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Breast Reconstruction
Tissue Expander, TRAM Flap, Latissimus Dorsi Flap

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Before and After BlepharoplastyBefore and After Blepharoplasty Before and After Blepharoplasty Before and After Blepharoplasty

Top Left - After a Breast Biopsy and the Finding of Breast Cancer

Top Right - After Tissue Expander Placement

Bottom Left - Tissue Expander Replaced & Implants both sides - Nipple Reconstruction

Bottom Right - After Tattooing the Nipple for Color


Tissue Expansion

Tissue Expander

What You Should Know

Radiation Therapy and Reconstruction with Implants

For all women who have had radiation therapy placing an implant to reconstruct the breast has a high risk of hardening of the breasts. 

But it may be a risk that some women are willing to take.  For example, the woman below took that risk and ended up with a great result, as well as soft breasts.



Latissimus dosi flap after a MastectomyAfter the flapBefore FlapAfter a Flap Before FlapBefore Flap

Top Left - After Lumpectomy + Radiation Therapy of the Right Breast for Breast Cancer

Top Right - After a Mentor Spectrum Tissue Expander/Implant on the Right + Implant on the Left

Middle Left - Final Front View After Replacement of Expander with an Implant + Adjustments

Middle Right - Side View Before Beginning Reconstruction

Bottom Left - During Expansion from the Side

Bottom Right - Final Side View After Reconstruction Complete

Latissimus Dorsi (back) Skin Muscle Flap

The Latissimus Dorsi muscle flap, like all other flaps is used in breast reconstruction to add skin lost from the mastectomy.  The muscle and a portion of the overlying skin is moved from the back to the front to recreate the breast.  Because this flap usually does not have enough bulk, an implant is placed underneath the flap.

Latissimus dosi flap after a MastectomyAfter the flapBefore FlapAfter a Flap


Indications for the use of a Latissimus Dorsi Flap

Previous radiation therapy

Loss or poor quality pectoralis muscle which lies under the original breast

Poor skin quality following the mastectomy

A need for bulk and a more maturing looking breast

When other areas, such as the TRAM flap are not available for use

The Latissimus Dorsi flap is a hardier flap than the TRAM flap and is less likely to have problems with healing

The need for using an implant with it is it's major disadvantage


TRAM Skin Muscle Flap - Transverse Rectus Abdominus Muscle

The TRAM muscle flap, adds skin and much needed bulk after a Mastectomy.  The muscle and a portion of the overlying skin is moved from the abdominal area to recreate the breast.  Because this flap usually has enough bulk, a Breast Implant is not needed

Before a TRAM flap6 months afterAfter Final Reconstruction

TRAM flap reconstruction: After Mastectomy / 6 months after surgery
End result after Nipple Areola Reconstruction and Nipple tattooing for color



Indications for the use of a TRAM Flap

Previous radiation therapy

Loss or poor quality pectoralis muscle which lies under the original breast

Poor skin quality following the mastectomy

A need for bulk and a more maturing looking breast

Good choice for large breasts, because the weight of the flap creates some sloping like the uninvolved side

The TRAM flap doesn't like to be moved and is less hardy than the Latissimus Dorsi Flap

A longer recovery and a longer operation with more chances for complications are it's more disadvantage



Breast Reconstruction and Restoration Surgery with a
Board Certified Plastic Surgeon

CALL

Thousand Oaks Plastic Surgeon Dr Costanzo
805 / 373-9919

Breast Reconstruction in Thousand Oaks by Christopher Costanzo MD, a Plastic and
Reconstructive Surgeon trained at the world famous Mayo Clinic.  Board Certified in1987
Dr. Costanzo performs Tissue Expanders and Latissimus Dorsi Flap reconstruction, but
no longer performs TRAM flaps.  For women in California, Beverly Hills, Los Angeles, Encino,
Sherman Oaks, Chatsworth, Woodland Hills, Tarzana, Granada Hills, West Hills, Malibu,
Calabasas,Agoura, Oxnard, Simi Valley, Moorpark, Camarillo, Santa Barbara, Los Angeles
County, Ventura County and Santa Barbara County.  Dr. Costanzo offers free cosmetic
consultations.


© Copyright 2009, Dr. Costanzo, All Rights Reserved
Disclaimer - The information about Cosmetic surgery contained in this web site is for
informational purposes only and does not constitute medical advice.
Call to schedule an appointment with Thousand Oaks Plastic surgeon Dr. Costanzo,
2190 Lynn Road, Suite 380, Thousand Oaks, CA 91360