Presentation on theme: "BREAST RECONSTRUCTION Mark S. Granick, MD, FACS Professor of Surgery, tenured Chief of Plastic Surgery."— Presentation transcript:
BREAST RECONSTRUCTION Mark S. Granick, MD, FACS Professor of Surgery, tenured Chief of Plastic Surgery
Why? “I have a long life to live and I want to live it whole.” “I wanted to once again put on a beautiful nightgown and fill it all out.” “”I was gardening one day when I bent over and my prosthesis fell out. Crying I picked it out of the muddy water. The next day I called a Plastic Surgeon.”
Patient Questions Who is a candidate for surgery? Will breast reconstruction interfere with cancer treatment or detection? Are there some women who should not have a reconstruction? Does the type of cancer make a difference? How does adjuvant therapy impact on reconstruction?
Patient Questions How do you get the breasts symmetric? If a patients gains or loses weight, how does it affect the reconstruction? Does a breast reconstruction look and feel natural? Are there psychological implications concerning breast reconstruction?
Autogenous Tissue Corrects skin deficiency Normal subcutaneous tissue No foreign material Longer operative time Higher morbidity
Latissimus Dorsi May require an implant Cannot be used if the thoracodorsal pedicle is damaged
Latissimus Flap Planning
TRAM Carl Hartrampf,MD Single or double pedicle Muscle sparing (perforator) Cannot use if the rectus muscle is divided superiorly (Kocher incision) Risks fat necrosis fat necrosis donor site slough donor site slough flap failure flap failure hernia hernia