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Learn about methods of autologous flap reconstruction after nipple sparing mastectomy to optimize breast reconstruction results. Understand the stages of implant reconstruction and options for autologous flaps such as SGAP, DIEP/SIEA, TUG, and IGAP. Compare various flap reconstruction techniques for post-mastectomy breast reconstruction.
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Autologous Free Flap Methods of Reconstruction Aldona J. Spiegel, MD February 22, 2014
Nipple Sparing Mastectomy • Once the NSM is performed how should the defect be reconstructed? • TE/ Implant • Autologous • Autologous + Implant Combination
Stages of Implant Reconstruction Pec. Major muscle Pec. Major muscle Needle injecting fat Needle injecting saline Pec. Major muscle Implant (textured) Tissue expander not filled Fat Alloderm sling Tissue expander filled Fat injected behind nipple and all the way around Alloderm sling Alloderm sling
Breast Reconstruction Flap Options SGAP DIEP/SIEA TUG IGAP
Stages of Flap Reconstruction Needle injecting fat Artery and vein Injected fat Flap
Composite Method| Post- Mastectomy Stages of Flap and Implant Reconstruction Artery and vein Artery and vein Pec. Major muscle Flap Implant Injected fat Flap Flap skin removed