Bilateral TRAM flaps for the reconstruction of the post implantectomy/capsulectomy breast deformity

The surgical management of patients desiring removal of silicone mammary prostheses can be controversial. Patients fearful of implants may choose not to undergo implant exchange with saline implants. This fear is well documented and has been influenced by the media. Anecdotal reports attempting to link silicone mammary prostheses to human adjuvant diseases have exacerbated this fear. Large outcome studies refute these claims. Significant breast deformity can result after implantectomy/capsulectomy. Various autogenous tissues have been used in the post mastectomy group of patients. Recently, latissimus dorsi muscle has been used in breast augmentation. This case report delineates the thought process involved in patient selection, describes the techniques employed, and suggests that bilateral deepithelialized TRAM flaps can be utilized in the aesthetic reconstruction of a growing population of patients: those who decline implant exchange but desire to maintain or improve the aesthetic appearance of their breasts.