In patients who have implants and develop a cancer, the cancer can sometimes be removed as a lumpectomy. Lumpectomy is often treated with radiation therapy post-operatively. Radiation can increase the risk for capsular contracture in the radiated breast. Correction requires release of the encapsulated breast pocket or excision of the capsule and often a lift of the contralateral side.
Patients can undergo mastectomy reconstruction with tissue expanders and implants following mastectomy. In certain patients, the mastectomy can be performed from the inframammary crease and can be well concealed giving the patient an optimal aesthetic result.
Lumpectomy defects can be reconstructed with the same techniques used to make the breast appear more youthful. The same techniques can be used to correct a deformity in the breast following radiation therapy.
DIEP flap reconstruction can be used to reconstruct the breast in patients who have undergone radiation who are no longer candidates for implant reconstruction. In the radiated breast, the skin may not tolerate an implant or may be more susceptible to infection. In these patients the breast is reconstructed with the patients own body tissue. This photos shows a bilateral…
DIEP flap breast reconstruction uses the tissue from the lower abdomen to reconstruct the breast. This allows a natural match to the other breast. What can determine if a patient is a candidate for DIEP flap breast reconstruction is the amount of tissue on the lower abdomen and presence or absence of abdominal scars from previous surgeries. The satisfaction rate…
DIEP flap reconstruction is a common method of reconstruction. Occasionally the lower abdomen does not have sufficient tissue for a bilateral reconstruction and the flap reconstruction can be augmented with mammary prosthesis. Typically, we wait until one year after a DIEP flap reconstruction to augment the breast. The satisfaction rate is high with augmentation of the DIEP flaps because the…
DIEP flap breast reconstruction is an excellent option for a unilateral mastectomy in a patient with the appropriate body habitus. The unilateral autologous reconstruction can match the contralateral breast well with respect to shape. Size can also be matched well, depending on the abdominal donor site. Autologous flap reconstructions tolerate radiation therapy well. This is a right unilateral DIEP flap…
Breast cancer in some patients can be successfully treated with lumpectomy and radiation. Often the same pattern used to make the breast appear more youthful can be utilized to reconstruct the breast and make it in a more suitable shape for radiation therapy to be more effective. When the tumor is in a location close to the skin and outside…
Bilateral implant breast reconstruction following bilateral mastectomy is a common procedure. The aesthetic outcome of the reconstruction is often determined by the quality of the mastectomy skin and the relation of the tissue characteristics and the implant. In patients who choose to undergo implant reconstruction I often indicate that the best outcomes and most durable reconstruction are the patients who…
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…
