In general implant mastectomy reconstruction takes place in two stages. At the time of the mastectomy a tissue expander is inserted beneath the pectoralis major muscle and a piece of acellular dermal matrix or Strattice is inserted to provide support to the tissue expander. There are times, albeit rare, when I proceed with immediate insertion of mammary prosthesis. Patients who…
Lumpectomy and radiation, either whole breast or intra-operative radiation therapy is an option for breast cancer treatment. Not only can oncoplastic reconstruction improve the appearance of the breast, it can also contour the breast to a more amenable shape and size for radiation therapy. When the breast is reconstructed into a smaller surface area, there is a smaller and more…
Breast cancers in patients with large breasts can often be successfully treated with lumpectomy. In larger breasted women, after the tumor is removed, there is still a significant amount of breast tissue available to reconstruct the breast. The standard mastopexy or lift patterns of the breast can be used to remove the tumor. On occasion, the tumor that needs to…
DIEP Flap breast reconstruction is the reconstruction of the breast following mastectomy. DIEP flap reconstruction is a form of autologous reconstruction where the breast is reconstructed with tissue from the patients own body. In this case, the breast can be reconstructed without the use of implants. The tissue from the lower abdomen is the most common site for autologous breast…
Superficial tumors of the breast can be removed using the same patterns to perform mastopexy or breast reduction. When the tumor lies outside of the standard pattern for mastopexy or breast reduction, the skin pattern can be adjusted to remove the skin above the tumor. In this case the skin from the lower aspect of the breast on the patients…
Lumpectomy defects often need to be closed carefully to minimize scar contracture following radiation therapy. The reduction or mastopexy pattern actually facilitates radiation delivery as it produces a more compact target for a directed radiation beam. In general, radiation begins approximately 6 weeks after lumpectomy unless chemotherapy is to be initiated. It is important for all wounds to be healed…
The same patterns that are used to improve the appearance of the breast can also be utilized to remove cancers in the breast. We encourage our patients to consume approximately 80-100 grams of protein per day for 4-6 weeks prior to surgery and for 4-6 weeks after surgery. The protein intake is important to facilitate wound healing. In general the…
In patients with larger breasts, one manner in which the breast can be reconstructed is with tissue from the lower abdomen. When the breast is ptotic, the nipple areola complex may not remain viable at the time of the mastectomy. Often a tissue expander is used at the time of mastectomy to let the skin heal before proceeding with DIEP…
Standard breast lift patterns are used to reconstruct the breast following lumpectomy. Often the tumor will be outside of the confines of the aesthetic mastopexy patterns and the pattern is adjusted. Post-operatively, xeroform gauze and Bacitracin ointment are placed on the wound edges. The xeroform gauze is removed after two days, by the patient, in the shower. It is common…
Many patients with breast cancer either choose or have cancers that are amenable to successful treatment with lumpectomy and radiation. This tends to be performed in an outpatient setting. Patients are instructed to wear a sports bra for 6 weeks after surgery. A high protein diet is important to facilitate healing after IORT or to get the wounds healed in…
