Just as a successful breast reconstruction cannot be achieved using a solitary method for every patient, no single surgical technique is a panacea for the final stage of nipple creation. For breast mounds with a thin subcutaneous layer, as commonly associated with the implanted breast, local flaps using a central subcutaneous core have strong advocates. The H-shaped local flap introduced here is a variant of the latter where large, well-vascularized side tabs provide adequate projection with minimal risk for flap slough. More importantly, a cylindrical shape geometrically identical to the norm avoids the bulbous appearance frequently resulting from many of the other central-core flap designs.

Female↗

PubMed1992

Assessment of TRAM flap perfusion using laser Doppler flowmetry: an adjunct to microvascular augmentation.

Any necrosis after reconstruction of the modified radical mastectomy defect using a superior epigastric based unipedicled lower transverse rectus abdominis myocutaneous flap should be unusual. Identification of the marginal flap at risk for this complication is important as this would permit immediate microvascular augmentation to enhance total survival. The dilemma, then, is how to define which flaps would benefit. We believe this is possible using laser Doppler flowmetry as a continuous, noninvasive, objective monitor of flap perfusion. Flow characteristics have been obtained in 16 consecutive transverse rectus abdominis myocutaneous flaps using the laser Doppler, where 2 were shown to have been in jeopardy for major flap loss. After appropriate microanastomoses as indicated, all flaps totally survived as predicted.

Abdominal Muscles↗

PubMed1989

Polyglactin 910 mesh for support of the donor defect of the double-pedicled rectus abdominis musculocutaneous flap.

The most significant concern in using the lower rectus abdominis musculocutaneous flap is creation of an eventration or even a frank hernia of the abdominal wall. Frequently, reinforcement using an alloplastic implant following closure of the double-pedicled donor defect is required. In an effort to avoid the use of any foreign materials, particularly if the goal in breast reconstruction is to use only autogenous tissues, strong consideration for incorporating an absorbable mesh is advocated to provide abdominal wall support.

Abdominal Muscles↗

PubMed1988

Prevention of the teardrop areola following the inferior pedicle technique of breast reduction.

Elevation of the inferior portion of the areola with placement of dermal traction sutures will reduce the risk of an inverted teardrop areola deformity following inferior pedicle reduction mammaplasty. The long-term results in creation of a circular areola have been uniformly successful.

Breast↗

PubMed1985

Simultaneous brachioplasty, thoracoplasty, and mammoplasty.

Body contour surgery for the patient who has experienced massive weight loss requires extensive and multiple operations. Any means of reducing the number of such procedures while obtaining optimal results would be most beneficial to both surgeon and patient. Combined brachioplasty, thoracoplasty, and mammoplasty has proven to be safe, effective, and appropriate toward achieving these goals.

Arm↗

PubMed1984

Modification of inferior pedicle technique for breast reduction.

Explore the source record for details and available documents.

Breast↗

PubMedDate not supplied

Necrotizing proctitis caused by injection of barium into the wall of the rectum: report of a case.

Explore the source record for details and available documents.

Aged↗