[Complex breast reconstruction after severe chest trauma by firearm].

Area of Science:

• Reconstructive surgery
• Plastic surgery
• Trauma surgery

Background:

• Ballistic chest trauma presents complex reconstructive challenges.
• Severe hemothorax and heart wounds necessitate immediate surgical intervention.
• Post-traumatic soft tissue defects require specialized reconstruction methods.

Observation:

• A 47-year-old female patient sustained ballistic chest trauma with significant soft tissue loss.
• Initial emergency treatment included heart surgery and chest wall coverage with a latissimus dorsi flap.
• The patient underwent subsequent breast reconstruction using an abdominal advancement flap and lipomodeling.

Findings:

• Microsurgical breast reconstruction was not feasible due to damaged recipient vessels from ballistic trauma.
• The latissimus dorsi flap provided essential coverage for the chest defect.
• Restoration of breast aesthetics was achieved through an abdominal advancement flap and multiple lipomodeling sessions.

Implications:

• This case highlights the successful application of combined reconstructive techniques for complex post-traumatic breast deformities.
• The study demonstrates the efficacy of latissimus dorsi flaps and lipomodeling in extreme thoracomammary region repairs.
• The findings offer valuable insights for managing challenging breast reconstruction cases following severe trauma.