Breast Reconstructive Surgery

Abstract

Breast reconstruction following mastectomy can be achieved by a variety of techniques using alloplastic implants, autogenous tissues, or both. In the last 30 years, breast reconstruction has progressed from a rarely requested procedure to one that has become an integral part of patient management. The modern era of breast reconstruction began in 1963 with the introduction of the silicone gel prosthesis. In 1972, Radovon described the use of tissue expansion for breast reconstruction. This technique allowed patients with more significant skin deficits to benefit from reconstruction. In the early 1980s, the use of autologous tissue for breast reconstruction was revolutionized by Hartrampf with introduction of the transverse rectus abdominis muscle (TRAM) flap. These developments have resulted in more natural and esthetically acceptable outcomes. Experience over time has also shown breast reconstruction to be an oncologically safe component of the overall treatment plan. Perhaps most importantly, breast reconstruction yields psychological benefits for women, offering a sense of normalcy, a “return to wholeness” and a way to leave the cancer experience behind them.