In women who are undergoing lumpectomy for breast cancer, the resulting lumpectomy defect can be closed with oncoplastic techniques to not only improve the resulting cosmetic outcome, but to also facilitate delivery of radiation, and in some instances facilitate delivery of chemotherapy. The lumpectomy defect is closed with dissolvable sutures. It is important to keep protein nutrition high before and…
In patients who have a breast cancer with a small diameter, the cancer or DCIS can be effectively removed with a lumpectomy. The oncoplastic reconstruction can facilitate the delivery of radiation by creating a more compact target for the radiation beam. The lifted appearance to the breasts often allows patients to feel better about themselves even though they have just…
Patients who undergo lumpectomy and radiation therapy have a higher rate of capsular contracture of their mammary prosthesis. The capsular contracture causes the normal lining around a breast implant to become thicker. This then causes the implant/soft tissue construct to become indurated and firm. Removing the mammary prosthesis can present the recurrence of the capsular contracture. Patient satisfaction is quite…
Treatment of breast cancer with lumpectomy is a viable option for many patients. Often the same patterns that are used to lift the breast can be used to resect tumors from the breast. Often the most commonly used pattern is the Wise pattern. When the breast cancer resides outside of the normal pattern, then the Wise pattern is modified to…
Breast implants can become dislodged or displaced from their surgical pocket. This can be the result of a trauma, surgery, radiation, or capsular contracture. Correction of the double-bubble deformity requires repositioning of the infra-mammary fold to its native location. Slightly decreasing the size of the mammary prosthesis can help with repositioning of the new breast implant pocket.
Incisions on the breast such as mastopexy Wise-patterns, crescents, T-lifts, etc. take several months to years to mature. In general we tell patients not to apply any creams or lotions on the skin for 4-6 weeks after surgery. After six weeks, silicone sheets can be applied to the scar to flatten the scar or prevent hypertrophic scars or keloid scars.…
Reconstruction of mastectomy defects is challenging. It is even more challenging in the face of radiation. Not all tissues and tissue types tolerate radiation to the same degree. In some patients implant reconstructions are not amenable after they have undergone radiation. Improving the tissue characteristics is important to making an implant reconstruction a viable option. One of the more common…
There are different ways that the breast can be reconstructed following a mastectomy or bilateral mastectomy. At the time of a mastectomy operation, tissue expanders are placed and the skin is allowed to heal. Once the skin has demonstrated appropriate healing, volume is added to the expanders. After an adequate time for swelling to subside, the tissue expanders can be…
Rhinoplasty is a common procedure. The results of rhinoplasty change over time. The swelling of the nose matures over time and yields more definition to the tip and dorsum. The scar contracture of the nose also changes over time and can affect the shape of the nose. The more supported the nose is with a cartilage framework, the more the…
In patients who have breast cancer, some can undergo lumpectomy and radiation therapy. In general the concept for this method of reconstruction is amenable to those patients who have a smaller tumor relative to the size of their breast. After lumpectomy and oncoplastic reconstruction in these patients, the goal is to get the wounds to heal by about the six…
