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…
There are several occasions where patients come to our practice and they have previously undergone a mastectomy reconstruction, but would like to improve the appearance of their reconstruction. Common reasons for wanting to improve the appearance of their reconstruction is thin skin, with waviness and rippling of the implant, asymmetry of the reconstructed breast volume or position, and capsular contracture.…
Reconstruction of mastectomy defects is challenging. It is even more challenging in the face of radiation. Not all tissues and tissue types tolerate radiation to the same degree. In some patients implant reconstructions are not amenable after they have undergone radiation. Improving the tissue characteristics is important to making an implant reconstruction a viable option. One of the more common…
There are different ways that the breast can be reconstructed following a mastectomy or bilateral mastectomy. At the time of a mastectomy operation, tissue expanders are placed and the skin is allowed to heal. Once the skin has demonstrated appropriate healing, volume is added to the expanders. After an adequate time for swelling to subside, the tissue expanders can be…
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.…
There are several oncoplastic techniques that are used to reconstruct the breast following lumpectomy for breast cancer. These oncoplastic techniques can be utilized in conjunction with DIEP flap reconstruction for mastectomy in sequence. Patients can undergo lumpectomy for breast cancer with oncoplastic reconstruction. The staging of the lumpectomy and oncoplastic reconstruction can place a ptotic nipple areola complex in a…
Occasionally, patients undergo mastectomy and then follow with radiation therapy. When these patients undergo breast reconstruction, we use the term delayed breast reconstruction. The term delayed reconstruction is utilized to characterize a reconstruction that occurs after a mastectomy and other treatments versus an immediate reconstruction that occurs in whole or in part simultaneously with the mastectomy. When the skin that…
The skin and fat from the lower abdomen can be used to reconstruct the breast following mastectomy. This type of reconstruction is called autologous breast reconstruction or flap reconstruction. The deep inferior epigastric artery perforator (DIEP) flap uses the skin and fat from the lower abdomen, and maintains a significant amount of abdominal wall musculature. The tissue that is transferred…
There are several options to reconstruct the breast following mastectomy. Depending upon the degree of pre-operative ptosis of the breast, the patient may be a candidate for a nipple sparing mastectomy. A nipple sparing mastectomy may be performed through an inframamary incision. For a DIEP flap reconstruction, the operative surgeon often needs access to blood vessels in the chest, usually…
