Breast reconstruction following mastectomy can be challenging for both the patient and surgeon. Breast reconstruction can be performed immediately following mastectomy or can be performed in a delayed fashion where a patient undergoes a mastectomy in one procedure and then implant or autologous tissue reconstruction in another procedure. I typically educate patients who undergo reconstruction with tissue expanders or implants…
Autologous breast reconstruction involves reconstructing the breast following mastectomy with the patient’s own body tissues. Patients who are candidates for autologous breast reconstruction are patients who have had radiation to the breast skin, those who have had repeated infections or capsular contracture, or those patients who wish to undergo breast reconstruction without implants. Other types of patients who are candidates…
Patients typically ask in consultation what the recovery is like following DIEP or TRAM Flap surgery. I find that patients may have some misconceptions regarding how they are going to look and feel post-operatively. Typically at one week post-operatively, most or all drains have been removed and steri-strips remain in place on the breast reconstruction or on the abdomen. Bruising…
Typically, breast reconstruction with autologous tissue occurs in three stages. For deep inferior epigastric artery perforator flaps, the skin and fat is harvested from the lower abdomen and transferred to the mastectomy site. In the second stage of the reconstruction which occurs at a later date, a symmetry procedure is performed on the reconstructed breast mound. Additionally, at that time,…
When the breast has been removed for cancer and the remaining skin on the chest has been radiated the optimal choice for autologous reconstruction is to use tissue from the lower abdomen.The deep inferior epigastric artery perforator flap or DIEP flap is a variation of the TRAM flap. The DIEP flap allows the plastic & reconstructive surgeon the opportunity to…
Often when patients come to discuss breast reconstruction options in consultation, the choices to be made regarding reconstruction can often be more confusing to patients than the oncologic surgery itself. In our initial breast reconstruction discussion, patients understand that they can either decide to have breast reconstruction or to not have breast reconstruction. More often, patients choose to undergo breast…
