Skip to main content
SpringerLink
Log in

Autologous Breast Reconstruction

  • Chapter
  • First Online:
Breast Disease

Abstract

The progress in the last 25 years, utilizing the patient’s own tissue for reconstruction, has been amazing. Starting with the landmark procedure of the transverse rectus abdominis flap by Carl Hartrampf, autologous reconstruction has become much more reliable. The aesthetic outcomes have improved as well. This chapter discusses the various types of flaps which are currently employed and their advantages and disadvantages.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 189.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Albornoz CR, Bach RB, Meharar BJ, et al. A paradigm shift in U.S. breast reconstruction: increasing implant rates. Plast Reconstr Surg. 2013;131(1):15–23.

    Article  CAS  PubMed  Google Scholar 

  2. Maxwell GP. Iginio Tnasini and the origin of the latissimus dorsi musculocutaneous flap. Plast Reconstr Surg. 1980;65:686.

    Article  CAS  PubMed  Google Scholar 

  3. Boehmler JH, Butler CE. Latissimus dorsi flap breast reconstruction. In: Hall-Findlay EJ, Evans GRD, editors. Aesthetic and reconstructive surgery of the breast. Edinburgh: Elsevier Limited; 2010. p. 51–60.

    Chapter  Google Scholar 

  4. Spear SL, Ducic I, Cuoco F, Hannan C. The effect of smoking on flap and donor-site complications in pedicled TRAM breast reconstruction. Plast Reconstr Surg. 2005;116(7):1873–80.

    Article  CAS  PubMed  Google Scholar 

  5. Kroll SS, Netscher DT. Complications of TRAM flap breast reconstruction in obese patients. Plast Reconstr Surg. 1989;84(6):886–92.

    Article  CAS  PubMed  Google Scholar 

  6. Paige KT, Bostwick J, Bried JT, Jones G. A comparison of morbidity from bilateral, unipedicled and unilateral, unipedicled TRAM flap breast reconstructions. Plast Reconstr Surg. 1998;101(7):1819–27. Print.

    Article  CAS  PubMed  Google Scholar 

  7. Berrino P, Campora E, Leone S, et al. The transverse rectus abdominis musculocutaneous flap for breast reconstruction in obese patients. Ann Plast Surg. 1991;27:221.

    Article  CAS  PubMed  Google Scholar 

  8. Moran SL, Serletti JM. Outcome comparison between free and pedicled TRAM flap breast reconstruction in the obese patient. Plast Reconstr Surg. 2001;108(7):1954–60. Print.

    Article  CAS  PubMed  Google Scholar 

  9. Bailey SH, Oni G, Guevara R, Wong C, Saint-Cyr M. Latissimus dorsi donor-site morbidity: the combination of quilting and fibrin sealant reduce length of drain placement and seroma rate. Ann Plast Surg. 2012;68(6):555–8.

    Article  CAS  PubMed  Google Scholar 

  10. Moon H, Taylor I. The vascular anatomy of the rectus abdominis musculocutaneous flaps based on the deep superficial epigastric system. Plast Reconstr Surg. 1988;82:815.

    Article  CAS  PubMed  Google Scholar 

  11. Takeishi M, Shaw W, Ahn C, et al. TRAM flaps in patients with previous abdominal scars. Plast Reconstr Surg. 1982;69:216.

    Article  Google Scholar 

  12. Weiss PR. TRAM flap breast reconstruction. In: Hall-Findlay EJ, Evans GRD, editors. Aesthetic and reconstructive surgery of the breast. Edinburgh: Elsevier Limited; 2010. p. 61–80.

    Chapter  Google Scholar 

  13. Parrett BM, Caterson SA, Tobia AM, Lee BT. DIEP flaps in women with abdominal scars: are complication rates affected? Plast Reconstr Surg. 2008;121(5):1527–31.

    Article  CAS  PubMed  Google Scholar 

  14. Takeishi M, Shaw WW, Anh CY, Borud LJ. TRAM flaps in patients with abdominal scars. Plast Reconstr Surg. 1997;99(3):713–22.

    Article  CAS  PubMed  Google Scholar 

  15. Scott JR, Liu D, Said H, et al. Computed tomographic angiography in planning abdomen-based microsurgical breast reconstruction: a comparison with color duplex ultrasound. Plast Reconstr Surg. 2010;125:446–53.

    Article  CAS  PubMed  Google Scholar 

  16. Rozen W, Ashton M, Stella D, et al. The accuracy of computed tomographic angiography for mapping the perforators of the DIEA: a cadaveric study. Plast Reconstr Surg. 2008;122:363–9.

    Article  CAS  PubMed  Google Scholar 

  17. Saad A, Rebowe RE, Hogan ME, Wise MW, Hilaire HS, Sadeghi A, Dupin CL. Localization of the dominant deep inferior epigastric artery perforator by computed tomography angiogram: does the standard deep inferior epigastric artery perforator flap design include the dominant perforator? Ann Plast Surg. 2014;72(6):670–3.

    Google Scholar 

  18. Dupin CL, Allen RJ, Glass CA, Bunch R. The internal mammary artery and vein as a recipient site for free-flap breast reconstruction: a report of 110 consecutive cases. Plast Reconstr Surg. 1996;98(4):685–9.

    Article  CAS  PubMed  Google Scholar 

  19. Greco III JA, Castaldo ET, Nanney LB, et al. Autologous breast reconstruction: the Vanderbilt experience (1998 to 2005) of independent predictors of displeasing outcomes. J Am Coll Surg. 2008;207:49–56.

    Article  PubMed  Google Scholar 

  20. Mehrara BJ, Santoro TD, Arcilla E, Watson JP, Shaw WW, Da Lio AL. Complications after microvascular breast reconstruction: experience with 1195 flaps. Plast Reconstr Surg. 2006;118:1100–9; discussion 1110–1.

    Article  CAS  PubMed  Google Scholar 

  21. Sullivan SR, Fletcher DR, Isom CD, Isik FF. True incidence of all complications following immediate and delayed breast reconstruction. Plast Reconstr Surg. 2008;122:19–28.

    Article  CAS  PubMed  Google Scholar 

  22. Selber JC, Kurichi JE, Vega SJ, Sonnad SS, Serletti JM. Risk factors and complications in free TRAM flap breast reconstruction. Ann Plast Surg. 2006;56:492–7.

    Article  CAS  PubMed  Google Scholar 

  23. Fosnot J, Jandali S, Low DW, Kovach SJ, Wu LC, Serletti JM. Closer to an understanding of fate: the role of vascular complications in free flap breast reconstruction. Plast Reconstr Surg. 2011;128(4):835–43.

    Article  CAS  PubMed  Google Scholar 

  24. Kroll SS, Schusterman MA, Reece GP, Miller MJ, Evans GR, Robb GL, Baldwin BJ. Timing of pedicle thrombosis and flap loss after free-tissue transfer. Plast Reconstr Surg. 1996;98:1230–3.

    Article  CAS  PubMed  Google Scholar 

  25. Khouri RK, Cooley BC, Kunselman AR, Landis JR, Yeramian P, Ingram D, Natarajan N, Benes CO, Wallemark C. A prospective study of microvascular free-flap surgery and outcome. Plast Reconstr Surg. 1998;102:711–21.

    Article  CAS  PubMed  Google Scholar 

  26. Chang EI, Mehrara BJ, Festekjian JH, Da Lio AL, Crisera CA. Vascular complications and microvascular free flap salvage: the role of thrombolytic agents. Microsurgery. 2011;31(7):505–9.

    Article  PubMed  Google Scholar 

  27. Bui DT, Cordeiro PG, Hu QY, Disa JJ, Pusic A, Mehrara BJ. Free flap reexploration: indications, treatment, and outcomes in 1193 free flaps. Plast Reconstr Surg. 2007;119:2092–100.

    Article  CAS  PubMed  Google Scholar 

  28. Fujino T, Harasina T, Aoyagi F. Reconstruction for aplasia of the breast and pectoral region by microvascular transfer of a free flap from the buttock. Plast Reconstr Surg. 1975;56:178–81.

    Article  CAS  PubMed  Google Scholar 

  29. Allen RJ, Tucker Jr C. Superior gluteal artery perforator free flap for breast reconstruction. Plast Reconstr Surg. 1995;95:1207–12.

    Article  CAS  PubMed  Google Scholar 

  30. Allen RJ, Levine JL, Granzow JW. The in-the-crease inferior gluteal artery perforator flap for breast reconstruction. Plast Reconstr Surg. 2006;118:333–9.

    Article  CAS  PubMed  Google Scholar 

  31. Zenn M, Milard JA. Free inferior gluteal flap harvest with sparing of the posterior femoral cutaneous nerve. J Reconstr Microsurg. 2006;22:509–12.

    Article  PubMed  Google Scholar 

  32. Ahmadzadeh R, Bergeron L, Tang M, Morris SF. The superior and inferior gluteal artery perforator flaps. Plast Reconstr Surg. 2007;120:1551–6.

    Article  CAS  PubMed  Google Scholar 

  33. Rozen WM, Ting JWC, Grinsell D, Ashton MW. Superior and inferior gluteal artery perforators: in-vivo anatomical study and planning for breast reconstruction. J Plast Reconstr Aesthet Surg. 2010;64(2):217–25.

    Article  PubMed  Google Scholar 

  34. Codner MA, Nahai F. The gluteal free flap breast reconstruction: making it work. Clin Plast Surg. 1994;21:289–96.

    CAS  PubMed  Google Scholar 

  35. Guerra AB, Metainger SE, Bidros RS, et al. Breast reconstruction with gluteal artery perforator flaps: a critical analysis of 142 cases. Ann Plast Surg. 2004;52:118–25.

    Article  PubMed  Google Scholar 

  36. Baek SM. Two new cutaneous free flaps: the medial and lateral thigh flaps. Plast Reconstr Surg. 1983;71:354.

    Article  CAS  PubMed  Google Scholar 

  37. Angrigiani C, Grilli D, Thorne CH. The adductor flap: a new method for transferring posterior and medial thigh skin. Plast Reconstr Surg. 2001;107:1725–31.

    Article  CAS  PubMed  Google Scholar 

  38. Allen RJ, et al. Breast reconstruction with the profunda artery perforator flap. Plast Reconstr Surg. 2012;129(1):16e–23.

    Article  PubMed  Google Scholar 

  39. Saad A, Sadeghi A, Allen RJ. The anatomic basis of the profunda femoris artery perforator flap: a new option for autologous breast reconstruction – a cadaveric and computer tomography angiogram study. J Reconstr Microsurg. 2012;28(6):381–6.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Plastic Surgery, Department of Surgery, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA, 70112, USA

    M. Whitten Wise MD, Hugo St.Hilaire MD, DDS, Ali Sadeghi MD, M’liss Hogan MD & Charles Dupin MD

Authors
  1. M. Whitten Wise MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hugo St.Hilaire MD, DDS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ali Sadeghi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M’liss Hogan MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Charles Dupin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hugo St.Hilaire MD, DDS .

Editor information

Editors and Affiliations

  1. Advocate Center for Breast Health, Advocate Cancer Institute, Oak Lawn, Illinois, USA

    Adam I. Riker

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Wise, M.W., St.Hilaire, H., Sadeghi, A., Hogan, M., Dupin, C. (2015). Autologous Breast Reconstruction. In: Riker, A. (eds) Breast Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1145-5_19

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-1145-5_19

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1144-8

  • Online ISBN: 978-1-4939-1145-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation