Nipple Areola Complex Reconstruction in Poland Syndrome: Techniques and Considerations | Chapter 28 | Key Flaps in Plastic Surgery

 This book chapter discusses the reconstruction of the nipple areola complex (NAC) in a follow-up case of Poland syndrome and left breast reconstruction with a Backer's implant, presenting with athelia. The operative procedure involved marking the nipple and areola comparable to the contralateral breast, using the purse-string technique for nipple reconstruction, and deepithelizing the proposed areolar region for subsequent grafting with split-thickness skin grafts (STSG) harvested from the thigh. The postoperative period was uneventful, and satisfactory results were observed during follow-up examinations.

The chapter introduces NAC reconstruction as a crucial component of breast reconstruction following mastectomy or breast-conserving surgery. It emphasizes the importance of restoring the natural appearance of the nipple and areola for aesthetic purposes. Various surgical techniques are discussed, including local flaps, skin grafts, and 3D tattooing, with an emphasis on patient preferences and customization. The chapter highlights the personalized nature of NAC reconstruction, considering the patient's desires and anatomy.

Postoperative care, long-term results, and potential complications are also addressed. Close collaboration between the patient and the surgeon, along with realistic expectations, is emphasized to achieve optimal outcomes and minimize the risk of complications. The chapter underscores the significance of NAC reconstruction in enhancing the aesthetics of the reconstructed breast and improving the patient's satisfaction with their breast reconstruction journey.

Author(s) Details:

Mohd. Altaf Mir,
Department of Burns and Plastic Surgery, All India Institute of Medical Sciences (AIIMS),Bathinda-151001, India.

Jaya Jain,
All India Institute of Medical Sciences (AIIMS), Bathinda-151001, India.

Please see the link here: https://stm.bookpi.org/KFPS/article/view/11523

Transverse Rectus Abdominis Myocutaneous (TRAM) Flap Advancements in Breast Reconstruction | Chapter 17 | Key Flaps in Plastic Surgery

 This book chapter presents a case report and discussion on the use of the transverse rectus abdominis myocutaneous (TRAM) flap for breast reconstruction following revision radical mastectomy in a patient with recurrent left breast tumour. The case presentation describes the preoperative condition, diagnosis, and the need for revision surgery and breast reconstruction. The operative procedure involved revision radical mastectomy, left axillary clearance, and reconstruction using a contralateral pedicled TRAM flap.

The surgical technique included flap planning and marking, flap elevation, transfer to the defect site through a subcutaneous tunnel, and final inset to reconstruct the left mastectomy defect. The donor site in the lower abdomen was closed primarily. The postoperative period remained uneventful, and satisfactory results were observed during follow-up examinations.

The discussion section introduces the TRAM flap technique as a well-established surgical option for breast reconstruction. The surgical techniques are described, including patient evaluation and planning, flap design and marking, incision and flap elevation, flap transposition and shaping, and donor site closure. The advantages of the technique, such as natural tissue characteristics, adequate tissue volume, consistent blood supply, and simultaneous abdominal contouring, are highlighted. The limitations, including muscle sacrifice, donor site morbidity, and longer operative time and recovery, are also discussed.

The abstract emphasizes the significance of the TRAM flap technique in breast reconstruction, particularly in cases of mastectomy. It highlights the importance of careful patient evaluation, meticulous surgical planning, and consideration of the advantages and limitations of the TRAM flap procedure. By understanding the principles and techniques of the TRAM flap, surgeons can achieve satisfactory outcomes in breast reconstruction, providing patients with natural-looking results and potential abdominal contouring benefits

Author(s) Details:

Mohd. Altaf Mir,
Department of Burns and Plastic Surgery, All India Institute of Medical Sciences (AIIMS),Bathinda-151001, India.

Jaya Jain,
All India Institute of Medical Sciences (AIIMS), Bathinda-151001, India.

Please see the link here: https://stm.bookpi.org/KFPS/article/view/11512