244 results match your criteria Breast Reconstruction Other Free Flaps


Anatomical Considerations to Optimize Sensory Recovery in Breast Neurotization with Allograft.

Plast Reconstr Surg Glob Open 2018 Nov 7;6(11):e1985. Epub 2018 Nov 7.

Plastic and Reconstructive Surgery, University of Ljubljana, Ljubljana, Slovenia, EU.

Background: Breast numbness is a recognized problem following mastectomy and subsequent reconstruction. Contemporary literature acknowledges the positive role of breast neurotization, but it is characterized by a variety of technical approaches and substantial heterogeneity with respect to the degree of recovered sensibility that remains suboptimal in comparison with other sensory nerve reconstructions. This study's purpose was to provide an anatomical basis for observed inconsistencies and therein provide a principle that can be used to develop a technical approach that will optimize sensory recovery. Read More

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http://dx.doi.org/10.1097/GOX.0000000000001985DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6414125PMC
November 2018
1 Read

Free Tissue Breast Reconstruction.

Semin Plast Surg 2019 Feb 8;33(1):59-66. Epub 2019 Mar 8.

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

Free tissue transfer serves as a modern workhorse for breast reconstruction. Advancements in microsurgical technique have allowed for the development of free flap procedures that produce an aesthetic breast while minimizing donor site morbidity. Here, the authors review the use of different free flap procedures for breast reconstruction with a focus on the preferred and most commonly used flap, the deep inferior epigastric perforator flap. Read More

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http://dx.doi.org/10.1055/s-0039-1677703DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408251PMC
February 2019
1 Read

[Application of dual-pedicle abdominal flap for unilateral breast reconstruction].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Jan;33(1):70-74

Department of Plastic and Reconstructive Surgery, Peking University People's Hospital, Beijing, 100044, P.R.China.

Objective: To explore the effectiveness of dual-pedicle abdominal flap for unilateral breast reconstruction.

Methods: Between March 2014 and March 2018, a clinical data of 19 female patients underwent dual-pedicle abdominal flap reconstruction because of unilateral mastectomy defect was reviewed retrospectively. The median age was 45 years (range, 32-51 years), including 3 immediate breast reconstruction and 16 delayed breast reconstruction, and left side in 7 cases and right side in 12 cases. Read More

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http://www.rrsurg.com/article/10.7507/1002-1892.201807043
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http://dx.doi.org/10.7507/1002-1892.201807043DOI Listing
January 2019
13 Reads

The Impact of Age on Perioperative Complications after Extremity Reconstruction with the Free Gracilis Flap: A Retrospective Cohort Study Involving 153 Patients.

J Reconstr Microsurg 2019 Jan 9. Epub 2019 Jan 9.

Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Center, Eberhard Karls University Tuebingen, Tuebingen, Germany.

Background:  The need for plastic and reconstructive surgery on elderly patients has been on the rise due to an increase in life expectancy in the past decades. Therefore, a study was conducted on young and elderly patients following microsurgical extremity reconstructions with free gracilis muscle flaps with the primary aim to investigate the influence of age and the American Society of Anesthesiologists (ASA) score on the general outcome, as well as surgical and medical complications.

Methods:  A retrospective analysis of 153 patients receiving free gracilis muscle flaps for extremity reconstructions between November 2009 and January 2018 was performed at two partner institutions specialized in microsurgical reconstructions. Read More

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http://dx.doi.org/10.1055/s-0038-1677455DOI Listing
January 2019
6 Reads

Chyle Leak Following Autologous Breast Reconstruction: A Rare Complication of a Deep Inferior Epigastric Artery Perforator Flap.

Ann Plast Surg 2019 Feb;82(2):193-195

Department of Plastic Surgery, University of Kansas Health System, Kansas City, KS.

Background: While complications of deep inferior epigastric artery perforator flaps are known and well documented, a thorough literature review revealed no other reports of a patient developing a chyle leak following the use of the internal mammary vessels for recipient vessels in autologous breast reconstruction.

Case: A 55-year-old woman underwent free autologous breast reconstruction. She developed a chyle leak during the postoperative period. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001639DOI Listing
February 2019
13 Reads

Lateral Breast and Axillary Reconstruction With Pedicled Parascapular Flap.

Eplasty 2018 26;18:e26. Epub 2018 Sep 26.

Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, Ky.

Immediate flap reconstruction following mastectomy in patients who may require adjuvant radiation therapy can be controversial. However, exposure of vital structure or defects too large for primary closure may necessitate immediate utilization of flaps. In this setting, both functional and cosmetic outcomes must be considered. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166232PMC
September 2018

Immediate Unilateral Breast Reconstruction using Abdominally Based Flaps: Analysis of 3,310 Cases.

J Reconstr Microsurg 2019 Jan 29;35(1):74-82. Epub 2018 Jul 29.

Division of Plastic and Reconstructive Surgery, University of Utah, School of Medicine, Salt Lake City, Utah.

Background:  The abdomen is the most common area from which tissue is harvested for autologous breast reconstruction. We sought to examine national data to determine the differences in total hospital charges, length of stay (LOS), and early postoperative complications following pedicled transverse rectus abdominis myocutaneous flap (pTRAM), free TRAM (fTRAM), deep-inferior epigastric perforator (DIEP), and superficial inferior epigastric artery perforator (SIEA) flaps.

Methods:  The 2009-2013 Nationwide Inpatient Sample Database was used to identify patients who underwent a unilateral mastectomy and only one type of abdominally based autologous flap (pTRAM, fTRAM, DIEP, and SIEA) during the same hospital admission. Read More

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http://dx.doi.org/10.1055/s-0038-1667046DOI Listing
January 2019
3 Reads

Medial Arm Flap: An Unexplored Option for Autologous Breast Reconstruction in the Setting of Morbid Obesity.

Ann Plast Surg 2019 Feb;82(2):190-192

Department of Plastic and Reconstructive Surgery, Hospital General Dr. Ruben Leñero, Mexico City, Mexico.

Currently, deep inferior epigastric perforator flap is undoubtedly the first choice for autologous breast reconstruction for most surgeons; however, there are instances where lower abdominal tissue is unavailable for microvascular transfer. In these cases, most surgeons choose gluteal or lower-extremity territories as donor sites.In the setting of morbid obesity, there is an increased risk of flap and donor site complications, as well as increased blood loss, surgical time, and risk of deep venous thrombosis, not to mention a more challenging surgical technique. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001586DOI Listing
February 2019
1 Read

Autologous reconstruction following nipple sparing mastectomy: a comprehensive review of the current literature.

Gland Surg 2018 Jun;7(3):316-324

Division of Plastic and Reconstructive Surgery, Mount Sinai Health System, New York, NY, USA.

As surgical methods continue to evolve and patients become more educated consumers of their medical care, both oncologic breast surgeons and reconstructive plastic surgeons should understand the current options for surgical management of breast cancer. This review evaluates the current autologous breast reconstruction options following nipple sparing mastectomy (NSM). A comprehensive review of the current literature discussing autologous reconstruction after NSM was performed. Read More

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http://dx.doi.org/10.21037/gs.2018.05.03DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006021PMC
June 2018
5 Reads

The Lumbar Artery Perforator Flap in Autologous Breast Reconstruction: Initial Experience with 100 Cases.

Plast Reconstr Surg 2018 07;142(1):1e-8e

Gent, Belgium From the Department of Plastic and Reconstructive Surgery, Gent University Hospital.

Background: The lumbar artery perforator flap is an alternative flap in breast reconstruction for those patients who are not eligible for a deep inferior epigastric artery perforator (DIEAP) flap. Shaping of this flap is easier compared with other flaps because of the quality of the lumbar fat and the gluteal extension.

Methods: Between October of 2010 and June of 2017, a total of 100 lumbar artery perforator free flap breast reconstructions were performed in 72 patients. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004522DOI Listing
July 2018
1 Read

[Gluteal flap harvest for breast reconstruction].

Ann Chir Plast Esthet 2018 Nov 18;63(5-6):498-504. Epub 2018 Jun 18.

Service de chirurgie plastique, hôpital Salengro, CHRU de Lille, 59037 Lille cedex, France. Electronic address:

The lower gluteal flap is an autologous microsurgical breast reconstruction procedure using the soft tissue of the region of the gluteal sulcus. The perineal extension increases the volume of the sample. The pedicle with one artery and two large veins extends up the ischial notch and can reach 8 to 12cm. Read More

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http://dx.doi.org/10.1016/j.anplas.2018.05.003DOI Listing
November 2018
2 Reads

Oncologic Resection and Reconstruction of the Chest Wall: A 19-Year Experience in a Single Center.

Plast Reconstr Surg 2018 08;142(2):536-547

Helsinki, Finland From the Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital.

Background: The aim of this study was to analyze chest wall reconstruction following oncologic resection performed by a single surgeon over a 19-year period.

Methods: A retrospective review was performed for 135 patients who underwent oncologic chest wall resection from 1997 to 2015.

Results: Average patient age was 57. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004597DOI Listing
August 2018
5 Reads

[Establishment and application of three-dimensional model of deep inferior epigastric artery perforator flap based on computed tomography angiography].

Zhonghua Shao Shang Za Zhi 2018 May;34(5):297-302

Department of Burns and Plastic Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China.

To explore the establishment and application of three-dimensional model of deep inferior epigastric artery perforator flap based on computed tomography angiography (CTA). Six patients with breast absence after modified radical mastectomy because of breast cancer, 5 patients with congenital absence of vagina, and 6 patients with Paget's disease of penis and scrotum were hospitalized in our unit from January 2012 to April 2017. The size of wounds after excision of the lesion or that of flaps needed for reconstruction ranged from 17 cm×5 cm to 25 cm×9 cm. Read More

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http://dx.doi.org/10.3760/cma.j.issn.1009-2587.2018.05.010DOI Listing
May 2018
4 Reads

Prospective Evaluation of Obese Patients Undergoing Autologous Abdominal Free Flap Breast Reconstruction.

Plast Reconstr Surg 2018 08;142(2):120e-125e

Houston, Texas From the Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center.

Background: Obesity has been viewed as a relative contraindication against autologous free flap breast reconstruction because of increased risks of complications, including flap loss.

Methods: The authors conducted a prospective analysis of obese patients undergoing autologous breast reconstruction.

Results: Overall, 72 patients (average age, 48. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004550DOI Listing
August 2018
2.990 Impact Factor

The Functional Impact of Breast Reconstruction: An Overview and Update.

Plast Reconstr Surg Glob Open 2018 Mar 6;6(3):e1640. Epub 2018 Mar 6.

Section of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, N.Y.; and Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pa.

As rates of bilateral mastectomy and immediate reconstruction rise, the aesthetic and psychosocial benefits of breast reconstruction are increasingly well understood. However, an understanding of functional outcome and its optimization is still lacking. This endpoint is critical to maximizing postoperative quality of life. Read More

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http://dx.doi.org/10.1097/GOX.0000000000001640DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5908499PMC
March 2018
2 Reads

DIEP Flap Breast Reconstruction Complication Rate in Previously Irradiated Internal Mammary Nodes.

J Reconstr Microsurg 2018 Jul 19;34(6):399-403. Epub 2018 Apr 19.

Department of Plastic and Reconstructive Surgery, Tel-Aviv Sourasky Medical Center, Affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Background:  Postmastectomy radiation therapy (PMRT) is a widely accepted treatment for locally advanced breast cancer. Some patients require additional boost radiation to the internal mammary nodes as the part of regional nodal irradiation (RNI). Delayed breast reconstruction with an autologous free flap using the internal mammary vessels for microvascular flap anastomosis is a common practice for these patients. Read More

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http://dx.doi.org/10.1055/s-0038-1625986DOI Listing
July 2018
4 Reads

How Does Autologous Breast Reconstruction Impact Downtime?

J Reconstr Microsurg 2018 Sep 13;34(7):530-536. Epub 2018 Apr 13.

Department of Plastic and Reconstructive Surgery, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom.

Background:  Although autologous breast reconstruction is technically quite demanding, it offers the best outcomes in terms of durable results, patient perceptions, and postoperative pain. Many studies have focused on clinical outcomes and technical aspects of such procedures, but few have addressed the impact of various flaps on patient recovery times. This particular investigation entailed an assessment of commonly used flaps, examining the periods of time required to resume daily activities. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1641711
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http://dx.doi.org/10.1055/s-0038-1641711DOI Listing
September 2018
5 Reads

Vascularized Lymph Node Transfer for Lymphedema.

Semin Plast Surg 2018 Feb 9;32(1):28-35. Epub 2018 Apr 9.

Department of Plastic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Advances in our understanding of the lymphatic system and the pathogenesis of lymphedema have resulted in the development of effective surgical treatments. Vascularized lymph node transfer (VLNT) involves the microvascular transplantation of functional lymph nodes into an extremity to restore physiological lymphatic function. It is most commonly performed by transferring combined deep inferior epigastric artery perforator and superficial inguinal lymph node flaps for postmastectomy breast reconstruction. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1632401
Publisher Site
http://dx.doi.org/10.1055/s-0038-1632401DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5891655PMC
February 2018
9 Reads

Two-Level Continuous Thoracic Paravertebral Nerve Blocks Providing Opioid-Free Postoperative Analgesia After Latissimus Dorsi Flap Breast Reconstruction: A Case Report.

A A Pract 2018 Sep;11(5):118-120

From the Department of Anesthesiology, University of California San Diego, La Jolla, California.

We present the case of a 55-year-old woman undergoing a delayed latissimus dorsi flap breast reconstruction after a simple mastectomy for breast cancer. Preoperatively, 2 unilateral paravertebral catheters were placed at T3/4 and T7/8 for postoperative analgesia. Postoperatively, ropivacaine 0. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000759DOI Listing
September 2018

Using Mesh to Reinforce the Abdominal Wall in Abdominal Free Flaps for Breast Reconstruction: Is There a Benefit? What are the Risks?

Ann Plast Surg 2018 May;80(5S Suppl 5):S295-S298

From the Department of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA.

Introduction: Abdominal wall integrity may be compromised after abdominal flap harvest for breast reconstruction, leading to bulging or herniation due to weakening of the abdominal wall and dissection through the rectus muscle. Mesh can be used to reinforce the abdominal wall to reduce the risk of hernia formation postoperatively, especially in patients who may be at high risk. In this study, we describe this institution's experience with the use of mesh in the abdominal wall and critically evaluate its impact on patient outcomes and complications. Read More

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http://Insights.ovid.com/crossref?an=00000637-900000000-9743
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http://dx.doi.org/10.1097/SAP.0000000000001468DOI Listing
May 2018
21 Reads

Vulvar field resection based on ontogenetic cancer field theory for surgical treatment of vulvar carcinoma: a single-centre, single-group, prospective trial.

Lancet Oncol 2018 04 9;19(4):537-548. Epub 2018 Mar 9.

Department of Gynecology, Women's and Children's Center, University of Leipzig, Leipzig, Germany.

Background: The incidence of vulvar cancer is increasing, but surgical treatment-the current standard of care-often leads to unsatisfactory outcomes, especially in patients with node-positive disease. Preliminary results at our centre showed that locoregional spread of vulvar carcinoma occurs within tissue domains defined by stepwise embryonic and fetal development (ontogenetic cancer fields and associated lymph node regions). We propose that clinical translation of these insights into practice could improve outcomes of surgical treatment of vulvar cancer. Read More

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http://dx.doi.org/10.1016/S1470-2045(18)30109-8DOI Listing
April 2018
13 Reads

Postoperative outcomes of breast reconstruction after mastectomy: A retrospective study.

Medicine (Baltimore) 2018 Feb;97(5):e9766

Department of Breast Surgery, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.

Breast reconstruction after mastectomy plays an active role in improving the quality-of-life (QoL) and alleviating the psychological trauma of breast cancer patients, and has become an indispensable part of the comprehensive treatment in breast cancer. However, compared with mastectomy alone, breast reconstruction also increase operative complications. The surgical, oncological outcomes, and cosmetic effect of breast reconstruction remains to be evaluated. Read More

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http://dx.doi.org/10.1097/MD.0000000000009766DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805437PMC
February 2018
5 Reads

Safety of Microsurgery Under Loupes Versus Microscope: A Head-to-Head Comparison of 2 Surgeons With Similar Experiences.

Ann Plast Surg 2018 Jun;80(6S Suppl 6):S340-S342

From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Florida, Gainesville, FL; and Beth Israel Deaconess Medical Center, Boston, MA.

Background: Microsurgery is performed using either the operating microscope or loupe magnification. Use of the operating microscope is considered the "criterion standard"; however, loupes are emerging as a safe and reliable technique to perform microsurgery. The purpose of this study was to analyze the safety of microsurgery under loupe magnification compared with the microscope. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001324DOI Listing
June 2018
10 Reads

Topical nitroglycerin for the treatment of intraoperative microsurgical vasospasm.

Microsurgery 2018 Jan 17. Epub 2018 Jan 17.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Background: Papaverine remains a popular agent to treat intraoperative microsurgical vasospasm. However, the recent shortage has forced surgeons to trial antispasmodic agents unproven in microsurgery, but commonly used in other areas. During this shortage we have trialed topical nitroglycerin to break intraoperative vasospasm. Read More

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http://dx.doi.org/10.1002/micr.30294DOI Listing
January 2018
27 Reads

Concordance between preoperative computed tomography angiographic mapping and intraoperative perforator selection for deep inferior epigastric artery perforator flap breast reconstructions.

Gland Surg 2017 Dec;6(6):620-629

Department of Plastic Surgery, Gelre Hospital, Apeldoorn, the Netherlands.

Background: Preoperative imaging for perforator identification prior to a deep inferior epigastric artery perforator (DIEP) flap elevation for breast reconstruction has many advantages. Currently, computed tomography (CT) angiography provides good visualization of the perforators and their course, and is thus the imaging technique of choice. The primary aim of this study was to determine the concordance between the perforators identified preoperatively and the perforators ultimately selected intraoperatively, with a standardized protocol, in a single institution. Read More

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http://dx.doi.org/10.21037/gs.2017.09.13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750307PMC
December 2017
8 Reads

Flap monitoring with continuous oxygen partial tension measurement in breast reconstructive surgery: A preliminary report.

Microsurgery 2018 May 13;38(4):402-406. Epub 2017 Nov 13.

Department of Plastic and Reconstructive Surgery, University of Sassari, Sassari 07100, Italy.

Background: The best method for the postoperative monitoring of flaps in reconstructive surgery is still a matter of debate. The aim of this study is to evaluate the usefulness of an oxygen partial tension monitoring system for the postoperative follow-up of a series of breast flaps, in addition to the traditional periodical clinical evaluations.

Patients And Methods: Twenty-one consecutive female patients (mean age: 61 years) who underwent free- or pedicled-flap reconstruction of the breast were included in the study. Read More

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http://dx.doi.org/10.1002/micr.30256DOI Listing
May 2018
7 Reads

Radiation Therapy Versus No Radiation Therapy to the Neo-breast Following Skin-Sparing Mastectomy and Immediate Autologous Free Flap Reconstruction for Breast Cancer: Patient-Reported and Surgical Outcomes at 1 Year-A Mastectomy Reconstruction Outcomes Consortium (MROC) Substudy.

Int J Radiat Oncol Biol Phys 2017 09 8;99(1):165-172. Epub 2017 May 8.

Department of Radiation Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada.

Purpose: To determine whether adjuvant radiation therapy (RT) is associated with adverse patient-reported outcomes and surgical complications 1 year after skin-sparing mastectomy and immediate autologous free flap reconstruction for breast cancer.

Methods And Materials: We compared 24 domains of patient-reported outcome measures 1 year after autologous reconstruction between patients who received adjuvant RT and those who did not. A total of 125 patients who underwent surgery between 2012 and 2015 at our institution were included from the Mastectomy Reconstruction Outcomes Consortium study database. Read More

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http://dx.doi.org/10.1016/j.ijrobp.2017.05.001DOI Listing
September 2017
13 Reads

101 Consecutive Profunda Artery Perforator Flaps in Breast Reconstruction: Lessons Learned with Our Early Experience.

Plast Reconstr Surg 2017 Aug;140(2):229-239

Dallas, Texas; and Philadelphia, Pa. From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; and the Department of Surgery, Division of Plastic Surgery, Temple University.

Background: Free and local flaps based on the profunda artery perforators were first used for reconstruction of pressure sores, burn contractures, and extremity wounds. Recently, a revised profunda artery perforator flap was introduced for breast reconstruction. However, despite increasing reports of the use of the flap, it remains a rarely used option. Read More

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http://dx.doi.org/10.1097/PRS.0000000000003553DOI Listing
August 2017
10 Reads

Co-surgeons in breast reconstructive microsurgery: What do they bring to the table?

Microsurgery 2018 Jan 11;38(1):14-20. Epub 2017 Jul 11.

Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.

Introduction: Current research within other surgical specialties suggests that a co-surgeon approach may reduce operative times and complications associated with complex bilateral procedures, possibly leading to improved patient and surgical outcomes. We sought to evaluate the role of the co-surgery team and its development in free flap breast reconstruction.

Methods: A retrospective review of free-flap breast reconstruction by two surgeons from 2011 to 2016 was conducted. Read More

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http://dx.doi.org/10.1002/micr.30191DOI Listing
January 2018
5 Reads

Umbilical necrosis rates after abdominal-based microsurgical breast reconstruction.

J Surg Res 2017 07 20;215:257-263. Epub 2017 Apr 20.

Division of Plastic Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. Electronic address:

Background: Umbilical stalk necrosis represents a rare, yet important complication after abdominal-based microsurgical breast reconstruction, which is both underrecognized and understudied in the literature. Once identified, umbilical reconstruction can be an extremely challenging problem.

Methods: All consecutive breast free flaps at a single institution from February 2004 to February 2016 were reviewed, excluding non-abdominal-based flaps. Read More

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http://dx.doi.org/10.1016/j.jss.2017.04.010DOI Listing
July 2017
12 Reads

Impact of adjuvant anti-estrogen therapies (tamoxifen and aromatase inhibitors) on perioperative outcomes of breast reconstruction.

J Plast Reconstr Aesthet Surg 2017 Nov 3;70(11):1495-1504. Epub 2017 Jun 3.

Department of Plastic, Reconstructive, Aesthetic and Maxillo-Facial Surgery, Henri Mondor University Hospital, UPEC, University Paris-Est Créteil, Créteil, France.

Purpose: Hormone (anti-estrogen) therapy (HT) plays a major role in hormone receptor-positive breast cancer management. The latest guidelines propose to extend the duration of adjuvant treatment from 5 to 10 years. The association between HT and thromboembolic or microvascular complications during breast reconstruction has been investigated. Read More

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http://dx.doi.org/10.1016/j.bjps.2017.05.046DOI Listing
November 2017
42 Reads

Studying the blood pressures of antegrade and retrograde internal mammary vessels: Do they really work as recipient vessels?

J Plast Reconstr Aesthet Surg 2017 Oct 22;70(10):1391-1396. Epub 2017 May 22.

Department of Plastic and Reconstructive Surgery, Jichi Medical University, Japan.

Background: The proximal ends of internal mammary (IM) vessels are now the most common recipient vessels for breast reconstruction. On the other hand, bilateral deep inferior epigastric artery perforator (DIEP) flaps are often needed according to the territory and the volume required for reconstruction. The usefulness of retrograde IM vessels as second recipients has recently been reported, but there are very few quantitative studies on the hydrodynamics of the retrograde IM vessels. Read More

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http://dx.doi.org/10.1016/j.bjps.2017.05.024DOI Listing
October 2017
1 Read

Versatility of the Profunda Artery Perforator Flap: Creative Uses in Breast Reconstruction.

Plast Reconstr Surg 2017 Mar;139(3):606e-612e

Dallas, Texas From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.

Background: Flaps based on the profunda artery perforators were first used for reconstruction of pressure sores, burn contractures, and extremity wounds. Recently, a revised profunda artery perforator flap was introduced for breast reconstruction. However, the flap is rarely used despite interesting reports on its use. Read More

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http://dx.doi.org/10.1097/PRS.0000000000003053DOI Listing
March 2017
3 Reads

Postmastectomy radiation therapy and breast reconstruction with autologous tissue.

Breast Cancer 2017 Jul 22;24(4):505-510. Epub 2017 Feb 22.

Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, Japan.

Immediate breast reconstruction is an important tool for patients to accept and overcome their breast cancer, as well as for cosmetic reasons. However, its use in patients who require postmastectomy radiation therapy (PMRT) is not yet clear. The purpose of this study was to analyze the effects of PMRT and reconstruction on each other. Read More

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http://dx.doi.org/10.1007/s12282-017-0760-5DOI Listing
July 2017
2 Reads

National and Regional Differences in 32,248 Postmastectomy Autologous Breast Reconstruction Using the Updated National Inpatient Survey.

Ann Plast Surg 2017 Jun;78(6):717-722

From the *Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; †T. Marciniak Lower Silesian Specialist Hospital, Wroclaw, Poland; ‡Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, LA; §Department of Plastic and Reconstructive Surgery, VU Medical Center, Amsterdam, the Netherlands; and ∥Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Background: The incidence of breast cancer (BC) cases has increased significantly. The number of breast reconstruction (BR) procedures performed has mirrored this trend. Although implant-only procedures remain the most commonly used type of immediate BR, autologous techniques involving donor sites account for approximately 20%. Read More

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http://dx.doi.org/10.1097/SAP.0000000000000963DOI Listing
June 2017
15 Reads
1 Citation
1.460 Impact Factor

Breast Reconstruction in Elderly Patients: Risk Factors, Clinical Outcomes, and Aesthetic Results.

J Reconstr Microsurg 2017 05 6;33(4):257-267. Epub 2017 Jan 6.

Department of Plastic Surgery, "Sapienza" University of Rome, Sant'Andrea Hospital, Roma, Italy.

 Correlation among age, clinical, and aesthetic outcomes in implant-based and autologous breast reconstructions was investigated.  Between 2004 and 2014, a retrospective study was performed on patients who underwent reconstruction following mastectomy. Patients were divided in group A (< 50 years), group B (≥ 50-59 years), group C (≥ 60-69 years), and group D (≥ 70 years). Read More

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http://dx.doi.org/10.1055/s-0036-1597822DOI Listing
May 2017
3 Reads

The laparoscopically harvested omentum as a free flap for autologous breast reconstruction.

Microsurgery 2017 Sep 26;37(6):539-545. Epub 2016 Oct 26.

Plastic Surgery, Máxima Medical Center, Veldhoven/Eindhoven, The Netherlands.

Background: In autologous breast reconstruction, abdominal based flaps are by far the most common choice from the wide range of free flaps available. In selected cases, a laparoscopically harvested omental free flap (LHOFF) can be used. Patient satisfaction has not been reported until now. Read More

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http://dx.doi.org/10.1002/micr.30126DOI Listing
September 2017
7 Reads

Fewer Revisions in Abdominal-based Free Flaps than Latissimus Dorsi Breast Reconstruction after Radiation.

Plast Reconstr Surg Glob Open 2016 Sep 20;4(9):e866. Epub 2016 Sep 20.

Departments of Plastic Surgery and Radiation Oncology, the University of Texas MD Anderson Cancer Center, Houston, Tex.

The most commonly chosen flaps for delayed breast reconstruction after postmastectomy radiation therapy (PMRT) are abdominal-based free flaps (ABFFs) and pedicled latissimus dorsi (LD) musculocutaneous flaps. The short-and long-term advantages and disadvantages of delayed ABFFs versus LD flaps after PMRT remain unclear. We hypothesized that after PMRT, ABFFs would result in fewer postoperative complications and a lower incidence of revision surgery than LD flaps. Read More

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http://dx.doi.org/10.1097/GOX.0000000000000811DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5054997PMC
September 2016
16 Reads

[Correction of thoraco-mammary deformity of Poland syndrome].

Ann Chir Plast Esthet 2016 Oct 24;61(5):652-664. Epub 2016 Aug 24.

Unité de chirurgie plastique et reconstructrice, centre Léon-Bérard, 28, rue Laënnec, 69373 Lyon cedex 08, France.

Breast deformity of Poland syndrome is a malformation known to be difficult to treat. Numerous descriptions of surgical corrections have been published but none achieved to correct severe cases before description of lipomodeling technique. The aim of this article is to present thoraco-mammary deformity of Poland syndrome, corrections techniques already available and therapeutical indications in primary and secondary cases. Read More

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http://dx.doi.org/10.1016/j.anplas.2016.07.011DOI Listing
October 2016
4 Reads

Predictors of Reoperations in Deep Inferior Epigastric Perforator Flap Breast Reconstruction.

Plast Reconstr Surg Glob Open 2016 Aug 29;4(8):e1016. Epub 2016 Aug 29.

Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden.

Background: The deep inferior epigastric perforator (DIEP) procedure is regarded a safe option for autologous breast reconstruction. Reoperations, however, may occur, and there is no consensus in the literature regarding the risk factors. The aim of this study was to identify factors associated with reoperations in DIEP procedure. Read More

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http://dx.doi.org/10.1097/GOX.0000000000001016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010354PMC
August 2016
1 Read

Comparing the Outcomes of Different Agents to Treat Vasospasm at Microsurgical Anastomosis during the Papaverine Shortage.

Plast Reconstr Surg 2016 Sep;138(3):401e-8e

Boston, Mass.; and Amsterdam, The Netherlands From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School; and the Department of Plastic Surgery, Vrije Universiteit Medical Center, Vrije Universiteit.

Background: Papaverine remains popular for treating intraoperative vasospasm, but the recent shortage has forced surgeons to trial antispasmodic agents unproven in microsurgery but commonly used in other body areas. During this shortage, the authors have used topical lidocaine and nicardipine to break intraoperative vasospasm. This study aims to analyze the outcomes of these medications on flap complications compared with papaverine. Read More

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http://dx.doi.org/10.1097/PRS.0000000000002430DOI Listing
September 2016
9 Reads

Protective effect of sevoflurane preconditioning on ischemia-reperfusion injury in patients undergoing reconstructive plastic surgery with microsurgical flap, a randomized controlled trial.

BMC Anesthesiol 2016 08 22;16(1):66. Epub 2016 Aug 22.

Department of Anaesthesiology, Regina Elena National Cancer Institute, V. Elio Chianesi 53, 00144, Rome, Italy.

Background: In many clinical conditions that involve free flaps and tissue transplantations the possibility of minimizing ischemia-reperfusion injury can be a determinant factor for the success of the surgery itself. We hypothesize that preconditioning with sevoflurane is a protective factor against ischemia-reperfusion injury.

Methods: In this randomized controlled trial, patients ASA I-II undergoing breast reconstruction with deep inferior epigastric perforator flaps were allocated into two groups and analyzed: group BAL included patients who received balanced anesthesia with sevoflurane for 30 min before removal of the flap and throughout the surgery. Read More

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http://dx.doi.org/10.1186/s12871-016-0230-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4994173PMC
August 2016
6 Reads

NSQIP Analysis: Increased Immediate Reconstruction in the Treatment of Breast Cancer.

Am Surg 2016 Jun;82(6):540-5

Walter Reed National Military Medical Center, Bethesda, Maryland, USA.

Immediate reconstruction after the surgical treatment of breast cancer has increased in the last decade. The purpose of this study is to use the National Surgical Quality Improvement Program database to analyze long-term trends in breast reconstruction. Women who underwent mastectomy for invasive or in situ breast cancer or prophylaxis between 2005 and 2011 were selected from the National Surgical Quality Improvement Program database. Read More

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June 2016
7 Reads

The vertical posteromedial thigh (vPMT) flap for autologous breast reconstruction: A novel flap design.

Microsurgery 2017 Jul 1;37(5):371-376. Epub 2016 Jun 1.

Department of Plastic and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.

Background: The vertical posteromedial thigh (vPMT) perforator flap is a new reliable flap with versatility. The purpose of this article was to report our experience with the use of free vPMT flap for reconstruction of the breast.

Patients And Methods: From May 2015 to December 2015, seven patients received immediate unilateral breast reconstruction with seven free vPMT flaps. Read More

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http://dx.doi.org/10.1002/micr.30074DOI Listing
July 2017
13 Reads

Improved sensory recovery with a novel dual neurorrhaphy technique for breast reconstruction with free muscle sparing TRAM flap technique.

Microsurgery 2017 Jan 21;37(1):21-28. Epub 2016 Apr 21.

University of Helsinki, Finland.

Background: We describe a new dual neurorrhaphy method for a free abdominal-based flap and compare sensory recovery with this novel technique to that with conventional neurorrhaphy technique for breast reconstruction.

Methods: 70 breast cancer patients underwent muscle sparing innervated transversal rectus abdominis myocutaneous flap (neuro ms-TRAM) breast reconstruction with either a novel dual neurorrhaphy technique (N = 41) or single (N = 29) neurorrhaphy only. Dual neurorrhaphy was performed on both sides and single neurorrhaphy on one side of the flap, using the end-to-end or end-to-side technique. Read More

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http://dx.doi.org/10.1002/micr.30064DOI Listing
January 2017
15 Reads

The microvascular anastomotic coupler for venous anastomoses in free flap breast reconstruction improves outcomes.

Gland Surg 2016 Apr;5(2):88-92

1 St Andrew's Anglia Ruskin (StAAR) Research Unit, 2 St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Mid Essex Hospital Services NHS Trust, Chelmsford, Essex CM1 7ET, UK.

Background: Venous couplers are ubiquitous around the world and are a useful tool for the reconstructive microsurgeon. A systematic review of coupler performance studies demonstrated a thrombosis rate range of 0% to 3%, whilst the average time of using the device is 5 minutes. There is sparse published data on cost analysis and the impact of operator experience on the anastomotic coupler device success. Read More

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http://gs.amegroups.com/article/view/6544/9887
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http://dx.doi.org/10.3978/j.issn.2227-684X.2015.05.14DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4791359PMC
April 2016
6 Reads

Impact of Prior Tissue Expander/Implant on Postmastectomy Free Flap Breast Reconstruction.

Plast Reconstr Surg 2016 Apr;137(4):1083-91

Los Angeles, Calif. From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles.

Background: Implant-based breast reconstructions can result in unsatisfactory results requiring surgical revision or salvage reconstructive surgery with autologous tissue. This study compares the outcomes and complications of salvage (tertiary) flap reconstruction after failed prosthesis placement to those of primary/secondary flap reconstruction.

Methods: All patients undergoing free flap breast reconstruction after failed prosthesis between July 1, 2005, and June 30, 2014, were identified. Read More

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http://pdfs.journals.lww.com/plasreconsurg/9000/00000/Impact
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http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:land
Publisher Site
http://dx.doi.org/10.1097/01.prs.0000481044.61991.6bDOI Listing
April 2016
11 Reads

The use of contralateral free extended latissimus dorsi myocutaneous flap for a tertiary failed breast reconstruction: Is it still an option?

J Plast Reconstr Aesthet Surg 2016 Aug 3;69(8):1087-91. Epub 2016 Feb 3.

Division of Plastic Surgery, University of São Paulo School of Medicine, São Paulo, Brazil.

Background: Unsuccessful breast reconstruction management represents a complex challenge for the plastic surgeon. Although these events rarely occur, many patients are not suitable candidates for conventional flaps, because of either previous donor-site surgery or lack of sufficient tissue.

Methods: In this study, a contralateral free latissimus dorsi musculocutaneous flap (CL-LDMF) was planned for correction of major lesions in the anterior chest wall. Read More

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http://dx.doi.org/10.1016/j.bjps.2016.01.019DOI Listing
August 2016
14 Reads

Conservative mastectomies and Immediate-DElayed AutoLogous (IDEAL) breast reconstruction: the DIEP flap.

Gland Surg 2016 Feb;5(1):24-31

1 Department of Plastic and Aesthetic Surgery, 2 Department of Senology, Sana Kliniken Düsseldorf, Düsseldorf, Germany.

Background: With the development of conservative mastectomies, there are an increasing number of women seeking immediate implant based and autologous breast reconstruction. Despite the oncologic safety of the procedures, the focus will be on the timing of reconstruction.

Methods: Our plastic surgery unit is focused primarily on autologous breast reconstruction and is part of an interdisciplinary breast center. Read More

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http://dx.doi.org/10.3978/j.issn.2227-684X.2015.05.15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4716867PMC
February 2016
8 Reads

The Effects of Perioperative Tamoxifen Therapy on Microvascular Flap Complications in Transverse Rectus Abdominis Myocutaneous/Deep Inferior Epigastric Perforator Flap Breast Reconstruction.

Ann Plast Surg 2016 Dec;77(6):630-634

From the Department of Plastic Surgery, University of California, Irvine, Orange, CA.

Background: Tamoxifen is an important adjunct therapy in breast cancer treatment; however, it has been implicated in increasing microvascular flap complications. Current recommendations on stopping tamoxifen are conflicting and do not address tamoxifen therapy that is continued perioperatively. The purpose of this study is to determine whether tamoxifen taken at the time of free transverse rectus abdominis myocutaneous (TRAM) and deep inferior epigastric perforator (DIEP) flap breast reconstruction affects thrombotic complication rates. Read More

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http://dx.doi.org/10.1097/SAP.0000000000000707DOI Listing
December 2016
15 Reads
1 Citation
1.460 Impact Factor