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Breast Reconstruction Under Local Anesthesia: Second-Stage Implant Exchange, Nipple Flap Reconstruction, and Nipple Flap Tattoo

  • Dimitri J. Koumanis
  • Jessie Bujouves
Chapter

Abstract

Implant-based reconstruction is strictly performed in three stages in the authors’ practice. The first stage is the tissue expander and acellular dermal matrix sling procedure performed immediately after the mastectomies. The second-stage reconstruction involves the removal of the tissue expander with a small incision, replacement with a permanent silicone gel implant, and possible revisions of the breast flaps breast pocket if needed. Finally, the third stage involves nipple flap reconstruction. Patients typically wait a few months post surgeries before undergoing medical tattooing of the areola and nipple to give it a three-dimensional look. The authors discuss the techniques used for each stage, the possible complications, and the complications of anesthesia. Star flap method, out of all stages of breast implant reconstruction, is the most amenable to local anesthetic techniques due to its minimalist approach.

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Capital Area Plastic Surgery of New YorkSaratoga SpringsUSA
  2. 2.LondonCanada

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