Advanced autologous tissue flaps for whole breast reconstruction

2020 ◽  
pp. 339-368
Author(s):  
Steven J. Kronowitz ◽  
John R. Benson ◽  
Maurizio B. Nava
Keyword(s):  
Breast Reconstruction ◽  
Autologous Tissue ◽  
Tissue Flaps

Implants versus autologous tissue flaps for breast reconstruction following mastectomy

2021 ◽  
Author(s):  
Nicola Rocco ◽  
Giuseppe Catanuto ◽  
Paolo Chiodini ◽  
Corrado Rispoli ◽  
Maurizio B Nava
Keyword(s):  
Breast Reconstruction ◽  
Autologous Tissue ◽  
Tissue Flaps

Indications and Controversies for Abdominally-Based Complete Autologous Tissue Breast Reconstruction

2018 ◽  
Vol 45 (1) ◽  
pp. 83-91 ◽  
Author(s):  
Blake D. Murphy ◽  
Isabel Kerrebijn ◽  
Jian Farhadi ◽  
Jaume Masia ◽  
Stefan O.P. Hofer
Keyword(s):  
Breast Reconstruction ◽  
Autologous Tissue

A new method for partial breast reconstruction: 3-year New Zealand experience.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 89-89
Author(s):  
Stan Govender ◽  
John Harman ◽  
Gail Lebovic ◽  
John Simpson ◽  
Benji Benjamin
Keyword(s):  
New Zealand ◽  
Breast Reconstruction ◽  
Tumor Resection ◽  
New Method ◽  
Healthcare Sector ◽  
Partial Mastectomy ◽  
Radiotherapy Planning ◽  
Public Healthcare ◽  
Tissue Flaps

89 Background: Most women in New Zealand undergo partial mastectomy (PM) and 6 weeks of whole breast irradiation for early breast cancer. Oncoplastic surgery (OPS) is common, however, reconstruction of the breast during partial mastectomy presents challenges for radiation targeting since tissues have been extensively rearranged. Further complicating matters, the seroma cavity is often absent, and many patients travel to different cities for radiation without much communication between the surgeon and radiation oncologist prior to treatment. Throughout the country there is interest in promoting hypofractionated or accelerated radiotherapy, however, these techniques cannot be popularized without accurate targeting to minimize complications. In this series of patients we studied a new method of breast reconstruction using a bioabsorbable implant that serves as a surgical site marker as well. Methods: Following informed consent, 15 women were studied in a prospective manner. The bioabsorbable implant was sutured into the tumor resection site, and tissue flaps were directly attached. Radiation treatment protocols followed ASTRO guidelines. Results: The implant provided volume replacement and acted as a scaffolding for the breast tissue flaps providing local reconstruction. Cosmetic outcomes were excellent in all patients, no device related or radiation complications occurred. One patient had a post-operative hematoma that resolved without intervention, there were no post-operative infections. 3 year follow up shows no tumor recurrences, and no untoward effects. When compared to conventional radiation targeting, use of the implant showed a > 50% reduction in treatment volume is possible. 3 year mammograms show normal regrowth of tissue without artifact and with minimal fibrosis. Conclusions: Three year follow-up shows this "mini" breast implant assists with oncoplastic breast reconstruction, while at the same time clearly marks the surgical site of tumor excision. Patients tolerated it well, and radiotherapy planning, positioning and treatment were all facilitated by the implant. Excellent patient outcomes in this pilot study have resulted in a national evaluation of this method in the public healthcare sector.

Perforator flap breast reconstruction in thin patients.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 242-242
Author(s):  
C. M. Chen ◽  
C. Ahn ◽  
J. Levine
Keyword(s):  
Breast Reconstruction ◽  
Subcutaneous Tissue ◽  
Donor Site ◽  
Perforator Flap ◽  
Preoperative Imaging ◽  
Perforator Flaps ◽  
Autologous Tissue ◽  
New Techniques ◽  
Medial Thigh ◽  
Abdominal Flaps

242 Background: Perforator flap breast reconstruction has strong appeal for many women seeking breast reconstruction, but the procedure requires adequate donor site tissue to produce realistic breasts. Thin women requesting perforator flaps are often advised that they lack sufficient donor site tissue for autologous tissue breast reconstruction, and that implants are their only option. We have expanded the reconstructive options for thin women who seek an alternative to implants with innovative new techniques. Methods: A retrospective review was done of 223 patients who underwent 293 consecutive perforator flap breast reconstructions from April 2007-May 2011. Preoperative imaging allowed visualization of the microvascular anatomy and subcutaneous tissue. Donor sites evaluated included the abdomen, medial thigh, buttocks, and back. Complications included flap loss, hematoma, seroma, takeback, and fat necrosis. No patients were turned away for perforator flap breast reconstruction due to insufficient donor site tissue. Results: Out of 293 perforator flap breast reconstructions, 45 perforator flap breast reconstructions (15.4%) were reported in 26 thin women with a BMI < 23 (mean BMI 20.7, range BMI 18.2-22.7). Out of 45 perforator flap breast reconstructions in thin women, donor sites included 35 hemi-abdominal flaps (77.8%), 4 medial thigh flaps (8.9%), 7 buttock flaps (15.6%), and 2 back flaps (4.4%). Of the 35 hemi-abdominal flaps, 8 hemi-abdominal flaps were combined to create 4 stacked DIEP flaps (22.9%) while the remaining 27 hemi-abdominal flaps were regular DIEP flaps (77.1%). There was one seroma (2.2%) and one takeback for postoperative pain (2.2%); there were no flap losses. Conclusions: Even in thin women, perforator flap breast reconstruction is a safe, reliable, and consistent technique for recreating new breasts. While implant-based breast reconstruction may be acceptable to many women, there is a growing subgroup of patients who prefer autologous tissue breast reconstruction. By challenging common conceptions about the amount of donor site tissue required, we have been able to expand reconstructive options in thin women by using perforator flaps to construct natural, aesthetic breasts.

Sign in / Sign up

Export Citation Format

Share Document