Breast Reconstruction - Current Techniques

288 Pages·2012·30.713 MB·English

by  M. Salgarello

BREAST RECONSTRUCTION
– CURRENT TECHNIQUES

Edited by Marzia Salgarello
Breast Reconstruction – Current Techniques
Edited by Marzia Salgarello

Published by InTech
Janeza Trdine 9, 51000 Rijeka, Croatia

Copyright © 2012 InTech
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Publishing Process Manager Ivana Zec
Technical Editor Teodora Smiljanic
Cover Designer InTech Design Team

First published January, 2012
Printed in Croatia

A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from [email protected]

Breast Reconstruction – Current Techniques, Edited by Marzia Salgarello
p. cm.
ISBN 978-953-307-982-0

Contents

Preface IX
Part 1 Oncology and Breast Reconstruction 1
Chapter 1 Oncological Considerations
for Breast Reconstruction 3
Grant W. Carlson
Part 2 Prosthetic Breast Reconstruction 21
Chapter 2 Implant and Implant
Assisted Breast Reconstructions 23
Sarah S.K. Tang and Gerald P.H. Gui
Chapter 3 One-Stage Immediate Breast Reconstruction
with Implants in Conservative Mastectomies 49
Marzia Salgarello, Giuseppe Visconti
and Liliana Barone-Adesi
Chapter 4 The Effect of Breast Reconstruction on Maintaining
a Proper Body Posture in Patients After Mastectomy 83
Sławomir Cieśla and Małgorzata Bąk
Part 3 Autogenous Breast Reconstruction 103
Chapter 5 Modified Extended Latissimus Dorsi Myocutaneous
Flap with Added Vascularised Chest Wall Fat in
Immediate Breast Reconstruction After
Conservative (Sparing) Mastectomies 105
Adel Denewer and Omar Farouk
Chapter 6 Breast Reconstruction with DIEP and S/IGAP 129
Maria M. LoTempio, Grace Lucta Gerald
and Robert J. Allen
VI Contents

Chapter 7 Preoperative Computed Tomographic Angiogram
for Deep Inferior Epigastric Artery Perforator Flap
for Breast Reconstruction: The Imaging Mapping Era 159
Jaume Masia, Carmen Navarro,
Juan A. Clavero and Xavier Alomar
Chapter 8 The Superficial Inferior Epigastric Artery (SIEA)
Flap and Its Applications in Breast Reconstruction 171
Zachary Menn and Aldona Spiegel
Chapter 9 Double-Pedicle DIEP and SIEA Flaps and
Their Application in Breast Reconstruction 177
Marzia Salgarello, Liliana Barone-Adesi
and Giuseppe Visconti
Chapter 10 The Omentum Flap 195
Sirlei dos Santos Costa and Rosa Maria Blotta
Part 4 Fat Graft in Breast Reconstruction 215
Chapter 11 Autologous Fat Transplantation –
A Paradigm Shift in Breast Reconstruction 217
Daniel Del Vecchio and Hetal Fichadia
Part 5 Breast Reconstruction
After Conservative Treatment 241
Chapter 12 Breast Reconstruction
Approach to Conservative Surgery 243
Egidio Riggio and Valentina Visintini Cividin

Preface

Breast reconstruction is an evolving art that challenges surgeons to combine
reconstructive and aesthetic principles in the search for the best results possible.
The goal of breast reconstruction after mastectomy and after conservative treatment, is
to restore the appearance of the breast and to improve a woman's psychological health
after cancer treatment. Similarly, rebuilding the breast after severe breast
malformation such as Poland syndrome, is similar to breast reconstruction after
oncologic treatment. In this way the book joins together breast reconstruction after
cancer treatment, and after a serious congenital condition that may even result in the
absence of the breast and the deformity of the homo-lateral chest. Although the
technical strategies for breast reconstruction are getting increasingly sophisticated, the
two main options can still be summarized as autogenous and/or prosthetic, both now
reaching a high standard of results. Having this in mind, the purpose of this book is to
examine many of the modern techniques for breast reconstruction, and also giving
some insight into specific topics.
The text consists of five sections. The first is an introduction to the oncologic aspects of
breast reconstruction. In brief, this chapter introduces the issue of immediate breast
reconstruction, of which the main benefit is superior aesthetic results compared to
those of delayed reconstruction, together with a gain in psychological, social, and
sexual well-being, and a significant cost reduction. The book goes on to examine the
topic of detection and treatment of local recurrences after breast reconstruction, and
the relationship between immediate breast reconstruction and adjuvant therapies. This
chapter also provides significant information on the safety of conservative
mastectomies. Section two focuses on prosthetic breast reconstruction, which contains
chapters for two-stage and one-stage implant-assisted reconstruction together with a
chapter examining the effect of mastectomy and implant breast reconstruction on the
maintenance of proper body posture after surgery. Section three is about autogenous
breast reconstruction, and has several chapters covering the main topics from
latissimus dorsi and abdominal flaps to omentum flap. Section four analyzes breast
reconstruction with the use of a fat graft. Finally, section five covers the current
X Preface

approaches to breast reshaping after conservative treatment, mainly modified
reduction mammaplasty, and adjacent tissue rearrangement.

Dr. Marzia Salgarello
University Hospital “Agostino Gemelli”,
University of “Sacro Cuore”,
Rome,
Italy