Transverse Upper Gracilis Flap as an Alternative to Abdominal Tissue Breast Reconstruction

Buntic, Rudolf F.; Horton, Karen M.; Brooks, Darrell; Althubaiti, Ghazi

doi:10.1097/prs.0b013e318230c2b6

Cited by 48 publications

(35 citation statements)

References 11 publications

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“…Le second choix se porte alors soit vers la fesse avec les lambeaux inferior gluteal artery perforator (IGAP) ou superior gluteal artery perorator (SGAP) [4,[17][18][19][20], soit vers la cuisse avec le lambeau de gracilis à palette transversale haute (TUG) [5,12,21,22] (Tableau 5).…”

Section: Discussionunclassified

“…Cependant plusieurs inconvénients sont à déplorer : il s'agit d'un lambeau musculocutané, le prélèvement musculaire pouvant entraîner des séquelles douloureuses ou fonctionnelles même s'il est admis que l'absence de muscle gracilis provoque une morbidité faible mais non nulle [21,23,25,26]. L'atrophie du muscle gracilis est inévitable dans les mois suivant l'intervention, impliquant un faible volume du sein reconstruit.…”

Section: Discussionunclassified

“…Les perforantes du PAP flap, plus postérieures [29,30], permettent un prélèvement prolongé à l'extrémité du sillon sous-fessier et une cicatrice antérieure moins étendue avec un meilleur résultat esthétique. De plus, la longueur du pédicule du lambeau PAP est supérieure à celui du TUG [5,9,21], autorisant un branchement au niveau du creux axillaire si cela est nécessaire. Dans notre série de 30 lambeaux PAP, un branchement sur les vaisseaux circonflexes scapulaires a été réalisé chez 3 patientes.…”

Section: Discussionunclassified

“…L'indice de masse corporel moyen (IMC) était de 23,7 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)5). Dix-sept patientes (57 %) ont eu de la radiothérapie en préopératoire.…”

Section: Résultatsunclassified

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Reconstruction mammaire par profunda artery perforator flap : étude prospective des 30 premiers cas consécutifs

Haddad¹,

Hunsinger²,

Obadia³

et al. 2016

Annales de Chirurgie Plastique Esthétique

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Section: Discussionunclassified

Section: Résultatsunclassified

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Reconstruction mammaire par profunda artery perforator flap : étude prospective des 30 premiers cas consécutifs

Haddad¹,

Hunsinger²,

Obadia³

et al. 2016

Annales de Chirurgie Plastique Esthétique

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“…The flap is best utilized in smaller breast individuals. It allows a natural breast cone to be created and also allows the nipple areola complex (NAC) to be reconstructed in the same stage, if desired [18]. Specific donor site complications include scar widening, eversion of the labia if the deep fascia is not captured and wound dehiscence.…”

Section: Thigh Based Flapsmentioning

confidence: 99%

Flap-based breast reconstructions

Bartlett

Kołacińska

Spiegel

2017

Nowotwory. Journal of Oncology

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Breast cancer reconstruction is generally broken down into two major categories: Implant based and autologous. Both can provide excellent aesthetic results in the well selected patient although the decision ultimately comes down to the patient under the guidance of a reconstructive plastic surgeon. Implant based reconstruction is beyond the scope of this text, rather we will discuss autologous based reconstructive options. Broadly classified, tissue based reconstruction can be categorized as local or free tissue transfer. The general theme is the use of excess or expendable tissue in order to reconstruct breast defects. Studies have shown women are more satisfied with autologous based reconstruction compared to implanted based [1]. In this chapter we will discuss different tissue flap options in the reconstructive plastic surgeons armamentarium, special considerations and how it relates to the oncologic breast surgeon.

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Breast reconstruction

Blondeel

and

Tromaropoulos

2015

Plastic and Reconstructive Surgery

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The presence of breasts is a defining feature of adult mammalian gender. It must therefore be considered an essential element of human femininity, and the role it plays in female psychology cannot be understated. 1,2 The requirement for reconstruction of the female breast is almost exclusively consequent on breast surgery for breast cancer.Providers are becoming legally bound to educate and prepare patients who require mastectomy for reconstruction, such that informed choices can be made. They are obliged to offer a mul tidisciplinary setting as part of a care pathway, in particular allowing for cross-specialty engagement to allow for immediate reconstruction. The surgery of reconstruction has become a recognized specialist area, which by virtue of its appreciation of three-dimensional form, and its possible call on microsurgical skills, naturally falls within the domain and skill set of the plastic surgeon.In this chapter the techniques of breast reconstruction and the principles behind them are reviewed, and it is hoped this will offer the practitioner a ready reference for what we trust will be a meticulously if not passionately executed endeavour. reconstructive aimsAny attempt at reconstruction should appreciate the nuances of breast form, volume and its complex three dimensionality. Its position on the chest wall is determined by its footprint, 3-5 a fixed entity that does not change with age, and that is set by the inframammary fold (IMF) at the 6-7th rib inferiorly, the 2nd rib superiorly, 1-2 cm behind the anterior axillary line laterally, and the lateral border of the sternum medially. The footprint sets the basic breast position on the chest, and by complementing the opposite side creates the necessary foundation for symmetry.The breast conus represents the tissue that projects from the chest wall, a complex of skin envelope with its glandular and fatty content that falls inferiorly to a variable extent over the IMF in a manner termed ptosis. Unlike the footprint, the conus is variable with age. Creating, therefore, a symmetrical ptotic conus precisely positioned on the breast footprint embodies the art of breast reconstructive sculpture. The skin envelope aids in determining shape and any damage or removal of skin will influence its final shape. The ultimate goal of breast reconstruc tion is to create symmetrical, natural-looking breasts and not necessarily a specific shape or volume. aesthetic and functional considerationsBreast ideals have changed over time, as depicted in art and reflecting past and existing cultural differences. There is also a potential variation between what the surgeon and the patient perceives as aesthetic. For this reason it is critical to be attentive to the patient's wishes, appreciating that simple breast symmetry rather than an idealized form may well be their preference.However, insofar as it is possible to specify what an ideal breast should be, the following can be stated: 6 • Breast size relates to the size and shape of the torso.• Nipple placement is critical -ideall...

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Transverse Upper Gracilis Flap as an Alternative to Abdominal Tissue Breast Reconstruction

Abstract: Therapeutic, IV.

Cited by 48 publications

References 11 publications

Reconstruction mammaire par profunda artery perforator flap : étude prospective des 30 premiers cas consécutifs

Reconstruction mammaire par profunda artery perforator flap : étude prospective des 30 premiers cas consécutifs

Flap-based breast reconstructions

Breast reconstruction

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