Plastic and Reconstructive Surgery in Breast Cancer Patients

Abstract

The evolution of breast reconstruction mirrors the progress in the field of reconstructive surgery in general. Early breast reconstructive attempts included migration of local and distant tubed pedicle flaps into the mastectomy defect and sharing of the opposite breast. These procedures are of historical interest only, as such methods usually fell short of a pleasing and satisfying reconstruction. With the development of new and reliable techniques, particularly rotation and advancement flaps, in combination with synthetic breast prosthesis, results have improved tremendously. Recent advances in reconstructive surgery, particularly the application of the latissimus dorsi and rectus abdominis musculocutaneous flap, have made breast reconstruction possible for virtually any patient who has had a mastectomy. Microvascular free flaps were added to these techniques and earned a role in certain breast reconstructions difficult to accomplish with convential techniques. Furthermore, tissue expanders have enriched our armamentarium, especially for immediate breast reconstruction. Now there are different ways to rebuild the breast and the development of numerous procedures have resulted in the most dramatic and impressive improvements in confidence and self-esteem that have been seen in the field of plastic surgery during the past decade.