A Comparison of Factors Affecting Aesthetic Outcomes of Tram Flap Breast Reconstructions

Achieving autologous breast reconstruction for breast cancer patients in the setting of post-mastectomy radiotherapy

“…Oncologic concerns, particularly those pertaining to the diagnosis and treatment of local recurrences, have been highlighted when considering timing of breast reconstruction [25][26][27][28][29] There is a distinct paucity of data assessing longterm oncologic outcomes among patients undergoing immediate reconstructions. A study by Huang et al, however, examined oncologic outcomes among postmastectomy radiotherapy patients [25].…”

“…It has been demonstrated that previous irradiation to the chest wall will confer a cosmetically inferior result to a radiation-naïve tissue bed [28]. Several studies have indicated that delaying reconstruction until after completion of radiotherapy enhances cosmetic outcomes.…”

“…Pedicled TRAMs, when undertaken in irradiated tissue beds, have complication rates reported to be in the order of 25-33% [22,47]. Following radiotherapy, pedicled TRAMs have been shown to have a higher incidence of skin and fat necrosis [37], flap failure [48] and major infection [28]. These complications are attributable to radiation induced microangiopathic changes which compromise tissue healing.…”

Postmastectomy radiation therapy and recommendations for immediate breast reconstruction in women with stage II breast cancer

“…The answer is that many aesthetic outcomes of delayed reconstruction, even when performed by experienced surgeons, are satisfactory at best [25,32]. The retained, irradiated, and scarred breast skin must be resected to permit reconstruction of a ptotic-appearing breast.…”

Reconstruction Following Surgery for Breast Cancer

“…19 The economic advantage of immediate reconstruction is obvious because the cost of a second hospitalization is eliminated. 20 The psychological benefits of immediate reconstruction are significant.…”