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A 52-Year-old woman underwent a two-stage total nose reconstruction for complete nasal defect due to skin cancer. In the 1
st
stage, innervated osteocutaneous radial forearm flap (“Neo nose”) was raised with the help of a 3D template. In the 2
nd
stage, well vascularised “Neo-nose” was transferred to the face and covered with pre-expanded forehead flap.
Patients undergoing two-stage breast reconstruction with tissue expander and a history of previous irradiation are predisposed to a various chest-wall deformations more than non-irradiated patients. If chest-wall depression with/without rib fracture is found intra-operatively, bigger implant should be used, with a subsequent radiologic evaluation. In the future, the development of a new, modified expander with a harder base could minimise such complications.
In order to achieve the best aesthetic result after immediate implant-based breast reconstruction, all the advantages and disadvantages of two-stage tissue expander and single-stage direct-to-implant breast reconstruction should be considered. Decision about the type of implant-based reconstruction is based on the consultations outcomes after multidisciplinary team meeting of breast and reconstructive specialist, but patients own wishes should be prioritised.
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