Simultaneous TRAM Flap Breast Reconstruction with Contralateral Reduction Mammoplasty

Symmetry is an important parameter for breast reconstruction. Contralateral breast frequently provides model to be reconstructed. But hypertrophic and ptotic breast is aesthetically unacceptable. And if the contralateral breast is large, larger flap which is required to reconstruct the breast including the zone of poor vascularity. Therefore, reduction of hypertrophic breasts may be preferable. Many surgeons prefer to perform contralateral procedures at least several months after reconstruction. However authors performed simultaneous contralateral reduction mammoplasty in 18 patients at the same time as pedicled TRAM flap reconstruction. The expected disadvantages of the simultaneous operation are increased hospitalization time, blood loss, and complications. But according to our result, it showed that there was no significant difference in hopitalization time and hemoglobin-decrease. Furthermore, simultaneous operation showed lower complication rate because of the reduced size of the required flap. Our results revealed that TRAM flap breast reconstruction and simultaneous contralateral reduction mammoplasty is a safe procedure. And the results were aesthetically acceptable.

Immediate Mastopexy after Breast Implant Removal

Women with breast implants are increasing in numbers with concerns ranging from possible implant rupture to local breast discomfort secondary to symptomatic capsular contracture and possible association with systemic illness. In cases where implants are removed, breast may result in unfavorable appearances. Mastopexy without reinsertion of implant can be an option in these patients. Ten patients were reviewed, all of them had undergone cosmetic breast augmentation and had the implants removed accompanied by mastopexy. Preoperative and postoperative photographs of all patients were randomly mixed and rated by two surgeons. Also, satisfaction of patient was rated by the patient themselves in five-point scoring method. The patients showed favorable result scores. In many of these cases, the post-removal appearance in conjunction with mastopexy actually results in high satisfaction. This present study allows the authors to offer patients an optimistic view of postoperative results following breast implant removal. The authors have begun to advise selected patients that implant removal accompanied by mastopexy provides a more pleasing aesthetic outcome than implant removal alone.