Delayed-delayed breast reconstruction in a 45-year old female who presented with a T2N3M0 left breast cancer who was known preoperatively to require postmastectomy.

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Presentation transcript:

Delayed-delayed breast reconstruction in a 45-year old female who presented with a T2N3M0 left breast cancer who was known preoperatively to require postmastectomy radiation therapy (PMRT). (Above, left) Preoperative view after neoadjuvant chemotherapy. (Above, right) Several weeks after stage I (subpectoral tissue expander at the time of mastectomy) with an intraoperative saline fill volume of 500 mL. (Center, left) The tissue expander was deflated in clinic to result in a flat chest wall surface for the delivery of external beam irradiation just before the start of PMRT. (Center, right) Seventeen days after PMRT, the patient was reinflated over 8 weeks to the predeflation volume of 500 mL. (Below, left) After removal of the expander, the remaining scar capsule layer is an ideal vascularized recipient for the nonradiated flap to revascularize the preserved breast skin. (Below, right) Sixteen months after removal of the tissue expander along with a skin-preserving delayed reconstruction with a deep inferior epigastric perforator (DIEP) flap and 22 months after PMRT with no evidence of contracture. The patient also underwent a right vertical mastopexy for symmetry. Source: Chapter 75. Considerations and Strategies for the Timing of Breast Reconstruction, Kuerer's Breast Surgical Oncology Citation: Kuerer HM. Kuerer's Breast Surgical Oncology; 2010 Available at: http://accesssurgery.mhmedical.com/DownloadImage.aspx?image=/data/books/kuer/kuer_c075f006.jpg&sec=39941714&BookID=428&ChapterSecID=39936206&imagename= Accessed: December 22, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved