Breast cancer is common. In patients who have relatively larger breasts and smaller tumors, there may be several different options to treat the breast cancer from an oncologic perspective and there may be different options for reconstruction. Patients who are candidates for breast conservation therapy tend to be patients who have smaller tumors relative to the overall size of the…
Patients who undergo lumpectomy have different options for breast reconstruction. In patients who have relatively larger breasts, smaller tumors, and who have breast ptotis may be able to have their tumor excised with a lumpectomy and their breast reconstructed with the same patterns that we use for a cosmetic mastopexy or breast reduction. It is quite common for patients to…
Autologous breast reconstruction is when the body’s own tissue is used to reconstruct the breast. There are several different parts of the body that serves as donor sites for breast reconstruction. Common areas of donor site locations include the abdomen, the back, and the gluteal region. When the breast is ptotic the native nipple areola complex can not be utilized…
Breast Reconstruction after mastectomy for breast cancer can be broken down into two main classifications: 1) Tissue Expander and Implant Reconstruction and 2) Autologous Tissue Reconstruction. In patients with larger breasts, the maximum size of a silicone gel mammary prosthesis is 800 cc. Often in mastectomy specimens weighing more than 800 grams, the implant is not sufficient to fill the…
Breast reconstruction in the radiated patient is different than in patients who have not received radiation. Patients who have undergone lumpectomy and radiation or patients who have undergone mastectomy and then radiation typically have a tight skin envelope. At times the skin envelope may be amenable to a breast implant reconstruction. Other times, the skin envelope results in a capsular…
Reconstruction following lumpectomy can be challenging and even more so in the setting of radiation therapy. Radiation and implant reconstructions can often cause capsular contracture. When one mammary prosthesis has capsular contracture and the other does not, obtaining symmetry can be quite challenging. In patients who have repeated capsular contracture, it is often best to remove the mammary prosthesis and…
Breast reconstruction following mastectomy is very common. Breast reconstruction often has a better result when the nipple areola complex is preserved. In patients who do not have a ptotic breast, the mastectomy can often be performed from an infra-mammary incision. At the time of the mastectomy, a tissue expander is placed. After the skin has healed the expander is removed…
Breast reconstruction following mastectomy is a common procedure. When the breast is ptotic, I often find that patient will do better when the resulting skin pattern is in the form of a Wise pattern. The Wise pattern allows the removal of ptotic skin and creates a skin envelope for an aesthetically pleasing breast. Tissue expander placement beneath the muscle entirely…
DIEP flap breast reconstruction is commonly used to reconstruct the breasts following mastectomy. When performing DIEP flap breast reconstruction, the lower abdominal tissue is used to replace the breast tissue and/or skin that have been removed. In patients who have ptotic breasts, or breasts in which there is a long sternal notch to nipple distance then the mastectomy may be…
Following mastectomy, breast reconstruction can be performed with tissue expanders and implants or with autologous tissue. Typically patients who do not need radiation can be reconstructed with either option. In the ptotic breast, the Wise skin pattern or inverted-T pattern allows the breast to have a less ptotic or more youthful appearance. I find that when using a Wise pattern…
