Plastic Surgery Essentials for Students-Chapter 12: Breast Reconstruction

Chapter 12: Breast Reconstruction

Pdf Summary

The document outlines critical aspects of breast anatomy and its relevance in surgical procedures like breast reconstruction, reduction, and mastopexy. The anatomy section details the composition of breast tissue, including the glandular and adipose structures, which are supported by fascia and ligaments like Cooper’s, playing a vital role in breast positioning and potential ptosis. Surgical definitions are provided, such as the boundaries for mastectomy and the aesthetic considerations for the nipple-areola complex (NAC).<br /><br />The vascular section discusses the primary blood suppliers to the breast and venous drainage, which are considerable for surgical interventions to avoid ischemic complications. Lymphatic pathways are highlighted for their importance in cancer-related surgeries, noting predominant axillary drainage. The nerve supply section explains the sensory pathways that inform positioning and sensation preservation in reconstructive procedures.<br /><br />Breast reconstruction is addressed, emphasizing its priority for women undergoing mastectomy, with timing classified into immediate, delayed-immediate, or delayed reconstruction. Numerous reconstruction techniques are available, such as implant-based methods or autologous tissue reconstructions like TRAM or DIEP flaps. The document notes the importance of considering patient preferences, potential irradiation impacts, and the need for symmetry in reconstruction efforts.<br /><br />Finally, it delves into the methods for reconstructing the NAC, such as using local skin flaps or skin grafts and tattooing to restore aesthetics, and touches on fat grafting as a complementary technique to enhance reconstructed breast volume and shape. The comprehensive layout is directed at equipping surgeons with the ability to choose appropriate methods based on anatomical, aesthetic, and clinical needs.

Keywords

breast anatomy

surgical procedures

breast reconstruction

mastopexy

vascular supply

lymphatic pathways

nerve supply

reconstruction techniques

nipple-areola complex

fat grafting