DIEP flaps are useful autologous flaps for breast reconstruction. There are many times when the DIEP flaps are performed in a delayed fashion with tissue expanders placed at the time of the mastectomy and prior to the DIEP flaps. In these cases, the mastectomy procedures are performed and the skin is allowed to heal with the tissue expanders in place.…
Abdominal wall hernias can occur as a congenital deformity of the abdominal wall or as a result of a previous surgery. There are many techniques used to reconstruct abdominal wall hernias as well as there are many techniques to improve the appearance of the abdominal wall. In abdominal wall reconstruction, Strattice acelluar dermal matrix is used to share the load…
The belly button is one of the areas of abdominoplasty that help to improve the overall aesthetics of the cosmetic procedure. During an abdominoplasty operation the umbilical stalk remains attached to the abdominal wall. The umbilicus is then delivered through the skin at a new position in the abdominal wall skin. The old umbilical stalk opening is then moved downward…
Abdominoplasty is a common procedure. It is often performed to improve the abdominal contour as a result of previous pregnancies or previous weight gain or both. Patients typically request abdominoplasty to remove stretch marks that are present on the lower abdomen after childbirth or to improve the lower abdominal contour through the tightening of the lower abdominal muscles.
There are several areas where surgeons can improve or work on to maximize aesthetic outcomes. As my practice has changed over time, I find that one area where we can camouflage signs of previous surgery is the belly button or umbilicus. In an abdominoplasty procedure, the umbilicus often remains attached to the abdominal wall. The umbilicus is then delivered through…
Breast Augmentation is a common aesthetic procedure. It is a procedure with a high satisfaction rate. Typically patients who request breast augmentation wish to improve the appearance of their breasts to match the remainder of their body. There are many different incision choices that patients can choose to undergo breast augmentation. The options are the inframammary crease, periareolar, transaxillary, and…
Radiation of mammary prosthesis can increase the chances of capsular contracture following lumpectomy for breast cancer. When patients experience a capsular contracture, they generally feel a tightness around the breast pocket and the implant tends to displace superiorly beneath the pectoralis major muscle if the implant is sub-pectoral. Treatment of the capsular contracture involves removal of all or some of…
Abdominal wall reconstruction and hernia repair is a rewarding operation for patients and physicians. The lower abdomen is a common place for hernia recurrence or bulge recurrence as there is a significant amount of tension placed on the lower abdominal core. Restoration of a functional abdominal wall allows not only for improved contour, but a better functioning abdomen. These operations…
DIEP flap breast reconstruction is often necessary to reconstruct the breast following radiation therapy. The lower abdomen is the primary source of tissue used to reconstruct the breast as it is soft and there is often adequate tissue available. After radiation therapy or removal of infected tissue expanders the skin can often not re-expand or is not amenable to placement…
There are several different manners in which to treat breast cancer. Breast cancer can be successfully treated with lumpectomy and IORT or intra-operative radiation therapy. In patients with smaller tumors and of a low grade the tumor can be resected and radiation delivered at the time of the lumpectomy. The breast can be rearranged and closed allowing for an optimal…
There are several different manners in which to reconstruct the breast following mastectomy. There are times when decreasing the size of the mammary prosthesis can help improve tissue characteristics and facilitate symmetry. One of the more challenging aspects of breast reconstruction is establishing symmetry of the inframammary folds. Once the inframammary folds are symmetric, establishing implant volume to attain symmetry…
There are breast tumors that invade through the skin of the breast. Depending upon the amount of skin that needs to be replaced different donor sites from the body can be used to replace the skin. For skin defects that reside in the upper outer quadrant of the breast, the latissimus dorsi myocutaneous flap is an excellent flap to replace…
