Patients who undergo lumpectomy and radiation therapy have a higher rate of capsular contracture of their mammary prosthesis. The capsular contracture causes the normal lining around a breast implant to become thicker. This then causes the implant/soft tissue construct to become indurated and firm. Removing the mammary prosthesis can present the recurrence of the capsular contracture. Patient satisfaction is quite…
Treatment of breast cancer with lumpectomy is a viable option for many patients. Often the same patterns that are used to lift the breast can be used to resect tumors from the breast. Often the most commonly used pattern is the Wise pattern. When the breast cancer resides outside of the normal pattern, then the Wise pattern is modified to…
Incisions on the breast such as mastopexy Wise-patterns, crescents, T-lifts, etc. take several months to years to mature. In general we tell patients not to apply any creams or lotions on the skin for 4-6 weeks after surgery. After six weeks, silicone sheets can be applied to the scar to flatten the scar or prevent hypertrophic scars or keloid scars.…
Reconstruction of mastectomy defects is challenging. It is even more challenging in the face of radiation. Not all tissues and tissue types tolerate radiation to the same degree. In some patients implant reconstructions are not amenable after they have undergone radiation. Improving the tissue characteristics is important to making an implant reconstruction a viable option. One of the more common…
There are different ways that the breast can be reconstructed following a mastectomy or bilateral mastectomy. At the time of a mastectomy operation, tissue expanders are placed and the skin is allowed to heal. Once the skin has demonstrated appropriate healing, volume is added to the expanders. After an adequate time for swelling to subside, the tissue expanders can be…
In patients who have breast cancer, some can undergo lumpectomy and radiation therapy. In general the concept for this method of reconstruction is amenable to those patients who have a smaller tumor relative to the size of their breast. After lumpectomy and oncoplastic reconstruction in these patients, the goal is to get the wounds to heal by about the six…
DIEP flaps are useful autologous flaps for breast reconstruction. There are many times when the DIEP flaps are performed in a delayed fashion with tissue expanders placed at the time of the mastectomy and prior to the DIEP flaps. In these cases, the mastectomy procedures are performed and the skin is allowed to heal with the tissue expanders in place.…
Radiation of mammary prosthesis can increase the chances of capsular contracture following lumpectomy for breast cancer. When patients experience a capsular contracture, they generally feel a tightness around the breast pocket and the implant tends to displace superiorly beneath the pectoralis major muscle if the implant is sub-pectoral. Treatment of the capsular contracture involves removal of all or some of…
DIEP flap breast reconstruction is often necessary to reconstruct the breast following radiation therapy. The lower abdomen is the primary source of tissue used to reconstruct the breast as it is soft and there is often adequate tissue available. After radiation therapy or removal of infected tissue expanders the skin can often not re-expand or is not amenable to placement…
There are several different manners in which to treat breast cancer. Breast cancer can be successfully treated with lumpectomy and IORT or intra-operative radiation therapy. In patients with smaller tumors and of a low grade the tumor can be resected and radiation delivered at the time of the lumpectomy. The breast can be rearranged and closed allowing for an optimal…
