Letter to the Editor
Response to “Comments on ‘Breast Striae after Cosmetic Augmentation’”
Aesthetic Surgery Journal 2015, Vol 35(2) NP37 © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: [email protected] DOI: 10.1093/asj/sju044 www.aestheticsurgeryjournal.com
Tsung-Lin Roger Tsai, MD; Alexander Chase Castillo, MD; and Clayton L. Moliver, MD, FACS
Disclosures The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article.
REFERENCES 1. Basile FV, Basile A. Comments on “Breast Striae after Cosmetic Augmentation.” Aesthet Surg J. 2015;35(2): NP35–NP36. 2. Wojtys EM, Huston LJ, Lindenfeld TN, et al. Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes. Am J Sports Med. 1998;26 (5):614-619. 3. Wojtys EM, Huston LJ, Boynton MD, et al. The effect of the menstrual cycle on anterior cruciate ligament injuries in women as determined by hormone levels. Am J Sports Med. 2002;30(2):182-188. 4. Arendt EA, Bershadsky B, Agel J. Periodicity of noncontact anterior cruciate ligament injuries during the menstrual cycle. J Gend Specif Med. 2002;5(2):19-26. 5. Slauterbeck JR, Fuzie SF, Smith MP, et al. The menstrual cycle, sex hormones, and anterior cruciate ligament injury. J Athl Train. 2002;37(3):275-278. 6. Beynnon BD, Johnson RJ, Braun S, et al. The relationship between menstrual cycle phase and anterior cruciate ligament injury: a case-control study of recreational alpine skiers. Am J Sports Med. 2006;34(5):757-764.
Dr Tsai is a plastic surgeon in private practice in West Hollywood, CA. Dr Castillo is a resident and Dr Moliver is a Clinical Professor of Plastic Surgery in the Division of Plastic Surgery, Department of Surgery, University of Texas Medical Branch, Galveston, Texas. Corresponding Author: Dr Clayton L. Moliver, 575 E Medical Center Blvd, Webster, TX 77598, USA. E-mail: [email protected]
Downloaded from http://asj.oxfordjournals.org/ by guest on October 6, 2015
Thank you very much for your comments on our paper.1 We absolutely agree with you that “a potentially significant hormonal imbalance is paramount in the development of striae distensae.” We recently performed a study on young women undergoing breast reduction. We found a statistically significant increased incidence of wound problems in women who had their surgery in the postovulatory period compared with women who had surgery in the preovulatory period. These findings were presented recently at a meeting and will be submitted for publication. This conclusion seems to fall in line with the thought that tissues undergoing greater mechanical stress and under increased progesterone and estrogen exposure respond differently. In our literature review for that research, we found articles in the orthopedic literature showing an increased incidence of tears of the anterior cruciate ligament (ACL) in young women in the preovulatory period as compared with tears occurring in the postovulatory period.2-6 This finding conflicts with those of our two groups; however, a hormonal component can also be noted. I hypothesize that the tissues are more pliant during the postovulatory period and less so before the increase in progesterone and estrogen. Perhaps in ACL tears, “the oak breaks while the willow bends.” Your most recent study on patients taking oral contraceptives pills (OCP) is intriguing. In our patients that developed striae, we also found no correlation with the use of OCP. Again, we believe the results are all related to age and circulating hormonal levels, although we cannot address receptor levels on the basis of our paper. We also will share that, since about 1 year ago, we have started encouraging all women 25 years old and younger to have their breast augmentation surgery immediately after their menses. We have not seen a single case of new onset striae since that change in policy.
Response to “Comments on ‘Breast Striae after Cosmetic Augmentation’”
Aesthetic Surgery Journal 2015, Vol 35(2) NP37 © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: [email protected] DOI: 10.1093/asj/sju044 www.aestheticsurgeryjournal.com
Tsung-Lin Roger Tsai, MD; Alexander Chase Castillo, MD; and Clayton L. Moliver, MD, FACS
Disclosures The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article.
REFERENCES 1. Basile FV, Basile A. Comments on “Breast Striae after Cosmetic Augmentation.” Aesthet Surg J. 2015;35(2): NP35–NP36. 2. Wojtys EM, Huston LJ, Lindenfeld TN, et al. Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes. Am J Sports Med. 1998;26 (5):614-619. 3. Wojtys EM, Huston LJ, Boynton MD, et al. The effect of the menstrual cycle on anterior cruciate ligament injuries in women as determined by hormone levels. Am J Sports Med. 2002;30(2):182-188. 4. Arendt EA, Bershadsky B, Agel J. Periodicity of noncontact anterior cruciate ligament injuries during the menstrual cycle. J Gend Specif Med. 2002;5(2):19-26. 5. Slauterbeck JR, Fuzie SF, Smith MP, et al. The menstrual cycle, sex hormones, and anterior cruciate ligament injury. J Athl Train. 2002;37(3):275-278. 6. Beynnon BD, Johnson RJ, Braun S, et al. The relationship between menstrual cycle phase and anterior cruciate ligament injury: a case-control study of recreational alpine skiers. Am J Sports Med. 2006;34(5):757-764.
Dr Tsai is a plastic surgeon in private practice in West Hollywood, CA. Dr Castillo is a resident and Dr Moliver is a Clinical Professor of Plastic Surgery in the Division of Plastic Surgery, Department of Surgery, University of Texas Medical Branch, Galveston, Texas. Corresponding Author: Dr Clayton L. Moliver, 575 E Medical Center Blvd, Webster, TX 77598, USA. E-mail: [email protected]
Downloaded from http://asj.oxfordjournals.org/ by guest on October 6, 2015
Thank you very much for your comments on our paper.1 We absolutely agree with you that “a potentially significant hormonal imbalance is paramount in the development of striae distensae.” We recently performed a study on young women undergoing breast reduction. We found a statistically significant increased incidence of wound problems in women who had their surgery in the postovulatory period compared with women who had surgery in the preovulatory period. These findings were presented recently at a meeting and will be submitted for publication. This conclusion seems to fall in line with the thought that tissues undergoing greater mechanical stress and under increased progesterone and estrogen exposure respond differently. In our literature review for that research, we found articles in the orthopedic literature showing an increased incidence of tears of the anterior cruciate ligament (ACL) in young women in the preovulatory period as compared with tears occurring in the postovulatory period.2-6 This finding conflicts with those of our two groups; however, a hormonal component can also be noted. I hypothesize that the tissues are more pliant during the postovulatory period and less so before the increase in progesterone and estrogen. Perhaps in ACL tears, “the oak breaks while the willow bends.” Your most recent study on patients taking oral contraceptives pills (OCP) is intriguing. In our patients that developed striae, we also found no correlation with the use of OCP. Again, we believe the results are all related to age and circulating hormonal levels, although we cannot address receptor levels on the basis of our paper. We also will share that, since about 1 year ago, we have started encouraging all women 25 years old and younger to have their breast augmentation surgery immediately after their menses. We have not seen a single case of new onset striae since that change in policy.
