Trigos MI

Language: Spanish
References: 22
Page: 74-80
PDF size: 149.50 Kb.

ABSTRACT

In the last 25 years, breast reconstruction has evolved in search of better and more permanent results. The process allows us to know the advantages and disadvantages of the different techniques accepted world wide. A new option is presented, using two well-known techniques, but applied in a different way to avoid some disadvantages of several techniques and the benefits of others. The technique proposed consists of inserting a tissue expander in submuscular position in the first stage and a delay procedure in the inferior pedicle of the contralateral rectus abdominis muscle. Once the expansion is obtained, in the second stage, a delayed TRAM flap is elevated, deepithelialiced and placed in the previously expanded area. In the same stage, the contralateral mamma is handled as needed and the nipple-areola complex reconstruction is done to finish the reconstructive procedure. Illustrative cases are presented and a discussion of different options are outlined. We conclude that this reconstructive sequence is a useful method for breast reconstruction.

REFERENCES

1. Radovan C. Breast reconstruction after mastectomy using temporary expander. Plast Reconstr Surg 1982; 69: 195-206.

2. Argenta LC. Reconstruction of the breast by tissue expansion. Clin Plast Surg 1984; 11: 257-263.

3. Robbins TH. Rectus abdominis myocutaneous flap in breast reconstruction. Aus N Z J Surg 1979; 49: 527-530.

4. Cohen BE, Cronin ED. Breast reconstruction with latissimus dorsi musculo cutaneous flap. Clin Plast Surg 1984; 11: 287-292.

5. Santamaría E y cols. Reconstrucción mamaria con colgajo TRAM libre. ¿Se justifica el riesgo? Cir Plast 2001;11:49-60.

6. Shaw WW. Superior gluteal free flap breast reconstruction. Clin Plast Surg 1998; 25: 267-274.

7. Boustred M, Nahai F. Inferior gluteal free flap breast reconstruction. Clin Plast Surg 1998; 25: 275-282.

8. Elliot MF, Hartrampf CR. The Rubens flap: the deep circunflex iliac artery flap. Clin Plast Surg 1998; 25: 283-292.

9. Trigos MI, Moya LA. Reconstrucción mamaria, indicaciones y técnicas en 163 casos. Cir Plast Iberolatinoam 1985; 11: 11-24.

10. Trigos MI, Hellow S. Detalles refinamientos y discrepancias en reconstrucción mamaria. Cir Plast Iberolatinoam 1992; 2: 197-208.

11. Trigos MI, Herrán FS. La mama contralateral como otro factor determinante de la reconstrucción mamaria. Cir Plast 2002; 12: 119-127.

12. Codner MA, Boswick J, Nahai F, et al. TRAM flap vascular delay for high risk breast reconstruction. Plast Reconstr Surg 1995; 96: 1615.

13. Codner MA, Bostwick J. The delayed TRAM flap. Clin Plast Surg 1998; 25: 183-189.

14. Papp C, Mac Craw JB. Autogenous latissimus breast reconstruction. Clin Plast Surg 1998; 25: 261-266.

15. Trigos MI, Santamaría E. Uso en Cirugía Plástica de la bioprótesis de pericardio bovino tratado con gluteraldehído. Cir y Cir 1994; 61: 85-92.

16. Halsted WS. The results of operation for the cure of cancer of the breast performed at the John Hopkins Hospital from june 1889 to january 1894. John Hopkins Hosp Rep 1894; 4: 297-350.

17. Patey DH, Dyson WH. The prognosis of carcinoma of the breast in relation to type of operation performance. Brt J Cancer 1948; 2: 7-13.

18. Mizuno H, Ito Y, Arai K. A breast reconstruction using a deepithelized transverse rectus abdominis myocutaneous flap with a tissue expander. Jpn J Plast Surg 1994; 37: 437-442.

19. Ken-ichiro K, et al. Breast Reconstruction using a deepithelized rectus abdominis musculocutaneous flap. Ann Plast Surg 2001; 46: 103-107.

20. Kroll SS. Bilateral breast reconstruction. Clin Plast Surg 1998; 25: 251-261.

21. Yamamoto Y, Nohira K, Sugihara T, et al. Superiority of microvascularity augmented flap: Analysis of 50 TRAM flaps for breast reconstruction. Plast Reconstr Surg 1996; 97: 79-83.

22. Ryan JJ. A lower thoracic advancement flap in breast reconstruction after mastectomy. Plast Reconstr Surg 1982; 70: 153-160.