Emilio, 7 - 00192 Rome
Legal Office: Viale Mazzini, 6 - 00195 Rome
E-mail address: m.scarani@alfafcm.com
Telephone numbers: 0039 0687757099 - 0039 06 87758855
Fax number: 0039 0687758886
Congress Website: www.romebreastsurgery.it
Website: www.alfafcm.com
Conference Venue Dinner 5th June
Sherathon Golf Parco de’ Medici Hotel TERRAZZA SAVOIA
39, Viale Salvatore Rebecchini Sherathon Golf Parco de’ Medici Hotel
Rome, 00148 Italy 39, Viale Salvatore Rebecchini
GPS ‘41.816049,12.412311’ Rome, 00148 Italy
Telephone number: 0039 (06) 65288 GPS ‘41.816049,12.412311’
Fax number: 0039 (06) 65287060 Telephone number: 0039 (06) 65288
Fax number: 0039 (06) 6528706029
USEFUL NUMBERS
Healthcare
Flying Squad: 118
Opened Pharmacies: 06-228941
Transportation
Taxi Service (Roma Capitale): 06-0609
Rome Public Transport (Atac Spa): 800-431784 (www.atac.roma.it)
Regional Public Transport (Cotral): 800-150008 (www.cotralspa.it)
National Trains Service (Trenitalia): 89.20.21
Public Safety
Firefighters: 115
State Police: 113
Municipal Police: 06-67691
Italian Police: 112
Rome Central Police Station: 06-4826.035 - 06-4826.97630
VISIT ROME
Ancient Capital of the Roman Empire, seat of Catholic Cristianity and cradle of Western Civilization,
the city of Rome bears witness to nearly three millennia of history. Its historic centre, a UNESCO
world heritage site, is rich in vistas of rare beauty and priceless artistic treasures.
There’s more to see here than in any other city in the world, with the relics of over two thousand
years of inhabitation packed into its sprawling urban area. You could spend a month here and still
only scratch the surface
There are of course the city’s classical features, most visibly the Colosseum, and the Forum and Pala-
tine Hill; but from here there’s an almost uninterrupted sequence of monuments - from early Chris-
tian basilicas, Romanesque churches, Renaissance palaces, right up to the fountains and churches
of the Baroque period, which perhaps more than any other era has determined the look of the city
today.
There is the modern epoch too, from the ponderous Neoclassical architecture of the post-Unifica-
tion period to the self-publicizing edifices of the Mussolini years.
MAIN ATTRACTIONS
Capitoline Hill
Capitoline Hill was the original Capitol of the ancient city
and continues to serve as the seat of the city’s govern-
ment.
The main feature of the area is Michelangelo’s Piazza del
Campidoglio, a testimony to the superiority of Renais-
sance town planning.
The piazza is bordered by three palaces: the Palazzo dei
Conservatori and the twin structures of the Palazzo dei
Senatori and Palazzo Nuovo which house the Musei Capi-
tolini, containing the largest collection of classical statues in the world.
Among the notable statues found here are the Dying Gaul and the Satyr, the Capitoline Wolf with
Romulus and Remus and the Spinario.
Paths cut along the side of the hill from the Campidoglio giving way to panoramic views of the an-
cient sites of the Forum and Colosseum.
Address: Piazza del Campidoglio; Telephone: 060608
Opening time: Museums open Tuesday to Sunday 9am to 8pm; Admission: €6.5031
Roman Forum (Foro Romano)
The site of ancient Rome’s commercial, political and reli-
gious centre retires in the valley between the Capitoline
and Palatine hills.
The Forum’s main thorough fare, Via Sacra, slices through
the old market square and former civic centre.
To make sense of the ruins and relics of the old Republic it
is helpful to consult a map of the area.
Some of the best preserved and most notable monuments
include the impressive Arch of Septimus Severus - a construction designed to celebrate Roman vic-
tory over the Parthinians - and the former atrium of the House of the Vestal Virgins and Temple of
Vesta.
Also of note are the Temple of Antoninus and Faustina, and the Arch of Titus, built to celebrate Titus’
destruction of Jerusalem in AD70.
To the right of the arch are stairs snaking up the Palatine hill through a series of terraces to the
Farnese gardens. The scented avenue festooned with roses and orange trees gives way to a vista
over the Forum.
Address: Via dei Fori Imperiali; Telephone: 06 3996 7700; Opening time: Daily 8.30am to 1 hour before
sunset Admission: €9.00 + pre booking fee €1,50 : Ticket lasts 2 days
The Colosseum
This enduring symbol of ancient Rome tenaciously clings
to its foundations as the site of former gladiatorial con-
quests. Its architecture boasts an impressive array of Doric,
Ionic and Corinthian columns and an underground net-
work of cells, corridors, ramps and elevators that were
used to transport animals from their cages to the arena.
The magnificence of the original structure has been erod-
ed through the years of pillaging and earthquakes so that
only a skeletal framework remains.
Address: Piazza del Colosseo; Telephone 06.39967700; Opening time: Daily 8.30am to 1 hour before
sunset Admission: €9.00 + pre booking fee €1,50 : Ticket is valid for Colosseum and lasts 2 days32
Pantheon
The stately Pantheon is one of the world’s most inspiring
architectural designs.
Fittingly built as a temple to the Gods by Hadrian in 120AD,
its perfectly proportioned floating dome rests seductively
on sturdy marble columns.
The only light source flowing through the central oculus
was used by the Romans to measure time (with the aid of a
sundial) and the dates of equinoxes and solstices.
The south transept houses the Carafa Chapel and the tomb of Fra Angelico rests under the left side
of the altar.
About 125 years ago, Raphael’s tomb was discovered here (fans still bring him flowers).
Vittorio Emanuele II, king of Italy, and his successor, Umberto I, are interred here as well.
Address: Piazza della Rotonda; Telephone: 06 6830 0230; Opening time: Monday to Saturday between
8.30am and 7.30pm and Sunday from 9am to 6pm; Admission: Free
The Spanish Steps and Piazza di Spagna
The graceful steps built in 1725, elegantly curve their way
from the Piazza di Spagna to the Church of Santa Trinità dei
Monti, a pastel tinted neoclassical building.
The steps and the square take their names from the Span-
ish Embassy, which used to be headquartered here
The shopper’s paradise of Via Condotti leads back from the
Spanish steps to Via del Corso, and during spring the steps
are decorated with pink azaleas.
At the foot of the steps lies Bernini’s boat-shaped Barcaccia fountain and to the right is Keats-Shelley
Memorial House.
The steps and the piazza below are always packed with a crowd: strolling, reading in the sun, brows-
ing the vendors’ carts, and people-watching.
Address: Piazza di Spagna Opening time: Shops are usually opened Monday to Saturday between
10:00am and 7.30pm and Sunday from 10:30am to 7:30pm;33
Trevi Fountain (Fontana di Trevi)
The tiny Piazza di Trevi has been immortalised through this
fountain built for Pope Clement XII.
Today this newly restored gem is a must on everybody’s
itinerary.
Supplied by water from the Acqua Vergine aqueduct and
a triumph of the baroque style, it was based on the design
of Nicolo Salvi and was completed in 1762.
The design centers on the triumphant figure of Neptunus
Rex, standing on a shell chariot drawn by winged steeds and led by a pair of tritons.
Two allegorical figures in the side niches represent good health and fertility.
Tossing a coin into the fountain is supposed to guarantee a return trip to Rome
Address: Piazza di Trevi Opening time Always opened with the exception of Mondays when they clean
the fountain
St Peter’s Basilica (Basilica di San Pietro)
The Basilica lies above the reputed site of St. Peter’s tomb.
It is an overwhelming interior containing notable sculp-
tures including Michelangelo’s Pieta, which is protected by
bullet-proof glass since the damaging attack on it in 1972.
In the central aisle stands Arnolfo da Cambio’s bronze stat-
ue of St Peter, its foot worn down by the constant flow of
pilgrims’ kisses.
Proudly resting above the papal altar is Bernini’s Throne of
St Peter.
The Vatican Grottoes, containing papal tombs, can be reached by steps from the statue of St Long-
inus. The Necropolis is located one level below the grottoes. This is the legendary site of St Peter’s
tomb and advance permission has to be obtained to view it.
Address: Piazza San Pietro; Telephone: 06 6988 4466; Opening time: Daily between 7am and 7pm (April
to September) and 7:00am to 6:00pm (October to March); Admission: Free
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The Sistine Chapel & Vatican Museums
The Sistine Chapel’s famous ceiling painted by Michelan-
gelo looms above the frescoes on the side walls that were
painted by an illustrious team of artists that included Bot-
ticelli, Ghirlandaio, Roselli, Pinturicchio, Signorelli and della
Gatta.
The altar wall is covered by Michelangelo’s Last Supper,
revealing the figure of Christ hovering above centre and
flanked by Mary and other saintly figures.
The Vatican Museums provide an inspiring visit to one of the world’s greatest collections of art.
The galleries stretch over four miles (six km) and include the magnificent Raphael rooms, the Etrus-
can Museum and the Pio-Clementino Museum which boasts the world’s largest collection of Clas-
sical statues.
Address: Viale Vaticano; Telephone: 06 6988 Opening time: Monday to Saturday between 09:00am
06:00pm , last entry at 04:00pm Closed on Sundays (with the exception of last Sunday every Month) and
Religious Holidays Admission: €14,oo. Free on the last Sunday of every month35 Bus Tour City Sightseeing Rome will allow you to travel through history and visit the places where the ancient Romans lived their social and political life as well as to admire the great Papal Rome, with its fine buildings and beautiful churches, by just sitting comfortable on board our buses. You will be able to visit the many churches, monuments, palaces, squares and streets of Imperial and Christian Rome, of Baroque and Modern Rome. Each bus has a highly technological, multilingual commentary sys- tem in eight languages available for every passenger, which will not only keep you entertained, but also well informed about the city. You can admire the great monuments of ancient Rome like the Imperial Forums, the Coliseum and the Circus Maximus. You will see the most beautiful Christian places like St. Peter’s Basilica and Santa Maria Maggiore. One must also visit the squares and streets where the history of Rome was written such as Piazza Venezia, Piazza della Repubblica, Piazza del Popolo and Piazza Barberini. Then you can enjoy a walk among the coffee shops of the Dolce Vita in Via Veneto and later drive along the river Tevere and admire Trastevere, one of the old quarters of the City, with its typical restaurants and bars, where you can taste typical Roman dishes. Start from Terminal A: Termini-Marsala (Via Marsala, 7) Arrive to Terminal B: Largo Di Villa Peretti (Largo Di Villa Peretti, 1) Duration 100’ Price 22 euro Tel. +39 06 69797554 / +39 06 2283957
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