By Stephen S. Kroll
Discussing the most up-tp-date and pioneering suggestions in breast reconstruction with out using implants, THE ARTISTRY OF BREAST RECONSTRUCTION WITH AUTOLOGOUS TISSE is the quantity each breast health practitioner has been looking ahead to. Focusing not just on how one can reconstruct breasts following mastectomy but additionally on tips on how to in attaining the top measure of aesthetic luck attainable, this quantity describes intimately Dr. Kroll's strategies in utilizing autologous tissue. Over 500 photos and customized illustrations display and evaluate different thoughts utilized in breast reconstruction with autologous tissue comparable to traditional (pedicled) TRAM flaps, unfastened TRAM flaps, the prolonged latissimus dorsi myocutaneous flap, the Rubens fats pad unfastened flap, between others. additionally contain are chapters on rapid and behind schedule reconstructions, shaping the breast mound, nipple and areolar reconstruction and selection of procedure, follow-up and sufferer choice. Dr. Kroll's method of reconstructive breast surgical procedure both encompasses paintings and technological know-how and either are totally represented during this quantity.
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Additional info for Breast Reconstruction with Autologous Tissue Art and Artistry
All scar tissue must be released so that whatever original breast skin is present can expand into its original position, making the defect apparent. Missing skin must then be replaced, along with the missing breast volume. This is most easily done with a TRAM flap, although other flaps can be used successfully. We prefer to use free flaps with the subscapular vascular system, especially the thoracodorsal vessels, as recipients; but the internal mammary vessels can be used as well and are preferred by some surgeons.
Moreover, a long pedicle facilitates positioning of the flap during the anastomoses so that the flap is not in the surgeon’s way. For this reason, I prefer a long pedicle even when using the internal mammary vessels (which otherwise do not require a long pedicle) as recipients. Having Adequate Assistance Although it is possible to perform a free flap procedure without assistance, free flaps are much easier to do with adequate help. A well-trained assistant can make the anastomoses much easier, and can perform parts of the operation independently, greatly speeding up the procedure and increasing the chances of success.
Unsuitable recipient vessels are more likely to be encountered in delayed reconstruction, when the previous surgery has caused scarring or vessel damage in the axilla. Before planning a free TRAM (or other) flap using the thoracodorsal vessels as recipients, the surgeon should check the patient for latissimus dorsi muscle function on the side of the mastectomy. If the latissimus dorsi muscle is functioning, the thoracodorsal artery and vein, which lie directly adjacent to the thoracodorsal nerve, are usually intact and patent.