Breast reconstruction is a challenging specialty in plastic and reconstructive surgery. Not only does the patient and reconstructive surgeon have to contend with a foreign object of the mammary prosthesis, but also chemotherapy and radiation which can make the reconstructive process more challenging. The photograph demonstrates before and after implant reconstruction of bilateral mastectomy defects with bilateral mammary prosthesis. The…
Breast cancer is a common cancer among women. There are two different surgical ways to treat breast cancer. One way is to perform a mastectomy and the other way is to perform a lumpectomy. One simple but consistent way to approach the question to have either a lumpectomy or mastectomy is the size of the tumor relative to the size…
In the ptotic patient and when the patient would like to have an autologous reconstruction, it is helpful to reconstruct the breast with an inverted-T skin pattern. The photograph demonstrates before and after breast reconstruction with a Deep Inferior Epigastric Artery Perforator Flap. The left breast underwent mastopexy reduction to set a new goal position to match. The right breast…
Left Breast Reconstruction with DIEP Flap to Reconstruct the Breasts when Implants are not an Option
After mastectomy, the breast can be reconstructed with implants or with the patient’s own tissue. When we reconstruct the breast with the patient’s own tissue, we use the term autologous breast reconstruction. Reconstruction with the patient’s own tissue is helpful in cases where radiation was required after mastectomy or in situations where implants became infected at any time after a…
Breast reconstruction following mastectomy can be performed with tissue expanders and implants. In some cases, patients do not want to have their breast reconstructed with implants and we can use the skin and fat from the abdomen to reconstruct the breast. In some patients the DIEP flap can be completed at the time of the mastectomy depending upon the size…
Many breast cancer patients have been treated with lumpectomy and radiation therapy. In some patients, the lumpectomy defect and the whole breast radiation can cause significant changes or deformities to the breast. In the before and after photograph shown, the patient had previous right breast cancer treated with lumpectomy and radiation. The lumpectomy defect as well as the whole breast…
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…
