[A selection of methods for immediate and delayed breast reconstruction].
OBJECTIVE
To investigate the surgical methods, indications and effects of postmastectomy breast reconstruction in 67 consecutive patients.


METHODS
From July 2002 to October 2005, 67 patients received postmastectomy breast reconstructions. Immediate breast reconstructions were performed using full-size implants in 38 cases, Becker expandable implants in 16 cases, unilateral pedicled transverse rectus of abdominis musculocutaneous (TRAM) in 2 cases. Delayed breast reconstruction were carried out in 6 cases with unilateral pedicled TRAM flaps, 4 cases with extended latissimus dorsi musculocutaneous flap (ELDF), one case with Becker expandable implant.


RESULTS
Of the patients, more than 90% were satisfied with the results. Minor complications were recorded in 5 patients, including small local skin necrosis, partial necrosis of nipple-areola complex preserved and seroma formation.


CONCLUSIONS
Full-size implant breast reconstruction is ideal for slender, small-breast women undergoing immediate breast reconstruction after skin-sparing mastectomy, but not suitable for delayed breast reconstruction. Expandable implants can be used for immediate breast reconstruction in patients with large breast or those who received modified mastectomy and also can be used for delayed breast reconstruction in patients with well-preserved skin and muscle. TRAM or ELDF flap for breast reconstruction is a useful procedure with advantages of autologous tissue and excellent results, both are suitable for immediate and delayed breast reconstruction.
Li
Fa-cheng
FC
Department of Plastic Surgery, Chao Yang Hospital, Affiliate of Capital University of Medical Sciences, Beijing 100020, China. lifcmd@yahoo.com.cn
Jiang
Hong-chuan
HC
Li
Jie
J
D000328:Adult; D019928:Breast Implantation; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D015409:Mastectomy, Radical; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps; D013997:Time Factors; D014182:Transplantation, Autologous