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…
Deep Inferior Epigastric Artery Perforator (DIEP) flaps are often a great choice when reconstructing the breast following mastectomy that has undergone radiation. There are many different scenarios that present to plastic and reconstructive surgeons with regard to breast reconstruction. We often see patients in our office who have undergone mastectomy followed by radiation and who now choose to undergo breast…
DIEP flaps are commonly used to reconstruct the breast following mastectomy in the setting of radiation. After a mastectomy and radiation, the skin that has been radiated, will not expand appropriately to accept an implant. Often the tissue has been damaged from the radiation and needs to be excised to appropriately reconstruct the breast. Autologous tissue reconstruction is the reconstruction…
Radiation therapy is often a necessary tool in the treatment of breast cancer. When breast reconstructions have been radiated, a patient’s skin and soft tissues can react in many different ways. The breast implant beneath the radiated tissue can undergo capsular contracture and occasionally the skin can undergo degenerative changes that can lead to wound breakdown and possible implant exposure.…
