In patients who have breast cancer, some can undergo lumpectomy and radiation therapy. In general the concept for this method of reconstruction is amenable to those patients who have a smaller tumor relative to the size of their breast. After lumpectomy and oncoplastic reconstruction in these patients, the goal is to get the wounds to heal by about the six…
DIEP flaps are useful autologous flaps for breast reconstruction. There are many times when the DIEP flaps are performed in a delayed fashion with tissue expanders placed at the time of the mastectomy and prior to the DIEP flaps. In these cases, the mastectomy procedures are performed and the skin is allowed to heal with the tissue expanders in place.…
Radiation of mammary prosthesis can increase the chances of capsular contracture following lumpectomy for breast cancer. When patients experience a capsular contracture, they generally feel a tightness around the breast pocket and the implant tends to displace superiorly beneath the pectoralis major muscle if the implant is sub-pectoral. Treatment of the capsular contracture involves removal of all or some of…
DIEP flap breast reconstruction is often necessary to reconstruct the breast following radiation therapy. The lower abdomen is the primary source of tissue used to reconstruct the breast as it is soft and there is often adequate tissue available. After radiation therapy or removal of infected tissue expanders the skin can often not re-expand or is not amenable to placement…
There are several different manners in which to treat breast cancer. Breast cancer can be successfully treated with lumpectomy and IORT or intra-operative radiation therapy. In patients with smaller tumors and of a low grade the tumor can be resected and radiation delivered at the time of the lumpectomy. The breast can be rearranged and closed allowing for an optimal…
There are several different manners in which to reconstruct the breast following mastectomy. There are times when decreasing the size of the mammary prosthesis can help improve tissue characteristics and facilitate symmetry. One of the more challenging aspects of breast reconstruction is establishing symmetry of the inframammary folds. Once the inframammary folds are symmetric, establishing implant volume to attain symmetry…
There are breast tumors that invade through the skin of the breast. Depending upon the amount of skin that needs to be replaced different donor sites from the body can be used to replace the skin. For skin defects that reside in the upper outer quadrant of the breast, the latissimus dorsi myocutaneous flap is an excellent flap to replace…
In patients who have implants and develop a cancer, the cancer can sometimes be removed as a lumpectomy. Lumpectomy is often treated with radiation therapy post-operatively. Radiation can increase the risk for capsular contracture in the radiated breast. Correction requires release of the encapsulated breast pocket or excision of the capsule and often a lift of the contralateral side.
Patients can undergo mastectomy reconstruction with tissue expanders and implants following mastectomy. In certain patients, the mastectomy can be performed from the inframammary crease and can be well concealed giving the patient an optimal aesthetic result.
Lumpectomy defects can be reconstructed with the same techniques used to make the breast appear more youthful. The same techniques can be used to correct a deformity in the breast following radiation therapy.
