Additional Information
Book Details
Abstract
Fully updated to meet the demands of the 21st-century surgeon, Breast, Volume 5 of Plastic Surgery 3rd Edition, provides you with the most current knowledge and techniques in breast surgery, allowing you to offer every patient the best possible outcome. Access all the state-of-the-art know-how you need to overcome any challenge you may face and exceed your patients’ expectations.
- Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability. Compatible with Kindle®, nook®, and other popular devices.
- Apply the very latest advances in breast plastic surgery and ensure optimal outcomes with evidence-based advice from a diverse collection of world-leading authorities.
- Purchase this volume individually or own the entire set, with the ability to search across all six volumes online!
- Make optimal use of the latest practices in aesthetic breast surgery, including imaging for breast augmentation and short scar mastopexy; autologous lipofilling of the breast; the use and challenges of silicone gel devices; and new techniques for developmental and congenital deformities of the breast.
- Know what to look for and what results you can expect with 1,300 photographs and illustrations.
- See how to perform key techniques with 25 surgical videos online.
- Access the complete, fully searchable contents online, download all the tables and figures, and take advantage of additional content and images at www.expertconsult.com!
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front cover | cover | ||
Plastic Surgery | i | ||
Copyright page | iv | ||
Table of Contents | v | ||
Video Contents | xi | ||
Foreword | xvi | ||
Preface | xvii | ||
List of Contributors | xviii | ||
Acknowledgments | xl | ||
Dedication | xli | ||
1 Anatomy for plastic surgery of the breast | 1 | ||
Introduction | 1 | ||
Ideal breast architecture | 1 | ||
Development of the breast | 2 | ||
Parenchyma | 3 | ||
Nipple areola complex | 5 | ||
Skeletal support | 5 | ||
Vascularity | 6 | ||
Lymphatics | 8 | ||
Innervation | 9 | ||
Musculature | 9 | ||
Pectoralis major | 9 | ||
Serratus anterior | 10 | ||
Rectus abdominis | 11 | ||
External oblique | 11 | ||
Surgical indications | 11 | ||
Conclusion | 11 | ||
References | 12 | ||
References | 12.e1 | ||
I Cosmetic Surgery of the Breast | 13 | ||
2 Breast augmentation | 13 | ||
Introduction | 13 | ||
History | 13.e1 | ||
Basic science/disease process | 13 | ||
Evolution of saline implants | 13 | ||
Silicone chemistry | 14 | ||
Evolution of silicone implants | 14 | ||
Diagnosis and patient presentation | 15 | ||
Patient selection | 16 | ||
Informed consent | 17 | ||
Operative planning | 19 | ||
Incision length and placement | 19 | ||
Pocket position | 20 | ||
Implant selection | 24 | ||
Filling material | 24 | ||
Implant size | 25 | ||
Implant surface texture | 25 | ||
Implant shape | 25 | ||
Treatment and surgical technique | 27 | ||
Inframammary incision | 27 | ||
Periareolar incision | 30 | ||
Transaxillary incision | 31 | ||
Transumbilical | 32 | ||
Postoperative care | 32 | ||
Perioperative complications | 32 | ||
Delayed complications of augmentation mammaplasty | 36 | ||
Periprosthetic capsular contracture | 36 | ||
Implant rupture and deflation | 37 | ||
Secondary procedures | 37 | ||
References | 38 | ||
References | 38.e1 | ||
3 Secondary breast augmentation | 39 | ||
Introduction | 39 | ||
Basic science/disease process | 40 | ||
Diagnosis/patient presentation | 40 | ||
Classification | 41 | ||
Patient selection/indications | 42 | ||
Treatment/surgical technique | 44 | ||
Contracture | 46 | ||
Malposition | 53 | ||
Etiology | 53 | ||
Treatment | 55 | ||
Implant failure | 58 | ||
Rippling and palpability | 59 | ||
Breast asymmetry | 61 | ||
Soft tissue changes | 63 | ||
Size change | 64 | ||
Postoperative care | 65 | ||
Outcomes, prognosis, and complications | 65 | ||
References | 66 | ||
References | 66.e1 | ||
4 Current concepts in revisionary breast surgery | 67 | ||
Introduction | 67 | ||
History | 68.e1 | ||
Basic science and disease process | 68 | ||
Acellular dermal matrix | 68 | ||
Published literature | 69 | ||
Regeneration | 69 | ||
Resorption | 69 | ||
Encapsulation | 71 | ||
Diagnosis and patient presentation | 71 | ||
Patient selection | 71 | ||
Treatment and surgical technique | 71 | ||
Coverage of the lower pole | 73 | ||
Implant stabilizer | 75 | ||
Tissue thickener | 76 | ||
Treatment of capsular contracture | 77 | ||
Outcomes, prognosis and complications | 78 | ||
References | 79 | ||
References | 80.e1 | ||
5 Endoscopic approaches to the breast | 81 | ||
Introduction | 81 | ||
The optical cavity | 81 | ||
Support systems | 82 | ||
Illumination and imaging | 82 | ||
History | 82.e1 | ||
Use of the surgical endoscope in cosmetic breast surgery | 82.e1 | ||
Use of the surgical endoscope in reconstructive breast surgery | 82.e1 | ||
Endoscopic augmentation mammaplasty | 83 | ||
Basic science/disease process | 83 | ||
Diagnosis/patient presentation | 83 | ||
Patient selection | 83 | ||
Treatment/surgical technique | 84 | ||
Postoperative care | 87 | ||
Outcomes, prognosis, and complications | 87 | ||
Endoscopic breast reconstruction | 88 | ||
Basic science/disease process | 88 | ||
Diagnosis/patient presentation | 88 | ||
Patient selection | 89 | ||
Treatment/surgical technique | 89 | ||
Postoperative care | 93 | ||
Outcomes, prognosis, and complications | 93 | ||
References | 96 | ||
6 Iatrogenic disorders following breast surgery | 97 | ||
Introduction | 97 | ||
Injection materials | 97 | ||
Paraffin (1899–1914) | 97 | ||
Liquid silicone injections (1944–1991) | 98 | ||
Polyacrylamide hydrogel (1988–2010) | 100 | ||
Breast implants | 101 | ||
The sponges (1951–1962, the early years) | 101 | ||
Silicone gel implants | 102 | ||
Implant disruption: silicone gel implants | 103 | ||
Hematoma | 104 | ||
Infection | 105 | ||
Capsular contracture | 106 | ||
Closed capsulotomy | 107 | ||
Capsular calcification: silicone gel implants | 107 | ||
Calcified capsules with saline implants | 110 | ||
Steroid atrophy | 110 | ||
Complications specific to saline implants | 110 | ||
Deflation | 110 | ||
Ripples and folds | 111 | ||
Autoinflation | 111 | ||
Implant malposition | 112 | ||
Plane of insertion | 112 | ||
Inadequate muscle release | 113 | ||
Submusculofascial plane | 114 | ||
Transaxillary dissection | 115 | ||
Symmastia | 115 | ||
Double-bubble deformity | 116 | ||
Ptosis of the augmented breast | 116 | ||
Secondary ptosis after pregnancy | 117 | ||
References | 118.e1 | ||
7 Mastopexy | 119 | ||
Introduction | 119 | ||
Basic science/disease process | 120 | ||
History | 120.e1 | ||
Diagnosis and patient presentation | 124 | ||
Patient evaluation | 124 | ||
Patient selection | 125 | ||
Treatment/surgical technique | 125 | ||
Periareolar techniques | 126 | ||
Concentric mastopexy without parenchymal reshaping | 126 | ||
Periareolar Benelli mastopexy | 127 | ||
Technique | 128 | ||
Góes periareolar technique with mesh support | 132 | ||
Technique | 132 | ||
Vertical/short scar techniques | 133 | ||
Lassus vertical scar technique | 134 | ||
Lejour vertical scar technique | 135 | ||
Grotting sculpted vertical pillar mastopexy | 136 | ||
Technique | 138 | ||
Authors’ preferred technique for augmentation mastopexy | 139 | ||
Technique | 142 | ||
Mastopexy post-explantation | 143 | ||
Technique | 145 | ||
Inverted-T technique | 146 | ||
Technique | 146 | ||
Postoperative care | 147 | ||
Outcomes, prognosis, complications | 148 | ||
Nipple loss | 148 | ||
Scars | 149 | ||
Flap necrosis | 149 | ||
Nipple malposition | 149 | ||
Cosmetic disappointments | 149 | ||
Other complications | 150 | ||
Secondary procedures | 150 | ||
References | 150 | ||
References | 151.e1 | ||
8.1 Reduction mammaplasty | 152 | ||
Introduction | 152 | ||
History | 153 | ||
Basic science | 161 | ||
Mammary hypertrophy | 161 | ||
Diagnosis/patient presentation | 162 | ||
Patient evaluation | 162 | ||
References | 164 | ||
References | 164.e1 | ||
8.2 Inferior pedicle breast reduction | 165 | ||
Evolution of the technique | 165 | ||
Patient selection | 166 | ||
Details of planning and marking | 166 | ||
Details of planning | 166 | ||
Creating an equilateral triangle | 166 | ||
Marking of the transverse incisions at the base of the triangle | 167 | ||
Marking of the inframammary fold | 167 | ||
Assessing symmetry of markings | 168 | ||
Visualizing or examining the asymmetric patient | 168 | ||
Detailed description of technical procedure | 168 | ||
Case examples | 172 | ||
Complications and how to handle them | 175 | ||
Summary | 175 | ||
References | 175 | ||
References | 176.e1 | ||
8.3 Superior or medial pedicle | 177 | ||
Evolution of the technique | 177 | ||
Patient selection | 180 | ||
Symptoms | 180 | ||
Patient characteristics | 180 | ||
Details of planning and marking | 181 | ||
General perioperative care | 181 | ||
Skin marking | 181 | ||
Detailed description of the technical procedure | 182 | ||
Anesthesia and positioning | 182 | ||
Selection of the pedicle | 182 | ||
Infiltration | 182 | ||
Deepithelialization | 184 | ||
Surgical excision | 184 | ||
Liposuction | 185 | ||
Breast shaping | 186 | ||
Wound closure | 187 | ||
Dressings and wound care | 188 | ||
General postoperative instructions and follow-up | 188 | ||
Examples of superior and medial pedicle breast reductions | 188 | ||
Superior pedicle breast reduction | 188 | ||
Medial pedicle breast reduction | 189 | ||
Complications and how to handle them | 189 | ||
Healing of the vertical scar | 190 | ||
Wound dehiscence | 191 | ||
Under-resection | 192 | ||
Summary | 192 | ||
References | 193.e1 | ||
8.4 Short scar periareolar inferior pedicle reduction (SPAIR) mammaplasty | 194 | ||
Evolution of technique | 194 | ||
Patient selection | 195 | ||
Surgical planning and marking | 196 | ||
Technique | 196 | ||
Results | 201 | ||
Complications | 203 | ||
Fat necrosis | 203 | ||
Shape distortion | 204 | ||
Areolar spreading | 204 | ||
PTFE infection/exposure | 204 | ||
Recurrence of hypertrophy | 204 | ||
Summary | 205 | ||
References | 205.e1 | ||
8.5 The L short-scar mammaplasty | 206 | ||
Evolution of the technique and patient selection | 206 | ||
Planning and marking | 207 | ||
Technical procedure | 207 | ||
Examples of large, medium, and small reductions | 210 | ||
Complications | 213 | ||
Summary | 214 | ||
References | 215 | ||
8.6 Periareolar technique with mesh support | 216 | ||
Evolution of the technique | 216 | ||
Patient selection | 217 | ||
Technique | 217 | ||
Marking | 217 | ||
Surgical technique | 218 | ||
Mesh application | 219 | ||
Complications | 226 | ||
Summary | 226 | ||
References | 226 | ||
References | 227.e1 | ||
8.7 Sculpted pillar vertical reduction mammaplasty | 228 | ||
Evolution of technique | 228 | ||
Patient selection | 228 | ||
Planning and markings | 229 | ||
Technique | 229 | ||
Closure | 231 | ||
Patient examples: small, medium, and large reductions | 235 | ||
Case 1: small breast reduction | 235 | ||
Case 2: moderate breast reduction | 236 | ||
Case 3: large breast reduction | 236 | ||
Complications | 236 | ||
Summary | 239 | ||
References | 241 | ||
9 Revision surgery following breast reduction and mastopexy | 242 | ||
Introduction | 242 | ||
Patient history | 242 | ||
Preoperative patient evaluation | 244 | ||
Diagnosis/patient presentation | 244 | ||
Basic science | 244 | ||
Postoperative management | 244 | ||
Outcomes/prognosis/complications | 245 | ||
Surgical re-intervention for acute problems | 245 | ||
Hematoma | 245 | ||
Skin flap necrosis | 246 | ||
Postoperative care | 246 | ||
Wound excision and re-closure | 246 | ||
Contour abnormalities at the end of incisions | 247 | ||
Nipple areola ischemia | 247 | ||
Areola deformities | 248 | ||
Areola hypopigmentation | 249 | ||
Fat necrosis | 251 | ||
Asymmetry(ies) | 251 | ||
Nipple retraction | 252 | ||
Nipple malposition | 252 | ||
Nipple loss | 253 | ||
Re-do breast reduction | 254 | ||
Revision of mastopexy | 254 | ||
Revision mastopexy | 262 | ||
II Reconstructive Surgery of the Breast | 266 | ||
10 Breast cancer: | 266 | ||
Introduction | 266 | ||
Basic science | 266 | ||
History | 266.e1 | ||
Diagnosis | 267 | ||
Clinical breast examination | 267 | ||
Diagnostic imaging modalities | 268 | ||
Mammography | 268 | ||
Ultrasonography | 268 | ||
Magnetic resonance imaging | 268 | ||
Diagnostic imaging in patients with breast implants | 270 | ||
Histologic diagnostic modalities | 271 | ||
Image-guided core biopsy | 271 | ||
Fine-needle aspiration | 272 | ||
Core needle biopsy | 272 | ||
Excisional biopsy | 273 | ||
Patient selection | 273 | ||
Treatment/surgical technique | 274 | ||
Breast conserving surgery | 274 | ||
Technique | 276 | ||
Oncoplastic surgery | 277 | ||
Mastectomy: terminology and techniques | 280 | ||
Total mastectomy | 281 | ||
Skin-sparing mastectomy | 282 | ||
Nipple sparing mastectomy | 282 | ||
Prophylactic mastectomy | 284 | ||
Modified radical mastectomy | 285 | ||
Nodal evaluation | 286 | ||
Outcomes, prognosis, complications | 286 | ||
Breast reconstruction after mastectomy | 287 | ||
Immediate reconstruction | 287 | ||
Delayed reconstruction | 291 | ||
Secondary procedures | 292 | ||
References | 294 | ||
References | 295.e1 | ||
11 The oncoplastic approach to partial breast reconstruction | 296 | ||
Introduction | 296 | ||
Disease process | 296 | ||
The history behind partial breast reconstruction | 296.e1 | ||
Patient presentation and selection | 297 | ||
Timing of partial breast reconstruction | 297 | ||
Management of margins | 298 | ||
Surgical planning | 301 | ||
Oncoplastic resection | 301 | ||
Treatment algorithm for partial reconstruction | 301 | ||
Volume displacement techniques | 302 | ||
Volume replacement techniques | 306 | ||
Oncologic safety | 310 | ||
Postoperative care | 310 | ||
Outcomes and secondary procedures | 310 | ||
Conclusion | 312 | ||
References | 312 | ||
References | 313.e1 | ||
12 Patient-centered health communication | 314 | ||
Healthcare decisions | 314 | ||
Unwarranted variation in medical practice | 315 | ||
Categories of variation and preference-sensitive decisions | 315 | ||
Variation in surgical decisions | 315 | ||
What about evidence? | 316 | ||
Risk communication | 317 | ||
Risk language | 317 | ||
Absolute versus relative risk | 318 | ||
Better data presentation | 319 | ||
Visual aids | 319 | ||
Balanced framing | 319 | ||
Teach-back method | 320 | ||
Creating a high quality decision | 320 | ||
Decision aids that are evidence-based | 321 | ||
Shared decision-making | 321 | ||
A shared decision-making process | 321 | ||
Decision quality reports | 322 | ||
The value proposition for shared decision-making | 323 | ||
Patients’ perception of SDM | 323 | ||
Surgeons’ acceptance of shared decision-making | 323 | ||
Looking forward: informed consent versus informed choice | 324 | ||
Summary | 324 | ||
References | 324 | ||
References | 325.e1 | ||
13 Imaging in reconstructive breast surgery | 326 | ||
Introduction | 326 | ||
Defining the ideal perforator vessel | 327 | ||
History | 326.e1 | ||
Conventional preoperative mapping methods in perforator flaps | 327 | ||
Hand-held Doppler ultrasound | 327 | ||
Color Doppler imaging | 328 | ||
Imaging techniques in breast reconstruction | 328 | ||
Radiological protocol of the acquisition sequence | 329 | ||
MDCT | 329 | ||
Noncontrast MRI | 329 | ||
How to select the most suitable perforator | 330 | ||
Conclusion | 331 | ||
References | 335.e1 | ||
14 Expander-implants breast reconstructions | 336 | ||
Introduction | 336 | ||
History | 336.e1 | ||
Development of breast implants | 336.e1 | ||
The controversy regarding silicone implants | 336.e1 | ||
Basic science | 336 | ||
Breast reconstruction with tissue expansion and permanent implants | 338 | ||
Reconstructive paradigms and surgical strategy | 340 | ||
Diagnosis and patient presentation | 344 | ||
Exclusion criteria | 345 | ||
Inclusion criteria according to dimensional considerations | 346 | ||
Patients with small breasts | 346 | ||
Patients with medium-sizes breasts | 346 | ||
Patients with large breasts | 346 | ||
Surgical technique | 346 | ||
The comprehensive preoperative project | 346 | ||
Evolution of prosthetic implants | 352 | ||
Shape (Fig. 14.15) | 352 | ||
Shell (Fig. 14.16) | 352 | ||
Filler materials (Fig. 14.17) | 352 | ||
Dimensions | 352 | ||
A good reconstruction always starts with a good mastectomy (Figs 14.18, 14.19) | 353 | ||
Immediate breast reconstruction after mastectomy (first stage) | 353 | ||
Surgical steps for insertion of expander | 353 | ||
Skin reducing mastectomy | 354 | ||
Immediate breast reconstruction in one stage for large and ptotic glands | 354 | ||
Second stage of immediate two stage reconstructions | 356 | ||
Surgical steps for prosthesis insertion | 356 | ||
Contralateral adjustment | 356 | ||
Patients with small breasts | 356 | ||
Patients with medium size breasts | 357 | ||
Patients with large breasts | 358 | ||
Delayed reconstruction | 358 | ||
Postoperative care | 358 | ||
Outcomes and complications | 359 | ||
Hematoma | 359 | ||
Erythema and cellulitis | 359 | ||
Persistent serous drainage through suction catheter | 359 | ||
Partial or complete skin necrosis | 360 | ||
Expander failure or malfunction | 360 | ||
Infection | 361 | ||
Outcomes of breast reconstruction with implants | 363 | ||
Experience of the authors | 365 | ||
Secondary procedures | 365 | ||
Revision for cosmetic purposes | 365 | ||
Fat injection | 365 | ||
Nipple reconstruction | 365 | ||
Other reconstructive techniques involving implants and/or tissue expansions | 366 | ||
Adjustable, permanent expander-implant (Fig. 14.41) | 366 | ||
Expander-implant use in association with flaps | 367 | ||
Breast envelope preservation for staged flap reconstruction | 367 | ||
Developments | 368 | ||
References | 369 | ||
References | 369.e1 | ||
15 Latissimus dorsi flap breast reconstruction | 370 | ||
Introduction | 370 | ||
Anatomy | 370 | ||
Patient presentation | 372 | ||
Patient selection/indications | 372 | ||
History | 370.e1 | ||
Specific indications | 374 | ||
Patients who are not candidates for a TRAM flap | 374 | ||
Previous irradiation during breast conservative therapy | 376 | ||
Partial mastectomy defects | 380 | ||
Excessively thin or unreliable skin flaps over an implant | 380 | ||
After a previous mastopexy or reduction | 380 | ||
Augmented breasts | 380 | ||
Large ptotic breasts | 380 | ||
Prophylactic mastectomy | 381 | ||
Contraindications | 381 | ||
Techniques | 381 | ||
Main surgical variants | 387 | ||
Secondary procedures | 389 | ||
Exchange of expander to implant | 389 | ||
Secondary thoracodorsal nerve ligation | 389 | ||
Postoperative care | 389 | ||
Outcomes and complications | 389 | ||
Flap necrosis | 390 | ||
Donor site morbidity | 390 | ||
Conclusion | 390 | ||
Financial disclosure | 390 | ||
References | 391 | ||
References | 392.e1 | ||
16 The bilateral pedicled TRAM flap | 393 | ||
Introduction | 393 | ||
Basic science/anatomy | 394 | ||
Patient selection | 395 | ||
History | 393.e1 | ||
Treatment/surgical technique | 396 | ||
Preoperative considerations | 396 | ||
Operative procedure | 396 | ||
Shaping of the TRAM flap breast reconstruction | 405 | ||
Postoperative care | 406 | ||
Outcomes, prognosis, complications | 407 | ||
Secondary procedures | 410 | ||
References | 410 | ||
References | 410.e1 | ||
17 Free TRAM breast reconstruction | 411 | ||
Introduction | 411 | ||
History | 411.e1 | ||
Basic science/disease process | 411 | ||
Anatomy and physiology | 412 | ||
Diagnosis/patient presentation | 414 | ||
Timing: delayed versus immediate reconstruction | 414 | ||
The pedicled versus free TRAM | 414 | ||
Radiation therapy | 415 | ||
Patient selection | 416 | ||
Risk factors | 416 | ||
Procedure selection | 417 | ||
Treatment/surgical technique | 418 | ||
Mastectomy planning | 419 | ||
Flap dissection | 419 | ||
Recipient vessel | 422 | ||
Flap insetting | 426 | ||
Abdominal closure | 426 | ||
Postoperative care | 428 | ||
Complications | 430 | ||
Revision | 430 | ||
Conclusion | 432 | ||
References | 433 | ||
References | 434.e1 | ||
18 The deep inferior epigastric artery perforator (DIEAP) flap | 435 | ||
Introduction | 435 | ||
History | 435.e1 | ||
Basic science: anatomy | 436 | ||
The deep inferior epigastric artery perforator (DIEAP) flap | 436 | ||
Recipient vessels | 439 | ||
Diagnosis/patient presentation | 439 | ||
Ultrasound evaluation of perforator vessels | 440 | ||
CT imaging | 440 | ||
Patient selection | 440 | ||
Surgical technique | 442 | ||
Preoperative marking | 442 | ||
Operative procedure | 443 | ||
Suprafascial dissection | 443 | ||
Intramuscular dissection | 446 | ||
Submuscular dissection | 446 | ||
Closure of the donor site and fashioning of the umbilicus | 447 | ||
Shaping of the DIEAP flap in secondary autologous breast reconstruction | 447 | ||
The breast footprint | 447 | ||
The breast conus | 449 | ||
The breast envelope | 451 | ||
Postoperative care | 451 | ||
Outcomes, prognosis, and complications | 452 | ||
Secondary procedures | 453 | ||
References | 455 | ||
References | 456.e1 | ||
19 Alternative flaps for breast reconstruction | 457 | ||
Introduction | 457 | ||
History | 457.e1 | ||
Transverse upper gracilis free flap (TUG) | 457.e1 | ||
Superior/inferior gluteal artery perforator free flap (SGAP/IGAP) | 457.e1 | ||
Basic science/disease process | 458 | ||
Diagnosis/patient presentation | 458 | ||
Transverse upper gracilis free flap (TUG) | 458 | ||
Patient selection | 458 | ||
Anatomy | 458 | ||
Treatment/surgical technique | 459 | ||
Complications | 459 | ||
Superior/inferior gluteal artery perforator free flap (SGAP/IGAP) | 459 | ||
Patient selection | 460 | ||
Anatomy | 461 | ||
Surgical technique | 463 | ||
Postoperative care | 464 | ||
Complications | 464 | ||
The deep femoral artery perforator flap (DFAP) | 464 | ||
Lumbar artery perforator flap (LAP) | 467 | ||
Secondary procedures | 470 | ||
References | 471 | ||
References | 471.e1 | ||
20 Omentum reconstruction of the breast | 472 | ||
Introduction | 472 | ||
Basic science/disease process | 472 | ||
Patient selection | 473 | ||
History | 472.e1 | ||
Treatment/surgical technique | 473 | ||
Laparoscopic harvesting of the omental flap | 473 | ||
Omentum reconstruction | 473 | ||
Omentum reconstruction and implant | 474 | ||
Use of implants, pectoralis major muscle, mixed-mesh, and omental flap | 474 | ||
Complementing with lipofilling | 476 | ||
Bilateral reconstruction | 476 | ||
Closing the epigastric region | 477 | ||
Symmetry and reconstruction of the nipple-areola complex | 480 | ||
Symmetry | 480 | ||
Reconstruction of the nipple-areola complex | 480 | ||
Postoperative care | 480 | ||
Outcomes, prognosis, and complications | 480 | ||
Secondary procedures | 481 | ||
References | 481 | ||
References | 481.e1 | ||
21 Local flaps in partial breast reconstruction | 482 | ||
Introduction | 482 | ||
Basic science | 482 | ||
History | 482.e1 | ||
Diagnosis/patient presentation | 483 | ||
Patient selection | 483 | ||
Type of reconstruction | 483 | ||
Timing of reconstruction | 484 | ||
Treatment/surgical technique | 485 | ||
Classification and vascular anatomy of flaps | 485 | ||
The TDAP flap | 486 | ||
The ICAP flap | 487 | ||
The SAAP flap | 488 | ||
The SEAP flap | 489 | ||
Indications for pedicled flaps | 489 | ||
Contraindications to pedicled flaps | 489 | ||
Flap design | 489 | ||
Flap choice | 489 | ||
Preoperative perforator mapping | 489 | ||
Markings | 492 | ||
Surgical technique | 493 | ||
Postoperative care | 493 | ||
Outcomes, prognosis, and complications | 495 | ||
Secondary procedures | 495 | ||
References | 498 | ||
References | 498.e1 | ||
22 Reconstruction of the nipple-areola complex | 499 | ||
Introduction | 499 | ||
Diagnosis and patient presentation | 499 | ||
Patient selection | 500 | ||
History | 499.e1 | ||
Surgical techniques | 500 | ||
Composite nipple graft | 500 | ||
Traditional flaps | 502 | ||
Skate flap | 502 | ||
Star flap | 504 | ||
C–V flap | 506 | ||
Arrow flap | 507 | ||
Pull-out/purse-string flap techniques | 507 | ||
Bell flap | 508 | ||
Double opposing peri-areolar/purse-string flap | 508 | ||
Top-hat flap | 510 | ||
Flap designs adjacent to scars | 511 | ||
S-flap | 511 | ||
Double-opposing tab flap | 512 | ||
Spiral flap | 513 | ||
Flaps with autologous graft augmentation | 514 | ||
Cartilage grafts | 514 | ||
Fat grafts | 514 | ||
Flaps with alloplastic augmentation | 515 | ||
Flaps with allograft augmentation | 515 | ||
Areola reconstruction | 516 | ||
Postoperative care | 518 | ||
Outcomes and satisfaction | 519 | ||
Complications | 519 | ||
Secondary and revisional reconstruction | 519 | ||
References | 520 | ||
References | 520.e1 | ||
23.1 Congenital anomalies of the breast | 521 | ||
Introduction | 521 | ||
Basic science/disease process | 522 | ||
Diagnosis/patient presentation | 522 | ||
Examination of the patient | 526 | ||
Classification of the different types of tuberous breast deformity | 526 | ||
Type I: tuberous breast | 526 | ||
Type II: tuberous breast | 526 | ||
Type III: tuberous breast | 529 | ||
Treatment/surgical technique | 529 | ||
General considerations | 529 | ||
Surgical technique | 529 | ||
Glandular correction flaps | 529 | ||
Glandular flap type I | 530 | ||
Glandular flap type II | 530 | ||
Glandular flap type III | 530 | ||
Glandular flap type IV | 530 | ||
Clinical examples | 531 | ||
Case I | 531 | ||
Index | i1 | ||
A | i1 | ||
B | i11 | ||
C | i30 | ||
D | i51 | ||
E | i53 | ||
F | i59 | ||
G | i79 | ||
H | i82 | ||
I | i95 | ||
J | i99 | ||
K | i99 | ||
L | i100 | ||
M | i108 | ||
N | i120 | ||
O | i131 | ||
P | i136 | ||
Q | i149 | ||
R | i149 | ||
S | i158 | ||
T | i172 | ||
U | i187 | ||
V | i195 | ||
W | i199 | ||
X | i202 | ||
Y | i203 | ||
Z | i203 | ||
Online Index | e1 | ||
A | e1 | ||
B | e2 | ||
C | e11 | ||
D | e12 | ||
E | e12 | ||
F | e12 | ||
G | e14 | ||
H | e15 | ||
I | e15 | ||
J | e16 | ||
K | e16 | ||
L | e16 | ||
M | e17 | ||
N | e19 | ||
O | e20 | ||
P | e20 | ||
R | e21 | ||
S | e23 | ||
T | e24 | ||
U | e25 | ||
V | e25 | ||
W | e26 | ||
Z | e26 |