1. BREAST RECONSTRUCTION
BREAST AUGMENTATION AND REDUCTION

2. BREAST RECONSTRUCTION
Flap reconstruction: Pg 306
Tissue from back, butt, thigh or:
Transverse Rectus Abdominus Myocutaneous (TRAM) flap
More extensive surgery; leaves defect at donor site
May be the only alternative if major scarring resulted from radiation
Skin Expansion
Tissue Expander placed under muscle
Several months of injections then replaced with permanent implants
No new incision – use original mastectomy scar
Glut Maximus, Lat Dorsi, Transverse Rectus Abd myocutaneous (TRAM) flap, (most popular)

3. Nipple Reconstruction
Graft may be taken from groin, axilla or other nipple. Can cause problems
Advanced procedure: cut skin in shape of a Skate, twist and mold in shape of nipple
Areola done at tattoo parlor

4. PROBLEMS WITH RECONSTRUCTION
IMPLANT
Implant leakage
Capsule formation
Change in position of implant
FLAP SURGERY
Loss of flap
Weakness of donor site
Hernia formation
Irregularity of breast and blood loss
Two scars

5. BREAST AUGMENTATION Pocket created under breast tissue/muscle
Refer to table pg 303
Subglandular
Capsular hardening of implant in the past
Now textured; also round or pear
Submuscular
Change in shape when pectoral muscle contracted
Implant remains high (Snoopy Breast)

6. BREAST AUGMENTATION Risks: Post-op: 1-2 weeks
Bleeding, infection, scar and numbness or change in feeling
Hardening of capsule
Leakage
Post-op: 1-2 weeks

7. BREAST REDUCTION Scarring Extensive
Less painful since nerves and breast skin already stretched due to weight
1-2 week recovery; no strenuous activity for
6 weeks
3-5 hr procedure
Keyhole incision around nipple, extends downward, follows natural curve of crease beneath breast
Fat, skin, glandular removed and nipple and areola re-positioned.

8. MASTOPEXY Skin tightening, no implant
Upside down T; similar to Breast Reduction
1-2 week recovery

9. POLAND’S SYNDROME

10. POLAND’S SYNDROME

11. PRE-PECTORAL SPONGES PLACED 40 YRS EARLIER

12. DIRECT INJECTION OF SILICONE

13. DIRECT INJECTION OF SILICONE

14. Percutaneous Silicone Injections: Siliconegranulomas/Rim Calcification

15. FIBROUS ENCAPSULATION

16. CAPSULAR CONTRACTION OF LT SILICONE IMPLANT

17. DEFLATED

18. HERNIA

19. SILICONE LEAK

20. INTACT IMPLANT

21. WRINKLES OR BULGES

22. SILICONE INTRACAPSULAR LEAK

23. SILICONE RUPTURE NOT IDENTIFIED ON US