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…
Often patients with breast cancer who undergo lumpectomy have implants in place that may have been ruptured or are not in anatomical position. Often these patients wish to have the mammary prosthesis removed at the time of lumpectomy while their cancer is being effectively treated. Removal of the mammary prosthesis and improvement of the shape of the breast can improve…
In patients with DCIS or breast cancer, the cancer can be removed using patterns to improve the appearance or shape of the breast. These patterns accomplish several things: 1) It allows large margins to be obtained as well as the overlying skin. 2) It prevents a post-operative lumpectomy defect. 3) It improves the appearance of the breast and “psyche” of…
Radiation is a therapy that patients will receive post-lumpectomy. After the oncoplastic reconstruction of the lumpectomy defect, patients will have tattoos or stickers placed to help guide the radiation beam. Radiation therapy typically occurs 6 weeks post lumpectomy. It is important for patients to eat a high protein diet post surgery to facilitate wound healing prior to initiating radiation therapy.
