Perforator Flap Breast Reconstruction Article from Dr. DellaCroce in MedScape

Perforator Flap Breast Reconstruction Article from Dr. DellaCroce in MedScape

Updated: May 09, 2023 Author: Frank J DellaCroce, MD; Chief Editor: James Neal Long, MD, FACS

A diagnosis of breast cancer and a treatment plan that includes mastectomy can profoundly affect a patient. Such a patient has concerns about disfigurement and anxiety about her diagnosis. These concerns are addressed with reconstructive techniques that have been developed to provide not only a return to normal clothing and full activities but also a restoration of beauty and femininity. [1]

The benefits of breast reconstruction transcend discarding the cumbersome breast prosthesis. Breast reconstruction helps women complete the healing process by mending the otherwise constant reminders of her diagnosis and treatment. As a result, breast reconstruction now occupies an important place in the overall modern treatment planning for women who face mastectomy. The art of breast reconstruction has undergone commensurate evolution over the last few decades. This progress has resulted in techniques that further the plastic surgeon’s quest toward the ideal method.

An ideal reconstructive technique should be safe, reliable, and reproducible, with limited or no resultant long-term morbidity. Such a technique would replace the breast with tissue of similar texture, producing an aesthetic result indistinguishable from the natural breast. The introduction of the transverse rectus abdominus myocutaneous (TRAM) flap by Hartrampf in 1982 has, to date, been the most significant step toward this goal. [2] The use of excess fatty tissue in the lower abdomen to reconstruct the breast allows for a final result that is living and durable and that eliminates concerns for artificial materials.