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Free Flaps

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Oncoplastic and Reconstructive Breast Surgery

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Abstract

Breast reconstruction contributes substantially to a woman’s physical, emotional, and psychological recovery from breast cancer. Free tissue transfer provides autologous tissue for a soft and natural feeling breast of enduring permanence with a natural inframammary fold and ptosis. There are many potential donor sites where a sizeable volume of tissue can be transferred safely, and the original anatomy at both donor and recipient sites restored optimally. The ideal patient for such a procedure is one who is physically fit and healthy, with an active lifestyle and committed to complete restoration of her body image. Free flap reconstruction can be associated with significant complications and morbidity. A high level of microsurgical expertise is imperative and even with this, there always remains a small and quantifiable failure rate in free tissue transfer. The main disadvantage is donor site morbidity, particularly with myocutaneous flaps where despite a degree of expendability, harvest still leads to loss of function of the donor muscle. Free perforator flaps are perfused by fascial or myocutaneous perforators and evolved as a refinement of conventional myocutaneous free flaps. This enables tissue harvest without the need to sacrifice muscle or fascia. Traditional donor sites used for breast reconstruction such as, the lower abdomen, upper lateral back, buttocks, peri-iliac, and lateral thigh areas are ideally suited for the application of the perforator flap concept. The potentially detrimental effects of adjuvant radiotherapy on autologous tissue breast reconstruction remain a subject of ongoing research and debate, particularly with respect to the decision of immediate versus delayed reconstruction.

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Authors and Affiliations

  1. Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, Glasgow, UK

    Eva M. Weiler-Mithoff & Ben K. Chew

Authors
  1. Eva M. Weiler-Mithoff
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  2. Ben K. Chew
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Correspondence to Eva M. Weiler-Mithoff .

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Editors and Affiliations

  1. , BreastUnit, Hospital Nossa Senhora das Gracas, Rua Padre Agostinho 913 ap 51, Curitiba, 80430050, Brazil

    Cicero Urban

  2. , Plastic and Reconstructive Division, European Institute of Oncology, Via Ripamonti, 435, Milan, 20100, Italy

    Mario Rietjens

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Weiler-Mithoff, E.M., Chew, B.K. (2013). Free Flaps. In: Urban, C., Rietjens, M. (eds) Oncoplastic and Reconstructive Breast Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-2652-0_30

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  • DOI: https://doi.org/10.1007/978-88-470-2652-0_30

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  • Publisher Name: Springer, Milano

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  • Online ISBN: 978-88-470-2652-0

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