By Mario Casales Schorr, Visnu Lohsiriwat
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Breast reconstructive and oncoplastic surgical procedure can decrease the feel of mutilation because of oncologic surgical procedure and meets the necessity to offer breast melanoma therapy that won't basically eliminate the melanoma but additionally re-establish the patient’s caliber of lifestyles. even though, the problems inherent in preoperative making plans and the intraoperative complexity of breast reconstruction and oncoplastic innovations symbolize significant demanding situations for the breast health care provider.
This atlas, meant for surgeons at each point, is an all-inclusive consultant that records surgical options step-by-step through a wealth of greater than 1800 colour images, extra high quality drawings and illustrations, and succinct accompanying textual content. either universal, confirmed strategies and the main lately brought thoughts are lined, making sure that readers may have at their disposal a number of ways for breast fix, home improvement, and reconstruction. as well as the great descriptions of thoughts, preoperative making plans is defined, symptoms and contraindications are pointed out, and the administration of surgical issues is mentioned. counsel, pitfalls, and key issues are highlighted.
The Atlas of Breast Reconstruction is an exceptional instrument that would elevate and refine the arsenal on the oncoplastic surgeon's disposal so as to make sure that the simplest therapy could be provided to every person patient.
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Additional resources for Atlas of Breast Reconstruction
17. 36 and 17. 37 Dissection of the medial border of the rectus abdominis muscle Figs. 17. 38 and 17. 39 Dividing the rectus muscle on the decrease half 147 148 Fig. 17. forty The rectus muscle used to be increased unfastened from the posterior rectus sheath Figs. 17. forty-one, 17. forty two, and 17. forty three Umbilicus dissection Case 17 Pedicle TRAM Flap Reconstruction method Delayed Breast Reconstruction (to exchange Prosthesis) Figs. 17. forty four and 17. forty five Contralateral adipocutaneous TRAM flap was once dissected from the anterior sheath Figs. 17. forty six and 17. forty seven sector four was once got rid of 149 150 Case 17 Pedicle TRAM Flap Reconstruction method Fig. 17. forty eight The belly donor web site Fig. 17. forty nine The left rectus muscle used to be folded with no rigidity Delayed Breast Reconstruction (to change Prosthesis) Figs. 17. 50, 17. fifty one, 17. fifty two, 17. fifty three, 17. fifty four, and 17. fifty five The mesh was once put and stuck the 1st illustrations current the lateral first separated “U” stitches and medial non-stop row of mesh to fascia Now the representation indicates the lateral moment non-stop row aspiring to mimic a extra anatomical belly wall closure 151 152 Case 17 Pedicle TRAM Flap Reconstruction method Figs. 17. fifty six, 17. fifty seven, and 17. fifty eight The reduce a part of the mesh used to be fastened with the rest rectus muscle Figs. 17. fifty nine, 17. 60, and 17. sixty one The preserved anterior rectus sheath was once coated over for you to make stronger the mesh closure Delayed Breast Reconstruction (to exchange Prosthesis) Fig. 17. sixty two the recent umbilicus region at more desirable stomach flap is deepithelized and created Figs. 17. sixty three and 17. sixty four Reshaping and insetting the TRAM flap a few extra tissue used to be discarded, and the deepithelization used to be additionally played 153 154 Figs. 17. sixty five and 17. sixty six fast end result Fig. 17. sixty seven the 20 th postoperative day with no issues Case 17 Pedicle TRAM Flap Reconstruction procedure Pedicle TRAM Flap Reconstruction method 18 Case unmarried Pedicle TRAM (Contralateral Pedicle) speedy Breast Reconstruction Following Nipple-Sparing Mastectomy sufferer: 66-year-old girl. analysis: neighborhood recurrence of in situ ductal carcinoma of the suitable breast with past radiotherapy. strategy: Oncologic method: correct nipple-sparing mastectomy (NSM) and sentinel lymph node biopsy. M. Rietjens et al. , Atlas of Breast Reconstruction, DOI 10. 1007/978-88-470-5519-3_19, © Springer-Verlag Italia 2015 correct NSM with radial higher outer incision strategy and sentinel lymph node dissection during the similar incision. Reconstructive process: correct breast speedy reconstruction with contralateral pedicled TRAM. a hundred and fifty five 156 Case 18 Pedicle TRAM Flap Reconstruction strategy Fig. 18. 2 TRAM flap dissection this situation, the determine skips the preliminary step of TRAM flap dissection. This determine indicates the step of freeing the lateral border of the left rectus abdominis muscle from the rectus sheath Fig. 18. 1 Preoperative drawings view Ptosis grade three, huge left and medium correct breast dimension, asymmetrical breasts – the left aspect higher than the perfect one Marking midline and inframammary fold.