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[Breast reconstruction: autologous tissue versus implant]
K Plogmeier1, S Handstein, W Schneider
1Klinik für Plastische, Wiederherstellungs- und Handchirurgie, Medizinische Fakultät, Otto von Guericke Universität Magdeburg.
Zentralblatt Fur Chirurgie
|March 4, 1999
Summary
Breast reconstruction using the TRAM flap offers superior aesthetic results with minimal complications compared to implants. This autologous tissue technique provides a natural feel and adapts to body changes, enhancing patient satisfaction after mastectomy.
Area of Science:
- Plastic Surgery
- Oncology
- Reconstructive Surgery
Background:
- Modified radical mastectomy is standard breast cancer treatment.
- Breast cancer diagnosis causes significant emotional distress, including fear and loss of femininity.
- Breast reconstruction aims to restore normality and wholeness for patients.
Purpose of the Study:
- To evaluate the outcomes of different breast reconstruction techniques.
- To compare implant-based reconstruction with autologous tissue methods.
- To assess patient satisfaction and aesthetic results of TRAM flap reconstruction.
Main Methods:
- Conducted 291 breast reconstructions.
- Utilized tissue expansion with implants in 125 cases.
- Employed Latissimus dorsi flaps in 57 cases and TRAM flaps (pedicled or microvascular) in 109 cases.
Main Results:
- Implant-based reconstruction had device perforation (2), capsular contracture (2), and infection (1).
- Autologous tissue reconstruction resulted in partial flap necrosis (2), hematomas (4), and prolonged healing (4).
- No complete flap necrosis occurred with autologous tissue methods.
Conclusions:
- TRAM flap (transverse rectus abdominis myocutaneous) reconstruction using autologous tissue is a standard technique.
- Microsurgical TRAM flap transplantation minimizes donor site morbidity.
- Autologous tissue reconstruction offers superior aesthetic results, adapts to body changes, and avoids implant-related complications, leading to high patient satisfaction.