Breast reconstruction as staged procedure has its benefits and limitations. Following radiotherapy, implant based procedures might suffer complications accordingly. Therefore, some surgeons suggest autologous breast reconstruction surgeries. They support of this idea illustrating predictability and acceptable long term aesthetic and functional results. Among autologous breast replacement surgeries, free tissue transfers need special facility and expert surgeons who passed steeped learning curves. Thus, pedicle based flaps are generally accepted and adopted by plastic surgeons. . . .

The perfect method for breast reconstruction would be safe, reliable, reproducible, applicable to all patients, and would have no donor site morbidity. The ideal reconstructed breast would provide symmetric, permanent, and natural results. There has been development and refinement of autogenous methods of breast reconstruction throughout the literature. The TRAM flap remains the most popular method of autogenous reconstruction. This popularity is due to the relative ease with which the procedure is performed but it has its own drawbacks. Other procedures include: Deep inferior epigastric artery perforator flap; free flaps (free TRAM flap; free superior gluteal myocutaneous flap); pedicled lattisimus dorsi flap, etc. We have reconstructed the breast in ten patients after mastectomy with a different technique which is cutaneoglandular flap from the contralateral normal breast. It has the advantage of using normal breast tissue for reconstruction in addition to reduction of a possible large breast the patient may have. It is almost without donor site morbidity and there is no need to reposition the patient intraoperatively. It is mostly used when the patient is reluctant to undergo a big operation. This technique can also be used when there are contraindications to other techniques. In this paper, patients are presented who have undergone contralateral cutaneouglandular flap with an inferior pedicle and free nipple graft technique with fairly satisfactory results.

Introduction & Objective: These days, the majority of women who are undergoing mastectomy can also have breast reconstruction. Implants and latissimus dorsi flaps are some kinds of surgery that can be performed. The development of Transverse Rectus Abdominis Myocutaneous (TRAM) flap, enabled surgeons to use it, extensively for breast reconstruction. The main aim of this study was determination of the prevalence of different reconstructive surgery in Iran, find out advantages and disadvantage of these procedure and also evaluation of satisfaction of the patients.Materials & Methods: In a descriptive and cross-sectional study 148 patients, undergoing breast reconstructive surgery during 14 years, were evaluated. Their demographic data, age, kind of surgery gathered from their medical files. Then they followed for 5 years and complication of surgery and their satisfaction were evaluated. Data analyzed with SPSS software.Results: The most kind of surgery was TRAM flap 127 (86.3%) then was tissue expanders, implants, respectively; Fat necrosis 13 (8.7%) patients, seroma in 12 (8.1%) patients were the most complication of TRAM flap surgery.Satisfaction of patients were excellent in 31%, 25% respectively for breast and abdomen reconstructive surgery.Conclusions: This study suggests that the TRAM flap for breast reconstruction is a safe and reliable technique which provides an excellent cosmetic outcome with a high degree of patients satisfaction.

Background: Breast reconstruction in women with breast cancer has not been thoroughly investigated in Indonesia. A pioneering study is needed to identify the breast reconstruction rate, treatment outcomes, and factors influencing treatment in a smaller population. Methods: The secondary data of 105 women with breast cancer who underwent reconstruction post-breast surgery at several cancer centers in Jakarta were collected retrospectively from 2020to the first quarter of 2024. We performed Fisher’s exact test, independent t-test, and multiple regression analyses to determine factors influencing the choice of breast reconstruction and surgical outcomes. Results: The breast reconstruction rate at one center after 2 years was 56. 8%, and the multicenter trend of breast reconstruction increased by 7. 6% after 1 year. Plastic surgeons performed 36. 8% of the total breast reconstructions, with DIEP-free flaps being the most performed type of reconstruction. The history of radiotherapy (P=0. 03), type of breast surgery (P<0. 05), and surgical site of the breast surgery (P<0. 05) were significantly associated with the choice of breast reconstruction in women with breast cancer. Moreover, lymph node dissection (P=0. 03), the timing of breast reconstruction (P=0. 05), and the presence of complications (P=0. 002) were significantly associated with the length of ICU stay. Conclusion: The breast reconstruction rate in our study was higher than several centers across Asia (56. 8%). However, further investigation is needed to evaluate the outcomes of therapy and factors influencing them.

Background: The technique most frequently employed for breast reconstruction, either immediate (IBR) or delayed (DBR), is the insertion of a prosthesis. The placement of a foreign body always carries the risk, albeit small, of peri-prosthetic infection and exposure of the implant that necessitates its removal, signaling the temporary or permanent failure of the reconstruction.Methods: We retrospectively analyzed data of 738 consecutive patients immediate implant-only breast reconstructions between 1989 and 2005 in order to evaluate the contributing factors of failure.Results: Our statistical analysis identified 3 statistically significant risk factors of implant extrusion: irradiation (P=0.01), post-operative chemotherapy (P= 0.03), and the use of non- Becker expanders (P=0.02).Conclusions: It is important, especially for the multidisciplinary breast cancer team members, to be aware of these factors in order to make the optimal decision for immediate reconstruction after mastectomy and the suggested techniques. The patients should also be aware, as part of a shared medical decision, of the risks and their frequency before accepting IBR.