Development of a breast reconstruction satisfaction questionnaire (BRECON): Dimensionality and clinical importance of breast symptoms, donor site issues, patient expectations, and relationships

2010 ◽  
pp. n/a-n/a
Author(s):  
Claire L.F. Temple ◽  
E. Francis Cook ◽  
Douglas C. Ross ◽  
Margo Bettger-Hahn ◽  
Joy MacDermid
2020 ◽  
Vol 20 (2) ◽  
pp. e188-e191
Author(s):  
Chin-Wen Tu ◽  
Chien-Liang Fang ◽  
Chong-Bin Tsai ◽  
Chin-Hao Hsu ◽  
Chih-Hsuan Changchien ◽  
...  

Author(s):  
Dimitra Kotsougiani-Fischer ◽  
Laura Sieber ◽  
Sebastian Fischer ◽  
Christoph Hirche ◽  
Spyridoula Maraka ◽  
...  

2020 ◽  
Vol 9 (9) ◽  
pp. 3030
Author(s):  
Kathrin Bachleitner ◽  
Laurenz Weitgasser ◽  
Amro Amr ◽  
Thomas Schoeller

Various techniques for breast reconstruction ranging from reconstruction with implants to free tissue transfer, with the disadvantage of either carrying a foreign body or dealing with donor site morbidity, have been described. In patients who had a unilateral mastectomy and offer a contralateral mamma hypertrophy a breast reconstruction can be performed with the excess tissue from the hypertrophic side using the split breast technique. Here a local internal mammary artery perforator (IMAP) flap of the hypertrophic breast can be used for reconstruction avoiding the downsides of implants or a microsurgical reconstruction and simultaneously reducing the enlarged donor breast in order to achieve symmetry. Methods: Between April 2010 and February 2019 the split breast technique was performed in five patients after mastectomy due to breast cancer. Operating time, length of stay, complications and the need for secondary operations were analyzed and the surgical technique including flap supercharging were described in detail. Results: All five IMAP-flaps survived and an aesthetically pleasant result could be achieved using the split breast technique. An average of two secondary corrections to achieve better symmetry were necessary after each breast reconstruction. Complications included venous flap congestion, partial flap necrosis and asymmetry. No breast cancer recurrence was recorded. An overall approval of the surgical technique among patients was observed. Conclusions: The use of the contralateral breast for unilateral total breast reconstruction represents an additional highly useful technique for selected patients, is safe and reliable results can be achieved. Although this technique is carried out as a single-stage procedure, including breast reduction and reconstruction at the same time, secondary operations may be necessary to achieve superior symmetry and a satisfying aesthetic result. Survival of the IMAP-flaps can be improved by venous supercharging of the flaps onto the thoracoepigastric vein.


2021 ◽  
Vol 148 (3) ◽  
pp. 357e-364e
Author(s):  
Ariel C. Johnson ◽  
Becky B. T. King ◽  
Salih Colakoglu ◽  
Jerry H. Yang ◽  
Tae W. Chong ◽  
...  

Author(s):  
Charles W. Patterson ◽  
Patrick A. Palines ◽  
Matthew J. Bartow ◽  
Daniel J. Womac ◽  
Jamie C. Zampell ◽  
...  

Abstract Background From both a medical and surgical perspective, obese breast cancer patients are considered to possess higher risk when undergoing autologous breast reconstruction relative to nonobese patients. However, few studies have evaluated the continuum of risk across the full range of obesity. This study sought to compare surgical risk between the three World Health Organization (WHO) classes of obesity in patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction. Methods A retrospective review of 219 obese patients receiving 306 individual DIEP flaps was performed. Subjects were stratified into WHO obesity classes I (body mass index [BMI]: 30–34), II (BMI: 35–39), and III (BMI: ≥ 40) and assessed for risk factors and postoperative donor and recipient site complications. Results When examined together, the rate of any complication between the three groups only trended toward significance (p = 0.07), and there were no significant differences among rates of specific individual complications. However, logistic regression analysis showed that class III obesity was an independent risk factor for both flap (odds ratio [OR]: 1.71, 95% confidence interval [CI]: 0.91–3.20, p = 0.03) and donor site (OR: 2.34, 95% CI: 1.09–5.05, p = 0.03) complications. Conclusion DIEP breast reconstruction in the obese patient is more complex for both the patient and the surgeon. Although not a contraindication to undergoing surgery, obese patients should be diligently counseled regarding potential complications and undergo preoperative optimization of health parameters. Morbidly obese (class III) patients should be approached with additional caution, and perhaps even delay major reconstruction until specific BMI goals are met.


2019 ◽  
pp. 781-794
Author(s):  
Maurice Y. Nahabedian

The deep inferior epigastric perforator (DIEP) and muscle-sparing (MS) free transverse rectus abdominis musculocutaneous (TRAM) flaps are arguably the most common flaps used for autologous breast reconstruction. The benefit of these flaps is that very little to no donor site muscle is harvested. The decision to use one or the other is occasionally made preoperatively based on body habitus but often intraoperatively based on the quality of the perforating vessels. The technical aspects of the operation are similar except for the actual dissection around the perforating vessels. Studies have demonstrated no significant differences in outcome when comparing the DIEP and MS free TRAM flaps.


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