When the mastectomy has been radiated and there is either a tissue expander or implant beneath the radiated pocket, a capsular contracture can develop which displaced the implant to a more superior location. When an implant reconstruction is not possible or favorable secondary to the radiation, then the breast can be reconstructed with a DIEP flap. In a DIEP flap…
Unilateral or a single side mastectomy reconstruction can often be accomplished with a DIEP flap from the abdomen. When a unilateral mastectomy is performed it may be easier to match the non-cancer breast with skin and fat from the abdomen. This may be even more appropriate when the mastectomy has undergone radiation therapy. The radiated breast skin and tissue expander…
Secondary mastopexy, or mastopexy in previously augmented breasts presents unique challenges due to compromised blood supply to the nipple areola complex. Magnetic Resonance imaging (MRI) with contrast can be used to facilitate pre-operative planning in both cosmetic cases and breast cancer patients. We had the opportunity to describe our experience using breast MRI in complicated aesthetic and reconstructive cases at…
Breast cancer reconstruction is an area of my practice which is rewarding as we are often able to successfully treat a patient’s breast cancer effectively, yet at the same time prevent a deformity of the breast or in some cases enhance the appearance of the breast. Elite athletes who have successfully completed IronMan/IronWoman triathlons are patients who are dear to…
The latissimus dorsi flap is an important and very versatile flap for breast reconstruction. The latissimus flap almost always requires a breast implant to add volume to the breast reconstruction in order to match the contralateral breast. The latissimus dorsi flap can be harvested and transferred with a skin paddle to replace a missing nipple areola complex or it can…
There are many patients who choose to undergo bilateral mastectomy for breast cancer or prophylactically to prevent cancer when patients have a genetic predisposition. In patients who are not going to receive radiation the breast is amenable to reconstruction with tissue expanders and implants. The tissue expander is placed at the time of the mastectomy and only a small amount…
Bilateral mastectomy breast reconstruction is common in patients who have BRCA gene positivity. Bilateral mastectomy is also common in patients who choose to undergo mastectomy and contralateral prophylactic mastectomy. When the breast is ptotic, defined by a nipple areola complex that descends below the level of the inframammary fold, the nipple areola complex cannot maintain a blood supply sufficient to…
Breast cancer is common among women with approximately 1 in 9 women developing invasive breast cancer in the United States. When a patient chooses to undergo mastectomy, the patient may also choose to undergo mastectomy on the contralateral or opposite side of the breast that has breast cancer. This choice can be made because of a genetic predisposition to breast…
In certain patients with breast cancer, they may be a candidate for a lumpectomy with oncoplastic reconstruction and intra-operative radiation therapy. In patients with smaller tumors and certain biologic characteristics radiation can be undertaken at the time of lumpectomy during the operation. This can have fewer deleterious effects on the breast tissue, skin, and the overall aesthetic result. Oncoplastic reconstruction…
Patients with breast cancer can undergo lumpectomy and oncoplastic reconstruction of their lumpectomy defects. Depending upon the size of a cancer the patient can undergo intra-operative radiation therapy at the time of the lumpectomy. Breast implants can be removed at the time of the operation. The satisfaction rate with oncoplastic reconstruction of lumpectomy defects is high.
