INTRODUCTION The National Institute for Health and Clinical Excellence guidelines recommend that breast reconstruction should be available to all women undergoing mastectomy and discussed at the initial surgical consultation (2002, and updated 2009). The National Mastectomy and Breast Reconstruction Audit (2009) showed that 21% of mastectomy patients underwent immediate breast reconstruction (I...

alloderm® (lifecell corp.; brancburg, nj) is an acellular dermal matrix (adm) that serves as an immunologically inert scaffold in plastic surgery. in breast reconstruction, it is used as a filler for lumpectomy defects and can be used to create the inferolateral portion of the tissue expander pocket or implant pocket in postmastectomy patients. however, there are limited reports of the radiolog...

HYPOTHESIS Transverse rectus abdominus musculocutaneous (TRAM) flap breast reconstruction provides excellent cosmetic results. Pedicle flap viability is greatly enhanced by prereconstruction inferior epigastric vessel ligation, which encourages collateral arterial flow (delayed TRAM). We report our initial experience with laparoscopic inferior epigastric vessel ligation. DESIGN Prospective ca...

Breast reconstruction after mastectomy should aim at resulting in an aesthetic outcome that matches the patient’s expectations and without interfering in the oncologic treatment. Whether the reconstruction is performed immediately or in a delayed fashion depends on various factors, which needs detailed attention. Autologous tissue, implants or both are used in the reconstruction. This article r...

Several surgical procedures exist in regard to reconstruction of the breast after mastectomy. The use of Brava a vacuum-based external soft-tissue expansion system in combination with fat transplantation is a less documented but viable option in treating patients after mastectomy. We share our experience in treating a 57-year-old patient with mastectomy, describing the complications and pitfall...

We congratulate Figus and colleagues on their series of 14 patients with DIEP flap breast reconstruction who underwent immediate (14 implants) or delayed (four implants) augmentation. We concur that implant augmentation offers an effective option for optimising the results of autologous tissue breast reconstruction but have independently taken a different approach. We would like to share our re...

BACKGROUND The authors performed a systematic review of the literature on the outcome of therapy for patients with breast cancer who underwent adjuvant radiotherapy after an immediate two-stage prosthetic breast reconstruction, either following tissue expansion (stage 1) or after removal of the tissue expander and insertion of a final breast implant (stage 2). Their outcomes were compared to th...

IMPORTANCE Most women undergoing mastectomy for breast cancer do not undergo breast reconstruction. OBJECTIVE To examine correlates of breast reconstruction after mastectomy and to determine if a significant unmet need for reconstruction exists. DESIGN, SETTING, AND PARTICIPANTS We used Surveillance, Epidemiology, and End Results registries from Los Angeles, California, and Detroit, Michiga...

BACKGROUND The usage of internal mammary artery perforators (IMAPs) has been described in autologous breast reconstruction although IMAPS are not yet considered standard recipient vessels. It remains unclear if these vessels can be safely used in large flaps after radiation therapy or in delayed breast reconstruction. METHODS Over a 2-year period, 515 free flaps for autologous breast reconstr...

Background Autologous breast reconstruction can be performed for breasts with ptosis to a certain extent, but if patients desire to correct ptosis, mastopexy of the contralateral breast is indicated. However, accurate prediction of post-mastopexy breast shape is difficult to make, and symmetrical breast reconstruction requires certain experience. We have previously reported the use of three-dim...