Patients who undergo lumpectomy have different options for breast reconstruction. In patients who have relatively larger breasts, smaller tumors, and who have breast ptotis may be able to have their tumor excised with a lumpectomy and their breast reconstructed with the same patterns that we use for a cosmetic mastopexy or breast reduction. It is quite common for patients to…
Autologous breast reconstruction is when the body’s own tissue is used to reconstruct the breast. There are several different parts of the body that serves as donor sites for breast reconstruction. Common areas of donor site locations include the abdomen, the back, and the gluteal region. When the breast is ptotic the native nipple areola complex can not be utilized…
Hernia repairs are common. Often the hernis can be exposed through a lower abdominal incision. The lower abdominal incision is similar to an incision used in a standard abdominoplasty or “tummy tuck” operation. The lower abdominal incision gives access to the entire abdominal wall up toward the ribcage. Any mesh that is placed in a central defect is not located…
Breast Reconstruction after mastectomy for breast cancer can be broken down into two main classifications: 1) Tissue Expander and Implant Reconstruction and 2) Autologous Tissue Reconstruction. In patients with larger breasts, the maximum size of a silicone gel mammary prosthesis is 800 cc. Often in mastectomy specimens weighing more than 800 grams, the implant is not sufficient to fill the…
Breast reconstruction in the radiated patient is different than in patients who have not received radiation. Patients who have undergone lumpectomy and radiation or patients who have undergone mastectomy and then radiation typically have a tight skin envelope. At times the skin envelope may be amenable to a breast implant reconstruction. Other times, the skin envelope results in a capsular…
Breast augmentation is a common procedure. There are several different incision choices when performing breast augmentation. There is a large advantage to the transaxillary incision. The transaxillary incision is well hidden in the armpit and there is no visible scar on the breast or chest wall. The transaxillary incision requires more care in the post-operative period. The armpits need to…
It is common for many women to want to have their implants removed. Often when patients want to have their implants removed, the breasts are already ptotic. The breast can be lifted following the removal of the breast implant. The most commonly used lift pattern is called the Wise pattern or T-lift. The T-lift allows the nipple areola complex to…
Hernias a common. They can occur from a defect at birth or can be from a previous surgery. The goal when repairing hernias is to restore the abdominal wall to its normal state of anatomy. Often, this coincides with normal muscle function. Hernias that protrude through the rectus muscle are often best repaired by separating the components of the rectus…
Abdominal Wall Hernias are common. The hernias can occur after previous surgery. Common causes of umbilical hernias are congenital defects or from previous laparoscopic surgery. Larger hernias can occur from previous incisions. Hernias can often be repaired from a lower abdominal incision. Smaller hernias can be repaired primarily by approximating the edges of the hernia. Larger hernias require release of…
Abdominal wall hernias are common. A hernia can occur from a congential defect or it can occur from a previous surgery. When the hernia increases in size, the abdominal contents can protrude through the abdominal wall. This can be painful to the patient. Ocassionally, this can cause an obstruction or abdominal symptoms. When the hernia is repaired, the muscles are…
