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ISSN 1405-0625 (Print)

2011, Number 2

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Cir Plast 2011; 21 (2)

Modern mammary reconstruction with expansion and autologous tissues

Trigos MI, Herrán MFS

Language: Spanish
References: 30
Page: 102-110
PDF size: 169.11 Kb.


ABSTRACT

In the last 40 years breast reconstruction has improved tremendously. Nowadays very satisfactory reconstruction with new paradigms is done, utilizing the same material for volume in both breast sides to guarantee good symmetry and long term evolution. Autologous tissue has proven to be the best option. Today we seek to avoid the use of skin that adds extra scars and leaves skin patches with a different color and texture. Bearing this in mind, modern objectives in mammary reconstruction are to obtain bilateral breasts with the same filling, volume and texture in both sides, avoiding extra scars and skin patches visible in the reconstructed area. These new objectives are obtained satisfactorily by combining tissue expansion with the later use of the same filling in both breasts particularly with autologous deepithelized tissues, if they are pedicled flaps, or free flaps or with lipoaspirated fat transfer. The purpose of this article is to present the different options in breast reconstruction available at present that allow us to obtain the new reconstructive objectives mentioned. To obtain the desired objectives, we can use different types of tissue expansion, be it with traditional mammary tissue expanders, or with vacuum negative pressure. To achieve the volume required for the mammary filling, we should use deepithelized autologous tissues provided by deepithelized TRAM flaps, free revascularized flaps or fat transfer techniques injected in pre expanded areas with negative pressure.


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