Breast cancer is a common malignancy in women and involves an organ that is the symbol of feminity.
The management of breast cancer is done by a multi-disciplinary team. The plastic surgeon in the team plays a vital role in psychological rehabilitation of the patient by performing the post-mastectomy breast reconstruction.
Breast reconstruction is a surgical procedure that restores the shape of the breast after mastectomy. The reconstruction should be performed as an immediate procedure whenever possible.
Breast reconstruction method includes:
- Implant based reconstruction
- Using own body tissue (autologous reconstruction)
- A combination of both
The commonly used autologous tissue flaps for breast reconstruction are latissimus dorsi myocutaneous with or without implants, pedicled Transverse Rectus Abdominis muscle flap (TRAM), free TRAM, Deep Inferior Epigastric Artery Perforator flap (DIEP) and Gluteal Artery Perforator flap.
DIEP (Deep Inferior Epigastric Artery Perforator) Flap
Perforator flaps uses skin and fat which is the ideal material for reconstruction of the breast. Advantages of this method include no muscle loss, no postoperative hernia, decreased postoperative pain and better contour and aesthetics.
The deep inferior epigastric perforator flap uses skin and fat from the lower abdomen and is an elegant method for breast reconstruction. The flap is based on one, two, or three perforators of the deep inferior epigastric vessels. After harvest, the flap is placed on the top of the pectoralis muscle, just as the natural breast lies on the top of the pectoralis muscle. Flap vascularity is restored following anastomosis to thoracodorsal or internal mammary vessel. The overall cosmetic result is excellent. |
