Hernia repairs are common. Larger hernias often require the repositioning of the rectus abdominus muscles to place the muscles back into anatomic position. When the rectus muscles are relocated this can often prevent the use of mesh to repair the hernia. In some cases mesh is necessary in addition to repositioning of the abdominal musculature. In patients with previous abdominal…
The deep inferior epigastric artery perforator flap is an option for breast reconstruction in those patients who do not want to undergo reconstruction with breast implants. There are several reasons why patients do not want to undergo reconstruction with breast implants and would prefer to undergo reconstruction with their own body tissue. Reconstruction of the breast with one’s own body…
Central breast tumors can be common. Central breast tumors are those tumors that lie directly behind or in close proximity to the nipple areola complex. Patients often have questions or concerns regarding the appearance of the breast mound after the nipple areola complex has been removed. What determines when the nipple areola complex will be removed is how close the…
Breast cancer is common. In patients who have relatively larger breasts and smaller tumors, there may be several different options to treat the breast cancer from an oncologic perspective and there may be different options for reconstruction. Patients who are candidates for breast conservation therapy tend to be patients who have smaller tumors relative to the overall size of the…
Patients who undergo lumpectomy have different options for breast reconstruction. In patients who have relatively larger breasts, smaller tumors, and who have breast ptotis may be able to have their tumor excised with a lumpectomy and their breast reconstructed with the same patterns that we use for a cosmetic mastopexy or breast reduction. It is quite common for patients to…
Autologous breast reconstruction is when the body’s own tissue is used to reconstruct the breast. There are several different parts of the body that serves as donor sites for breast reconstruction. Common areas of donor site locations include the abdomen, the back, and the gluteal region. When the breast is ptotic the native nipple areola complex can not be utilized…
Hernia repairs are common. Often the hernis can be exposed through a lower abdominal incision. The lower abdominal incision is similar to an incision used in a standard abdominoplasty or “tummy tuck” operation. The lower abdominal incision gives access to the entire abdominal wall up toward the ribcage. Any mesh that is placed in a central defect is not located…
Breast Reconstruction after mastectomy for breast cancer can be broken down into two main classifications: 1) Tissue Expander and Implant Reconstruction and 2) Autologous Tissue Reconstruction. In patients with larger breasts, the maximum size of a silicone gel mammary prosthesis is 800 cc. Often in mastectomy specimens weighing more than 800 grams, the implant is not sufficient to fill the…
Breast reconstruction in the radiated patient is different than in patients who have not received radiation. Patients who have undergone lumpectomy and radiation or patients who have undergone mastectomy and then radiation typically have a tight skin envelope. At times the skin envelope may be amenable to a breast implant reconstruction. Other times, the skin envelope results in a capsular…
Breast augmentation is a common procedure. There are several different incision choices when performing breast augmentation. There is a large advantage to the transaxillary incision. The transaxillary incision is well hidden in the armpit and there is no visible scar on the breast or chest wall. The transaxillary incision requires more care in the post-operative period. The armpits need to…
It is common for many women to want to have their implants removed. Often when patients want to have their implants removed, the breasts are already ptotic. The breast can be lifted following the removal of the breast implant. The most commonly used lift pattern is called the Wise pattern or T-lift. The T-lift allows the nipple areola complex to…
Hernias a common. They can occur from a defect at birth or can be from a previous surgery. The goal when repairing hernias is to restore the abdominal wall to its normal state of anatomy. Often, this coincides with normal muscle function. Hernias that protrude through the rectus muscle are often best repaired by separating the components of the rectus…
