World Journal of Surgery

, Volume 36, Issue 4, pp 730–742 | Cite as

The Evolution of Breast Reconstruction: A Historical Perspective

  • Manish C. ChampaneriaEmail author
  • Wendy W. Wong
  • Michael E. Hill
  • Subhas C. Gupta


Plastic surgeons have been performing operations to improve the aesthetic aspect of the breast for centuries. Throughout ancient times, great controversy produced many theories of how breast cancer occurred and the best treatment. Because of beliefs that closure of mastectomy sites could conceal tumor recurrence, breast reconstruction did not gain wide acceptance until the mid-1900s. Today, plastic surgeons have a variety of techniques to reconstruct the breast. The first autologous muscle flap for breast reconstruction was the latissimus dorsi myocutaneous flap, described in 1896 by Iginio Tansini. The introduction of Carl Hartrampf’s transverse rectus abdominis myocutaneous flap and Robert J. Allen’s deep inferior epigastric perforator flap have also provided excellent reconstructive options. With regard to augmentation, Vincenz Czerny attempted to enhance a woman’s breast in 1895 with implantation of a lumbar lipoma. Soon after, surgeons used paraffin injections and polyvinylic alcohol sponge implantation, which yielded disastrous results. In 1961, Thomas Cronin and Frank Gerow promoted the first silicone implant, paving the way for today’s silicone and saline prototypes. Although reduction mammaplasty techniques had originated centuries earlier than mastopexy methods, the advancements of both have largely paralleled one another. In 1949, the Wise pattern was introduced to preoperatively plan safer and predictable outcomes in breast reductions. Efforts to minimize scars were achieved with Claude Lassus’ introduction and Madeleine Lejour’s subsequent modification of the vertical scar mammaplasty. In hopes of fostering an understanding of current post-mastectomy procedures and instilling passion for innovating future techniques, we provide a near-complete, surgically focused historical account of the primary contributors to breast reconstruction.


Breast Reconstruction Myocutaneous Flap Free Tissue Transfer Reduction Mammaplasty Latissimus Dorsi Flap 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors are grateful to the staff of the Cushing/Whitney Medical Library at Yale University for providing access to several obscure references. Online translating programs such as Reverso and Babylon 9 were used for the purposes of this manuscript.

Conflicts of interest

None of the authors have any conflicts of interest to disclose.


  1. 1.
    Breasted J (1930) The Edwin Smith surgical papyrus. The University of Chicago Press, ChicagoGoogle Scholar
  2. 2.
    Bryan PW (1930) The Papyrus Ebers. Geoffrey Bles, LondonGoogle Scholar
  3. 3.
    Wood WC (1994) Progress from clinical trials on breast cancer. Cancer 74:2606–2609PubMedCrossRefGoogle Scholar
  4. 4.
    Ariel I (1987) Breast cancer, a historical review: is the past prologue? McGraw-Hill, New YorkGoogle Scholar
  5. 5.
    Robbins G (1984) Clio chirurgica: the breast. Silvergirl, AustinGoogle Scholar
  6. 6.
    Halsted WS (1894) I. The results of operations for the cure of cancer of the breast performed at the Johns Hopkins Hospital from June, 1889 to January, 1894. Ann Surg 20:497–555PubMedCrossRefGoogle Scholar
  7. 7.
    Tajima T (2000) History of breast cancer surgery and its perspectives [in Japanese]. Nippon Geka Gakkai Zasshi 101:833–839PubMedGoogle Scholar
  8. 8.
    Teimourian B, Adham MN (1983) Louis Ombredanne and the origin of muscle flap use for immediate breast mound reconstruction. Plast Reconstr Surg 72:905–910PubMedCrossRefGoogle Scholar
  9. 9.
    De Cholnoky T (1963) Late adverse results following breast reconstructions. Plast Reconstr Surg 31:445–452CrossRefGoogle Scholar
  10. 10.
    Bartlett W (1917) An anatomic substitute for the female breast. Ann Surg 66:208–211PubMedCrossRefGoogle Scholar
  11. 11.
    Patey DH, Dyson WH (1948) The prognosis of carcinoma of the breast in relation to the type of operation performed. Br J Cancer 2:7–13PubMedCrossRefGoogle Scholar
  12. 12.
    Fisher B, Anderson S, Bryant J et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241PubMedCrossRefGoogle Scholar
  13. 13.
    Veronesi U, Cascinelli N, Mariani L et al (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347:1227–1232PubMedCrossRefGoogle Scholar
  14. 14.
    Toth BA, Lappert P (1991) Modified skin incisions for mastectomy: the need for plastic surgical input in preoperative planning. Plast Reconstr Surg 87:1048–1053PubMedCrossRefGoogle Scholar
  15. 15.
    Hait P (1994) History of the American Society of Plastic and Reconstructive Surgeons, Inc. 1931–1994. Plast Reconstr Surg 94:1A–109APubMedCrossRefGoogle Scholar
  16. 16.
    Tansini I (1896) Nuovo processo per l’amputazione della mammaella per cancre. Reforma Med 12:3Google Scholar
  17. 17.
    Ombredanne L (1906) Restauration autoplastique du sein après amputation totale. Trb Med 4:325Google Scholar
  18. 18.
    Ombrédanne L (1924) Titres et travaux scientifiques. Masson, ParisGoogle Scholar
  19. 19.
    Kleinschmidt O (1924) Uber mamma-plastik. Zbl Chir 51:488Google Scholar
  20. 20.
    Gillies H (1959) Surgical replacement of the breast. Proc R Soc Med 52:597–602PubMedGoogle Scholar
  21. 21.
    Holdsworth WG (1956) A method of reconstructing the breast. Br J Plast Surg 9:161–162PubMedCrossRefGoogle Scholar
  22. 22.
    Harris HI (1949) Automammaplasty. J Int Coll Surg 12:827–839PubMedGoogle Scholar
  23. 23.
    Alexander JE, Block LI (1967) Breast reconstruction following radical mastectomy. Plast Reconstr Surg 40:175–179PubMedCrossRefGoogle Scholar
  24. 24.
    Tansini I (1906) Sopra il mio nuovo processo di amputazione della mamella. Reforma Med 12:757Google Scholar
  25. 25.
    McCraw JB (1980) The recent history of myocutaneous flaps. Clin Plast Surg 7:3–7PubMedGoogle Scholar
  26. 26.
    Olivari N (1976) The latissimus flap. Br J Plast Surg 29:126–128PubMedCrossRefGoogle Scholar
  27. 27.
    Gillies HD, Millard DR Jr (1957) The principles and art of plastic surgery. Brown & Company, BostonGoogle Scholar
  28. 28.
    Mathes SJ, Bostwick J 3rd (1977) A rectus abdominis myocutaneous flap to reconstruct abdominal wall defects. Br J Plast Surg 30:282–283PubMedCrossRefGoogle Scholar
  29. 29.
    Hartrampf CR Jr, Noel RT, Drazan L et al (1994) Ruben’s fat pad for breast reconstruction: a peri-iliac soft-tissue free flap. Plast Reconstr Surg 93:402–407PubMedCrossRefGoogle Scholar
  30. 30.
    Taylor GI, Townsend P, Corlett R (1979) Superiority of the deep circumflex iliac vessels as the supply for free groin flaps. Clinical work. Plast Reconstr Surg 64:745–759PubMedCrossRefGoogle Scholar
  31. 31.
    Holmstrom H (1979) The free abdominoplasty flap and its use in breast reconstruction. An experimental study and clinical case report. Scand J Plast Reconstr Surg 13:423–427PubMedCrossRefGoogle Scholar
  32. 32.
    Allen RJ, Treece P (1994) Deep inferior epigastric perforator flap for breast reconstruction. Ann Plast Surg 32:32–38PubMedCrossRefGoogle Scholar
  33. 33.
    Hartrampf CR, Scheflan M, Black PW (1982) Breast reconstruction with a transverse abdominal island flap. Plast Reconstr Surg 69:216–225PubMedCrossRefGoogle Scholar
  34. 34.
    Grotting JC, Urist MM, Maddox WA et al (1989) Conventional TRAM flap versus free microsurgical TRAM flap for immediate breast reconstruction. Plast Reconstr Surg 83:828–841 Discussion 842–844PubMedCrossRefGoogle Scholar
  35. 35.
    Taylor GI, Corlett R, Boyd JB (1983) The extended deep inferior epigastric flap: a clinical technique. Plast Reconstr Surg 72:751–765PubMedCrossRefGoogle Scholar
  36. 36.
    Koshima I, Soeda S (1989) Inferior epigastric artery skin flaps without rectus abdominis muscle. Br J Plast Surg 42:645–648PubMedCrossRefGoogle Scholar
  37. 37.
    Koshima I, Moriguchi T, Soeda S et al (1992) Free thin paraumbilical perforator-based flaps. Ann Plast Surg 29:12–17PubMedCrossRefGoogle Scholar
  38. 38.
    Daniel RK, Taylor GI (1973) Distant transfer of an island flap by microvascular anastomoses. A clinical technique. Plast Reconstr Surg 52:111–117PubMedCrossRefGoogle Scholar
  39. 39.
    Fujino T, Harashina T, Enomoto K (1976) Primary breast reconstruction after a standard radical mastectomy by a free flap transfer. Case report. Plast Reconstr Surg 58:371–374PubMedCrossRefGoogle Scholar
  40. 40.
    Wei FC, Suominen S, Cheng MH et al (2002) Anterolateral thigh flap for postmastectomy breast reconstruction. Plast Reconstr Surg 110:82–88PubMedCrossRefGoogle Scholar
  41. 41.
    Orticochea M (1973) Use of the buttock to reconstruct the breast. Br J Plast Surg 26:304–309PubMedCrossRefGoogle Scholar
  42. 42.
    Allen RJ, Levine JL, Granzow JW (2006) The in-the-crease inferior gluteal artery perforator flap for breast reconstruction. Plast Reconstr Surg 118:333–339PubMedCrossRefGoogle Scholar
  43. 43.
    Adams WM (1949) Labial transplant for correction of loss of the nipple. Plast Reconstr Surg 4:295CrossRefGoogle Scholar
  44. 44.
    Bunchman HH 2nd, Larson DL, Huang TT et al (1974) Nipple and areola reconstruction in the burned breast. The “double bubble” technique. Plast Reconstr Surg 54:531–536PubMedCrossRefGoogle Scholar
  45. 45.
    Little JW 3rd, Munasifi T, McCulloch DT (1983) One-stage reconstruction of a projecting nipple: the quadrapod flap. Plast Reconstr Surg 71:126–133PubMedGoogle Scholar
  46. 46.
    Smith JW, Nelson R (1986) Construction of the nipple with a mushroom-shaped pedicle. Plast Reconstr Surg 78:684–687PubMedCrossRefGoogle Scholar
  47. 47.
    Cronin ED, Humphreys DH, Ruiz-Razura A (1988) Nipple reconstruction: the S flap. Plast Reconstr Surg 81:783–787PubMedCrossRefGoogle Scholar
  48. 48.
    Anton M, Eskenazi LB, Hartrampf CR (1991) Nipple reconstruction with local flaps: star and wrap flaps. Perspect Plast Surg 5:67–78Google Scholar
  49. 49.
    Becker H (1986) The use of intradermal tattoo to enhance the final result of nipple–areola reconstruction. Plast Reconstr Surg 77:673–676PubMedCrossRefGoogle Scholar
  50. 50.
    Maliniac JW (1950) Lessons of the postwar organization of plastic surgery in Europe. Plast Reconstr Surg 6:38–40CrossRefGoogle Scholar
  51. 51.
    Goldwyn RM (1980) The paraffin story. Plast Reconstr Surg 65:517–524PubMedCrossRefGoogle Scholar
  52. 52.
    Schmorl R (1922) Paraffingranulome. Munch Med Wochenschr 69:215–220Google Scholar
  53. 53.
    Boo-Chai K (1965) Paraffinoma. Plast Reconstr Surg 36:101–110CrossRefGoogle Scholar
  54. 54.
    Smith AR, Garrison JL, Greene WB et al (1999) The clinical, histologic, and ultrastructural presentation of polyvinyl sponge (Ivalon) breast prostheses removed for massive fluid accumulation. Plast Reconstr Surg 103:1970–1974PubMedCrossRefGoogle Scholar
  55. 55.
    Georgiade NG, Georgiade GS, Riefkohl R (1990) Aesthetic surgery of the breast. W. B. Saunders Company, PhiladelphiaGoogle Scholar
  56. 56.
    Czerny V (1895) Plastischer ersatz der brustdruse durch ein lipom. Zentralbl Chir 27:72Google Scholar
  57. 57.
    Lalardrie JP, Mouly R (1978) History of mammaplasty. Aesthetic Plast Surg 2:167–176CrossRefGoogle Scholar
  58. 58.
    Blocksma R, Braley S (1965) The silicones in plastic surgery. Plast Reconstr Surg 33:366CrossRefGoogle Scholar
  59. 59.
    Schnur P, Hait P (2009) The History of Plastic Surgery, Arlington Heights, IL. American Society of Plastic Surgeons/Plastic Surgery Educational FoundationGoogle Scholar
  60. 60.
    Janowsky EC, Kupper LL, Hulka BS (2000) Meta-analyses of the relation between silicone breast implants and the risk of connective-tissue diseases. N Engl J Med 342:781–790PubMedCrossRefGoogle Scholar
  61. 61.
    Cunningham B (2007) The mentor core study on silicone MemoryGel breast implants. Plast Reconstr Surg 120:19S–29S Discussion 30S–32SPubMedCrossRefGoogle Scholar
  62. 62.
    Radovan C (1982) Breast reconstruction after mastectomy using the temporary expander. Plast Reconstr Surg 69:195–208PubMedCrossRefGoogle Scholar
  63. 63.
    Olenius M, Wickman M, Malm M et al (1994) Skin thickness in expanded human breast skin. Plast Reconstr Surg 93:1428–1432PubMedCrossRefGoogle Scholar
  64. 64.
    Thorek M (1942) Plastic surgery of the breast and abdominal wall. Charles C Thomas, SpringfieldGoogle Scholar
  65. 65.
    Hippocrates (1881) On airs, waters, and places, translated from Greek by Francis Adams. Kessinger, WhitefishGoogle Scholar
  66. 66.
    Aegineta P (1847) The seven books of Paulus Aegineta, Vol 2, Book 6, Sect. 46, p. 334 translated from Greek by Francis Adams. Syndenham Society, LondonGoogle Scholar
  67. 67.
    Aegineta P (1538) Libri septem, quilus medendi ratio ac uia tam in diatetico, quam pharmaceutico & chirurgio genere compendio continetur. BasileGoogle Scholar
  68. 68.
    Letterman G, Schurter M (1974) Will Durston’s “mammaplasty”. Plast Reconstr Surg 53:48–51PubMedCrossRefGoogle Scholar
  69. 69.
    Biesenberger H (1931) Deformitaten und Kosmetische Operationen der weiblichen brust. Wilhem Maudich, ViennaGoogle Scholar
  70. 70.
    Girard P (1910) Mastoptose und mastopexie. Verhandlungen der deutschen Gesellsch Fur Chirurgie 39:200Google Scholar
  71. 71.
    Guinard (1903) In discussion of report by Morestin on the removal of benign tumors of the breast. Bull Mem Soc Chir Paris 29:568Google Scholar
  72. 72.
    Hollander E (1924) Die Operation der Mammahypertrophie und der hangebrust. Deutsch Med Wochenschr 50:1400CrossRefGoogle Scholar
  73. 73.
    Morestin H (1909) Hypertophie mammaire unilaterale corrige par la resection discoide. Bull Mem Soc Chir Paris 35:996Google Scholar
  74. 74.
    Dartigues L (1925) Traitement chirurgical du prolapsus mammaire. Arch Franco-Belg Chir 28:313–328Google Scholar
  75. 75.
    Lexer E (1912) Hypertrophie bei der mammae. Munch Med Wochenschr 59:2702Google Scholar
  76. 76.
    Tamerin JA (1963) The Lexer-Kraske mammaplasty: a reaffirmation. Plast Reconstr Surg 31:442–444PubMedCrossRefGoogle Scholar
  77. 77.
    Kraske H (1923) Die operation der atrophischen und hypertrophischen hangebrust. Munch Med Wochenschr 70:672Google Scholar
  78. 78.
    Biesenberger H (1928) Eine neue Methode der Mammaplastik. Zentralbl Chir 55:2382Google Scholar
  79. 79.
    Gupta SC (1965) A critical review of contemporary procedures for mammary reduction. Br J Plast Surg 18:328–335PubMedCrossRefGoogle Scholar
  80. 80.
    Aufricht G (1949) Mammaplasty for pendulous breasts; empiric and geometric planning. Plast Reconstr Surg 4:13–29CrossRefGoogle Scholar
  81. 81.
    Gläsmer E, Amersbach R (1930) Die Formfehler und Die Plastischen Operationen der Weiblichen Brust. Ferdinand Enke, StuttgartGoogle Scholar
  82. 82.
    Wise RJ (1956) A preliminary report on a method of planning the mammaplasty. Plast Reconstr Surg 17:367–375CrossRefGoogle Scholar
  83. 83.
    Strombeck JO (1960) Mammaplasty: report of a new technique based on the two pedicle procedure. Br J Plast Surg 13:79–90PubMedCrossRefGoogle Scholar
  84. 84.
    McKissock PK (1972) Reduction mammaplasty with a vertical dermal flap. Plast Reconstr Surg 49:245–252PubMedCrossRefGoogle Scholar
  85. 85.
    McKissock PK (1978) Reduction mammaplasty. Ann Plast Surg 2:321–331CrossRefGoogle Scholar
  86. 86.
    Skoog T (1963) A technique of breast reduction; transposition of the nipple on a cutaneous vascular pedicle. Acta Chir Scand 126:453–465PubMedGoogle Scholar
  87. 87.
    Regnault P (1966) The hypoplastic and ptotic breast: a combined operation with prosthetic augmentation. Plast Reconstr Surg 37:31–37PubMedCrossRefGoogle Scholar
  88. 88.
    Meyer R, Kesselring UR (1975) Reduction mammaplasty with an L-shaped suture line. Development of different techniques. Plast Reconstr Surg 55:139–148PubMedCrossRefGoogle Scholar
  89. 89.
    Arie G (1957) Una nueva tecnica de mastoplastia. Rev Latino Am Cir Plast 3:23–38Google Scholar
  90. 90.
    Lassus C (1970) A technique for breast reduction. Int Surg 53:69–72PubMedGoogle Scholar
  91. 91.
    Lassus C (1986) Reduction mammaplasty with short inframammary scars. Plast Reconstr Surg 77:680–681PubMedCrossRefGoogle Scholar
  92. 92.
    Lejour M (1994) Vertical mammaplasty and liposuction of the breast. Plast Reconstr Surg 94:100–114PubMedCrossRefGoogle Scholar
  93. 93.
    Asplund OA, Davies DM (1996) Vertical scar breast reduction with medial flap or glandular transposition of the nipple–areola. Br J Plast Surg 49:507–514PubMedCrossRefGoogle Scholar
  94. 94.
    Pousson M (1897) De la mastopexie. Bull Mem Soc Chir Paris 23:507Google Scholar
  95. 95.
    Verchere F (1898) Mastopexie laterale contre la mastoptose hypertrophique. Med Mod (Paris) 9:540Google Scholar
  96. 96.
    Girard C (1910) Uber mastoptose und mastopexie. Arch Klin Chir 92:829Google Scholar
  97. 97.
    Gobell R (1914) Mamma pendula und heftiger Mastodynie. Munch Med Wochenschr 61:1760Google Scholar
  98. 98.
    Gobell R (1927) Uber Autoplastische freie Fascien und Aponeurosentransplantation nach Martin Kirschner. Arch Klin Chir 146:463Google Scholar
  99. 99.
    Dartigues L (1925) Traitement chirurgical du prolapsus mammaire. Arch Franco-Belg Chir 28:313Google Scholar
  100. 100.
    Axhausen G (1926) Hypertrophie mammaire de la puberte: resection partielle restauratrice. Arch Franco-Belg Chir 4:13Google Scholar
  101. 101.
    Noel S, Lopez-Martinez X (1928) Nouveaux procedes chirurgicaux de correction du prolapsus mammaire. Arch Franco-Belg Chir 31:138Google Scholar
  102. 102.
    Gillies HD, Marino H (1958) Periwinkle-shell principle in treatment of small ptotic breast. Plast Reconstr Surg 21:1–7CrossRefGoogle Scholar
  103. 103.
    Gonzalez-Ulloa M (1960) Correction of hypotrophy of the breast by means of exogenous material. Plast Reconstr Surg Transplant Bull 25:15–26PubMedCrossRefGoogle Scholar
  104. 104.
    Marchac D, de Olarte G (1982) Reduction mammaplasty and correction of ptosis with a short inframammary scar. Plast Reconstr Surg 69:45PubMedCrossRefGoogle Scholar
  105. 105.
    De Longis E (1986) Mammoplasty with an L-shaped limited scar and retropectoral dermopexy. Aesthetic Plast Surg 10:171–175PubMedCrossRefGoogle Scholar
  106. 106.
    Benelli L (1990) A new periareolar mammaplasty: the “round block” technique. Aesthetic Plast Surg 14:93–100PubMedCrossRefGoogle Scholar
  107. 107.
    Flowers RS, Smith EM Jr (1998) “Flip-flap” mastopexy. Aesthetic Plast Surg 22:425–429PubMedCrossRefGoogle Scholar
  108. 108.
    Johnson GW (1981) Central core reduction mammoplasties and Marlex suspension of breast tissue. Aesthetic Plast Surg 5:77–84PubMedCrossRefGoogle Scholar
  109. 109.
    Goes JC (1996) Periareolar mammaplasty: double skin technique with application of polyglactine or mixed mesh. Plast Reconstr Surg 97:959–968PubMedCrossRefGoogle Scholar
  110. 110.
    Loustau HD, Mayer HF, Sarrabayrouse M (2008) The owl technique combined with the inferior pedicle in mastopexy. Aesthetic Plast Surg 32:11–15 Discussion 16–17PubMedCrossRefGoogle Scholar
  111. 111.
    Hall-Findlay EJ (1999) A simplified vertical reduction mammaplasty: shortening the learning curve. Plast Reconstr Surg 104:748–759 Discussion 760–763PubMedCrossRefGoogle Scholar
  112. 112.
    Graf R, Reis de Araujo LR, Rippel R et al (2003) Reduction mammaplasty and mastopexy using the vertical scar and thoracic wall flap technique. Aesthetic Plast Surg 27:6–12PubMedCrossRefGoogle Scholar
  113. 113.
    Cao YL, Lach E, Kim TH et al (1998) Tissue-engineered nipple reconstruction. Plast Reconstr Surg 102:2293–2298PubMedCrossRefGoogle Scholar
  114. 114.
    De Lorenzi F (2010) Oncoplastic surgery: the evolution of breast cancer treatment. Breast J 16(Suppl 1):S20–S21PubMedCrossRefGoogle Scholar
  115. 115.
    Tan WT (2002) 12th chapter of surgeons lecture: shifting paradigms in the management of breast cancer—a surgical perspective. Ann Acad Med Singapore 31:813–815PubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Manish C. Champaneria
    • 1
    Email author
  • Wendy W. Wong
    • 1
  • Michael E. Hill
    • 1
  • Subhas C. Gupta
    • 1
  1. 1.Department of Plastic SurgeryLoma Linda University Medical CenterLoma LindaUSA

Personalised recommendations