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…
Breast cancer that is treated with lumpectomy defects will often undergo radiation therapy. The radiation therapy can adversely effect the skin and tissue of the breast. Common changes can be atrophy of the skin and fat necrosis. The latissimus flap can be helpful to fill lumpectomy defects or defects that occur after removal of fat necrosis. The latissimus flap can…
Bilateral DIEP flaps are rewarding procedures to perform. In patients who have larger breasts and who undergo mastectomy, there are often implants that are not large enough to adequately reconstruct the breasts. In these patients the tissue from the lower abdomen can be used to reconstruct the breasts and provide a natural look and feel to the breast. After the…
DIEP flap breast reconstruction is helpful to reconstruct the breast when there has been previous tissue expander or implant infection. When the mastectomy defect is reconstructed with DIEP flaps the patients own body tissue is used. This is called an autologous breast reconstruction. The primary source of tissue to reconstruct the breast is the tissue from the lower abdomen. This…
When breast cancers are located close to the skin surface, it is often helpful to remove the skin above the tumor during surgery for wire directed segmental resection. When the tumor is located outside of the standard Wise-mastopexy pattern, the pattern is adjusted to remove the skin over the breast cancer.
Tumors of the breast that are located superior to the areola within a certain distance can be removed with bilateral crescent mastopexy incisions. These incisions are placed superior to the areola and in a crescent pattern. The resulting scar ends in the superior portion of the areola and the nipple is positioned in a higher position relative to the previous…
There are a subset of patients who have undergone implant reconstruction following mastectomy and who choose to have their implants removed and their breasts reconstructed with DIEP flaps. The deep inferior epigastric artery perforator flap uses the skin and/or fat from the lower abdomen to reconstruct the breast. This flap is helpful to reconstruct the upper pole of the breast…
Reconstruction of lumpectomy defects has advanced over the past several years with the implementation of oncoplastic reconstruction techniques. Patients often have questions about how their skin will look following post-lumpectomy radiation therapy. This patient underwent right lumpectomy with post-operative radiation therapy and left breast reduction/mastopexy for symmetry. The right sided scars that underwent radiation therapy have healed better than the…
