Reconstruction of the breast following mastectomy

The experience with 300 reconstructions after mastectomy over a ten year period is reported. The whole reconstruction was performed in one stage, including latissimus dorsi flap, volume replacement by a double lumen prosthesis and nipple-areola reconstruction. In 50% of the cases adjustment of the opposite breast has been necessary to achieve symmetry. Prophylactic subcutaneous or total mastectomy was done in the high risk group. Twenty-six patients have undergone immediate reconstruction at the time of the mastectomy, but the psychological reaction of these patients is less positive, because they have not lived with the deformity. There are few early complications despite of the extended operation. No local recurrence has occurred. The best results are obtained with the latissimus dorsi flap because of maximum protection for the implant and better correction of the absent anterior axillary fold.