Breast Reconstruction

CHAPTER 22 Breast Reconstruction


Breast reconstruction has become an essential component of the care of women with breast cancer. The goals of modern breast reconstruction are to recreate a natural-appearing breast mound that matches the opposite breast in size, contour, and degree of ptosis (i.e., droopiness). This chapter discusses a variety of alloplastic (implant-based) and autologous techniques for breast reconstruction after mastectomy.

Autologous reconstruction is defined as any form of breast reconstruction that uses a patient’s own tissues to recreate the breast mound. A variety of donor sites can be used for autologous breast reconstruction, including the lower abdomen, buttocks, and back. Alloplastic reconstruction refers to any form of breast reconstruction in which an implant is used. Implant-based reconstruction is typically performed in stages. The first stage involves placement of an inflatable tissue expander that permits the recruitment of additional skin and soft tissue. Subsequently, the expander is replaced with a permanent prosthesis.

Delayed breast reconstruction is defined as reconstruction that occurs after a patient has undergone a mastectomy. Delayed breast reconstruction is most commonly performed for patients who require postoperative radiation therapy. Immediate breast reconstruction, on the other hand, refers to any reconstruction that begins at the time of mastectomy.


There are various techniques for reconstructing the breast mound after mastectomy. The most common procedures involve using either autologous tissues (e.g., transverse rectus abdominis myocutaneous [TRAM] flap), tissue expander placement followed by a silicone gel prosthetic implantation, or some combination of the two (e.g., latissimus dorsi flap with implant).

May 26, 2018 | Posted by in GENERAL SURGERY | Comments Off on Breast Reconstruction

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