ABSTRACT
The free TRAM flap has been accepted as an excellent method of autogenous tissue breast reconstruction. In addition, oncologic surgeons and plastic surgeons are trying to perform skin preserved mastectomy to get more esthetically better result in breast reconstruction. Breast tissue and mass would be removed through circumareolar incision, and axillary lymph node dissection could be carried through separate incision on axilla. This paper represents our experiences and results of immediate breast reconstruction with transverse rectus abdominis myocutaneous free flap after skin-sparing mastectomy. From 1999 to 2001, the flaps were utilized in 15 patients to reconstruct the new breast by free TRAM flap after skin sparing mastectomy. The mean age of the patients were a 42-years-old. Location of cancer was on the right breast in 12 cases, left breast in 2 cases and bilateral breasts in 1 case. We chose the thoracodorsal artery and its venae commitantes as recipient vessels, and deep inferior epigastric vessels as donor vessels.All flaps survived completely. There has been no flap necrosis, hematoma, and seroma. The results have been functionally and esthetically satisfactory. There are several advantages in this technique comparing with similar breast reconstruction of routine modified radical mastectomy. This technique leaves less scar and allows better preservation of sensation, aesthetically more natural shape, and better symmetry in reconstructed breast with free TRAM flap afterskin sparing-mastectomy.
Subject(s)
Female , Humans , Arteries , Axilla , Breast , Cicatrix , Free Tissue Flaps , Hematoma , Lymph Node Excision , Mammaplasty , Mastectomy , Mastectomy, Modified Radical , Necrosis , Rectus Abdominis , Sensation , Seroma , Skin , Tissue DonorsABSTRACT
The free TRAM flap has been accepted as an excellent method of autogenous tissue breast reconstruction. In addition, oncologic surgeons and plastic surgeons are trying to perform skin preserved mastectomy to get more esthetically better result in breast reconstruction. Breast tissue and mass would be removed through circumareolar incision, and axillary lymph node dissection could be carried through separate incision on axilla. This paper represents our experiences and results of immediate breast reconstruction with transverse rectus abdominis myocutaneous free flap after skin-sparing mastectomy. From 1999 to 2001, the flaps were utilized in 15 patients to reconstruct the new breast by free TRAM flap after skin sparing mastectomy. The mean age of the patients were a 42-years-old. Location of cancer was on the right breast in 12 cases, left breast in 2 cases and bilateral breasts in 1 case. We chose the thoracodorsal artery and its venae commitantes as recipient vessels, and deep inferior epigastric vessels as donor vessels.All flaps survived completely. There has been no flap necrosis, hematoma, and seroma. The results have been functionally and esthetically satisfactory. There are several advantages in this technique comparing with similar breast reconstruction of routine modified radical mastectomy. This technique leaves less scar and allows better preservation of sensation, aesthetically more natural shape, and better symmetry in reconstructed breast with free TRAM flap afterskin sparing-mastectomy.
Subject(s)
Female , Humans , Arteries , Axilla , Breast , Cicatrix , Free Tissue Flaps , Hematoma , Lymph Node Excision , Mammaplasty , Mastectomy , Mastectomy, Modified Radical , Necrosis , Rectus Abdominis , Sensation , Seroma , Skin , Tissue DonorsABSTRACT
This paper represents the versatility of buccinator myomucosal flap for intraoral and orbital reconstruction of mild to moderate defect and we introduce recontructive methods are introduced along with our clinical experience. Buccal artery from internal maxillary artery is the main arterial pedicle, and buccal branch from facial artery also can supply blood for the buccinator muscle. The abundant blood flow from interconnected pedicles supports the reliable circulation of the buccal mucosa. So we could reconstruct the eye socket using reversed island buccinator myomucosal flap based on the angular vessel. The motor innervation of the buccinator muscle comes from the facial nerve. The buccinator muscle is considered to be a part of the sphincteric muscular system involving the functions of sucking, whistling, propelling food during mastication and voiding the buccal cavity. From 1990 to 1999, the flap was utilized in 8 patients to reconstruct the small to moderate intraoral defect and 1 patient for orbital mucosal defect. All flaps survived completely. There has been no flap necrosis and fistula. The results have been functionally and esthetically satisfactory. It is very reliable and safe flap with a minimal morbidity of donor site. It doesn't require microsurgical technique. Rapid healing may be achieved with its mucosal nature. We conclude that buccinator myomucosal flap can be widely used with a lot of advantages for intraoral and orbital defect because of its many advantages.