Breast reconstruction with autologous tissue: 380 consecutive cases

ABSTRACT

Introduction:

Breast reconstruction plays an important role in the treatment of breast cancer. Several options are available for autologous breast reconstruction, the more widespread being the transverse rectus abdominis myocutaneous (TRAM) flap, the latissimus dorsi myocutaneous (LDM) flap, and the local muscle (LM) flap. The objective of this work was to demonstrate the initial experience in breast reconstruction with autologous tissue, with or without implants.

Method:

A retrospective analysis was performed of medical charts of 367 patients who underwent immediate and delayed breast reconstruction with the unipediculated TRAM flap, LD flap, or LM flap.

Results:

Three hundred eighty breasts were reconstructed. There were 156 TRAM flap procedures, 179 LD flap procedures, and 49 other techniques. The size of the implants ranged between 155 cc and 640 cc. The mean age of the patients was 49.33 years. One hundred ninety-seven patients underwent surgery on the right side and 169 on the left; 14 patients underwent bilateral reconstruction. Reconstruction was immediate in 80% of the patients. There were few moderate (partial dehiscence of the wound requiring suturing) and severe complications (flap liponecrosis, extrusion of the implant after infection, and pulmonary thromboembolism) and some minor complications that did not require surgical correction.

Conclusions:

Breast reconstruction with autologous tissue provides the plastic surgeon with a consistent and reliable method of breast reconstruction, with very satisfactory aesthetic results and low morbidity in selected patients.

Keywords:
Mammoplasty; Surgical flaps; Muscles; Breast tumors; Reconstructive surgical procedures