DIEP flaps are excellent options for breast reconstruction in patients who have undergone radiation therapy. Often the skin above the tumor needs to be resected during a mastectomy and an oncoplastic mastectomy is completed to facilitate clearing an anterior margin. When tissue expanders are placed and then radiated, the tissue expander can be affected by capsular contracture forces around the…
Patients who have breast cancer may be a candidate for lumpectomy and intra-operative radiation therapy. The intra-operative radiation therapy is completed at the time of the lumpectomy and the lumpectomy defect is closed. The aesthetic outcome following this type of oncologic resection and reconstruction can have a great outcome.
Bilateral mastectomy is often reconstructed with tissue expanders and breast implants. The tissue expander is inserted at the time of the mastectomy and the skin is allowed to heal and more oncologic information is gathered. Once the mastectomy skin has healed, saline is placed in the tissue expander to gradually expand the skin. The expanded skin is allowed to settle…
Capsular contracture can be a challenging problem for patients and surgeons. Often correcting a chronic capsular contracture may require a staged procedure to most effectively treat the problem. When a capsular contracture is recurrent, it is often best to remove the implants for approximately one year prior to placing the implants back into position. Removing the mammary prosthesis and changing…
When a patient undergoes a bilateral mastectomy, there can be several different options for breast reconstruction. One option is to reconstruct the breast with mammary prosthesis or breast implants. In patients who are not going to undergo radiation therapy implant reconstruction can be a viable option for breast reconstruction. In an implant reconstruction, often a tissue expander is placed first…
When tumors are close to the nipple areola complex the nipple is often removed at the time of the lumpectomy to clear the anterior margin. When mammary prosthesis are in place, often the mammary prosthesis can be removed at the time of the lumpectomy procedure. Patients often choose to have their implants removed at the time of lumpectomy as they…
Breast reconstruction for bilateral mastectomy can be accomplished in several ways. One option for breast reconstruction is the placement of tissue expanders at the time of mastectomy and then removal of the tissue expanders and replacement with implants at a later date. The interval placement of tissue expanders allows the skin to heal prior to the direct placement of implants.…
In patients with ptotic breasts who have breast cancer, the nipple areola complex can not often be kept alive during the mastectomy because the remaining blood supply is not adequate enough to perfuse the nipple areola complex. In these patients, the nipple areola complex is removed at the time of mastectomy. These patients can then choose to undergo nipple areola…
There are often times when patients may undergo a lumpectomy with an oncoplastic reconstruction of the lumpectomy defect and then in the future undergo a mastectomy. This may happen in patients who have a genetic mutation that puts them at higher risk for breast cancer. In these patients, the nipple areola complex may be preserved as it is re-positioned to…
Bilateral DIEP flap reconstructions are common operations for breast cancer reconstruction. When the breast has been radiated, DIEP flaps can be very helpful for breast reconstruction. When implants or expanders have extruded through the skin the DIEP flap can help reconstruct the breast. After the breast has been reconstructed with a DIEP flap the final stage of the reconstruction is…
