One of the most common questions that we receive from patients in consultation, is “Can I have my breast reconstructed after a lumpectomy and radiation therapy?”. The answer to this question is “yes”. However, the degree to which breast tissue can be rearranged might be limited, but there are definitely options. Radiation tends to cause capsular contracture when an implant…
Breast reconstruction is an extremely challenging aspect of plastic and reconstructive surgery. Not only does the cancer need to be appropriately addressed, but implants are also placed in less than optimal environments. During a mastectomy, the breast tissue is removed and the only soft tissue that remains is a skin envelope. Tissue expanders and implants are placed beneath the pectoralis…
There are many different ways to successfully treat or prevent breast cancer in genetically susceptible individuals. In some patients, one of the first steps is to create the best possible shape of the breast for a future mastectomy. In some patients, implants are removed and a mastopexy is performed to place the nipple areola complex in a higher and more…
Breast reconstruction can be done in an immediate setting at the time of mastectomy or can be accomplished in a delayed setting after mastectomy. When an immediate breast reconstruction with flaps is to be performed it is important that the quality of the mastectomy flaps is considered. During the DIEP flap harvest, the skin and fat from the abdomen is…
Breast cancer reconstruction can be challenging for the Plastic & Reconstructive surgeon as well as the patient. In the patient with “ptotic” breasts, where the nipple areola complex is significantly below the inframammary fold or breast crease, the nipple cannot be safely kept during a mastectomy based on significant impairment in blood supply. In these cases, when the nipple is…
Breast cancer can be treated with lumpectomy. The same patterns that are used for a mastopexy (breast lift) can be used to facilitate breast cancer treatment. If a cancer lies outside of traditional patterns, then the breast lift pattern can be modified to remove the skin above the tumor when necessary. One component of breast cancer treatment for lumpectomy is…
Breast cancer reconstruction is one of the most challenging aspects of Plastic & Reconstructive Surgery. The surgery often involves an oncologic component that requires close attention and may require chemotherapy before and/or after surgery that needs to be completed in a timely manner. The DIEP flap uses microvascular soft tissue transplantation to transfer the skin and fat from the abdomen…
Mastectomy Breast Reconstruction is challenging. Mastectomy reconstruction in some patients can involve using the patient’s own tissue rather than implants for breast reconstruction. In the DIEP flap breast reconstruction, the lower abdominal tissue that is usually discarded in a tummy tuck is used to reconstruct the breast. The deep inferior epigastric artery and vein provides the blood supply to the…
In some breast cancer patients who have lymph node positivity or large tumors, breast cancer may be best treated with lumpectomy if radiation will be needed for either lumpectomy or mastectomy. When the breast tumor is close to the overlying skin or involves the overlying skin, the skin will need to be removed during a lumpectomy or mastectomy. The latissimus…
Breast cancer reconstruction is challenging. In some patients, who do not wish to have implants, we can reconstruct the breast with the patient’s own body tissue. This is called an autologous breast reconstruction. In the DIEP flap reconstruction, the skin and fat from the abdomen and sometimes a small cuff of rectus muscle is disconnected from the blood supply in…
