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Implant-Based Breast Reconstruction

  • Cagri Cakmakoglu
  • Thomas Y. Xia
  • Risal S. Djohan
  • Graham S. SchwarzEmail author
Chapter
  • 14 Downloads

Abstract

Implant-based breast reconstruction is the most frequently employed breast reconstruction approach due to its relative technical ease and short postoperative recovery. In particular, increasing usage of both direct-to-permanent implant placement and pre-pectoral positioning of breast implants necessitate a trustworthy test for mastectomy skin flap perfusion.

Intraoperative identification of potentially ill-perfused mastectomy skin flaps with indocyanine green angiography allows for preventative excision of inadequately perfused skin. In cases of implant-based breast reconstruction, the reconstruction technique will include placement of a full-sized, heavier, permanent implant or a partially deflated expander, which can be securely inflated to its full volume over time as satisfactory mastectomy incisional healing and skin envelope viability are demonstrated. If a wide area of skin has low perfusion, pre-pectoral or partial, sub-pectoral device placement can be changed to complete, sub-muscular expander breast reconstruction with minimal volume fill.

Keywords

Breast reconstruction Indocyanine green Mastectomy skin necrosis Breast reconstruction algorithm Mastectomy skin flap Implant-based breast reconstruction 

Supplementary material

Video 28.1

Case 1 (MP4 71586 kb)

Video 28.2

Case 2 (MP4 38916 kb)

References

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Cagri Cakmakoglu
    • 1
  • Thomas Y. Xia
    • 2
  • Risal S. Djohan
    • 1
  • Graham S. Schwarz
    • 1
    Email author
  1. 1.Department of Plastic SurgeryCleveland ClinicClevelandUSA
  2. 2.School of MedicineCase Western Reserve UniversityClevelandUSA

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