The latissimus dorsi flap is an important and very versatile flap for breast reconstruction. The latissimus flap almost always requires a breast implant to add volume to the breast reconstruction in order to match the contralateral breast. The latissimus dorsi flap can be harvested and transferred with a skin paddle to replace a missing nipple areola complex or it can…
There are many patients who choose to undergo bilateral mastectomy for breast cancer or prophylactically to prevent cancer when patients have a genetic predisposition. In patients who are not going to receive radiation the breast is amenable to reconstruction with tissue expanders and implants. The tissue expander is placed at the time of the mastectomy and only a small amount…
Bilateral mastectomy breast reconstruction is common in patients who have BRCA gene positivity. Bilateral mastectomy is also common in patients who choose to undergo mastectomy and contralateral prophylactic mastectomy. When the breast is ptotic, defined by a nipple areola complex that descends below the level of the inframammary fold, the nipple areola complex cannot maintain a blood supply sufficient to…
Breast augmentation is a common aesthetic procedure performed in our practice. The most commonly used implant is a smooth silicone gel implant. There are several options for the incision choice in breast augmentation with silicone gel implants. The three choices are inframammary crease, periareaolar, and transaxillary. There are different benefits to each incision. It is helpful to select an implant…
Mastopexy and abdominoplasty are a very powerful combination of procedures. Mastopexy involves lifting the nipple areola complex and some component of the parenchyma of the breast. Often a mastopexy may involve removing the lateral aspect of the breast tissue or “bra fat” to improve the contour of the breast. The mastopexy markings involve determining the position of the nipple areola…
There are many occasions when patients acquire infections in their breasts. This can occur from previous mastitis during breast feeding or from previous galactocele, intraductal papilloma, or previous breast trauma. When the breast has been previously infected, scarring between the skin and the chest wall can occur. This can cause breast asymmetry and deformity of the breast. If the infections…
Breast cancer is common among women with approximately 1 in 9 women developing invasive breast cancer in the United States. When a patient chooses to undergo mastectomy, the patient may also choose to undergo mastectomy on the contralateral or opposite side of the breast that has breast cancer. This choice can be made because of a genetic predisposition to breast…
In certain patients with breast cancer, they may be a candidate for a lumpectomy with oncoplastic reconstruction and intra-operative radiation therapy. In patients with smaller tumors and certain biologic characteristics radiation can be undertaken at the time of lumpectomy during the operation. This can have fewer deleterious effects on the breast tissue, skin, and the overall aesthetic result. Oncoplastic reconstruction…
Rhinoplasty is one of my favorite procedures to perform. One of the more common reasons for people to request a rhinoplasty operation is to decrease the projection of their nose and to reduce the hump on their nose. When changing the characteristics of the nose it can be advantageous to keep or maintain many aspects. In this way, the new…
Patients with breast cancer can undergo lumpectomy and oncoplastic reconstruction of their lumpectomy defects. Depending upon the size of a cancer the patient can undergo intra-operative radiation therapy at the time of the lumpectomy. Breast implants can be removed at the time of the operation. The satisfaction rate with oncoplastic reconstruction of lumpectomy defects is high.
