Chapter 37 – Breast Reconstruction

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1、CHAPTER37BREASTRECONSTRUCTIONKendallR.Roehl,BradonJ.Wilhelmi,andLindaG.Phillips6%recurrencerate.Thehalstediantheoryofbreastcancertreat-roleofthegeneralsurgeoninbreastreconstructionmentwouldremainthemainstayofbreastcancersurgeryforhistorythenext60years.Hebelievedthat“theslightestinattentiont

2、opatientselectiondetailandorattemptstohastenconvalescencebysuchplastictimingoperationsasarefeasibleonlywhenarestrictedamountofskinprocedureselectionandsurgicalplanningisremovedmaysacrificehispatienttothedisease.”So,con-nipple-areolarreconstructioncernedwiththepossibilityofinadequateskinexci

3、sion,Halstedmanagementofthecontralateralbreastwentontosaythat“Toattempttoclosethebreastwoundmoresurveillanceorlessregularlybyanyplasticmethodishazardous,andinmyconclusionsopinion,tobevigorouslydiscounted.”Therefore,trueattemptsatbreastreconstructionwouldhavetowaitforalmost50years.DespiteHal

4、sted’scondemnationofreconstructiveproce-dures,itwasrecognizedthatthesizabledefectsleftafterthisROLEOFTHEGENERALSURGEONINradicalsurgerydidneedtobeclosed.AlthoughprimaryclosureBREASTRECONSTRUCTIONwasoftenused,skingraftingoflargerwoundswasacceptable.Breastcancerisanextremelyemotionaltopicbecau

5、seofitsEventhoughplasticprocedureshadbeenreportedbyLegueuanatomiclocationandtheimportanceofthefemalebreastinandGraeveofFranceandWarrenoftheUnitedStates,thesetoday’ssociety.Therefore,itisimperativeforsurgeonsperform-weremerelychestwallclosuretechniquesandnottruebreastingbreastsurgerytohaveab

6、asicunderstandingofwhichmoundreconstructions.patientsarecandidatesforbreastreconstructionandoftheThefirstattemptattruebreastreconstructionoccurredinreconstructiveoptions.Mostpatientsstarttheirinquiryabout1895,whenVincentCzernytransplantedalargelipomafrombreastreconstructionwiththesurgeonwho

7、willbeperforminghispatient’sflanktothemastectomysite.Inrecountingthiscase,themastectomy.Theymightask,“WhatwillitlooklikewhenDr.RobertGoldwynnotedthat1yearaftersurgery,thepatientyouaredone?”or“WillIhavetolivewithoutabreast?”Itisatwasdoingwellandhadgoodbre