Occasionally, patients undergo mastectomy and then follow with radiation therapy. When these patients undergo breast reconstruction, we use the term delayed breast reconstruction. The term delayed reconstruction is utilized to characterize a reconstruction that occurs after a mastectomy and other treatments versus an immediate reconstruction that occurs in whole or in part simultaneously with the mastectomy. When the skin that…
The skin and fat from the lower abdomen can be used to reconstruct the breast following mastectomy. This type of reconstruction is called autologous breast reconstruction or flap reconstruction. The deep inferior epigastric artery perforator (DIEP) flap uses the skin and fat from the lower abdomen, and maintains a significant amount of abdominal wall musculature. The tissue that is transferred…
Deep inferior epigastric artery perforator flaps can be very helpful for unilateral breast reconstruction following mastectomy for breast cancer. Autologous breast reconstruction is a type of breast reconstruction where the patients own body tissue is used to reconstruct the breast. This is a different type of reconstruction from an implant based breast reconstruction. When a patient undergoes a unilateral mastectomy,…
There are several options to reconstruct the breast following mastectomy. Depending upon the degree of pre-operative ptosis of the breast, the patient may be a candidate for a nipple sparing mastectomy. A nipple sparing mastectomy may be performed through an inframamary incision. For a DIEP flap reconstruction, the operative surgeon often needs access to blood vessels in the chest, usually…
Ventral hernias can occur after previous abdominal surgery. Hernias can often occur from the presence of medical or surgical comorbidities. One of the most important factors that can be readily controlled is protein intake. We often tell patients that protein intake should be increased to 1-2 grams per kg of body weight so that patients have adequate protein stores to…
There are different ways that the buttocks or gluteal region can be augmented. One common way is gluteal fat transfer. In these cases, liposuction is performed in areas of the body that have excess deposits of fat. After the fat is removed, the fat is transferred to the buttocks to augment their projection and/or shape. The typical harvest sites tend…
Patients who have breast implants schedule consultations wishing to undergo changes to their breast implants or mammary prosthesis. One common request is to downsize their breast implants. The first step is to determine their current bra size and to determine the volume of the mammary prosthesis that they have in place. Once these are determined, the patient and physician can…
It is common for patients to present with breast cancer or ductal carcinoma in situ and to also have implants in place at the time of diagnosis. Depending upon the stage of breast cancer and the size of the breast, the patient may choose to undergo lumpectomy. Often, a mastopexy pattern can be utilized to remove the breast cancer or…
There can be different ways in which the physician and patient can manage breast cancer or ductal carcinoma in situ of the breast. The patient and oncologic surgeon or team of physicians may choose lumpectomy, or, conversely they may choose mastectomy. If a patient chooses a lumpectomy, the patient and reconstructive team can often reconstruct the breast with the patient’s…
There are several ways to reconstruct a breast following mastectomy. One option is to use tissue expanders and implants (saline or silicone) and the other option is to use ones own body tissue or what is often called autologous reconstruction. One of the most commonly used sites for autologous reconstruction is the lower abdomen. The lower abdomen is often…
Lumpectomy Defects of the breast can be treated with oncoplastic reconstructive techniques to improve contour following resection. The same principles used for mastopexy and reduction techniques can be used to improve upon the appearance of the breast following the resection of a breast tumor. The recovery following these procedures tends to be standard. The first week following surgery consists of…
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…
