Garza Ramon, Ochoa Oscar, Chrysopoulo Minas
Plastic Reconstructive & Microsurgical Associates, San Antonio, Tex.
Plast Reconstr Surg Glob Open. 2021 Feb 18;9(2):e3433. doi: 10.1097/GOX.0000000000003433. eCollection 2021 Feb.
Breast reconstruction is an option that should be considered for any patient facing a mastectomy. Autologous breast reconstruction provides the benefits of excellent longterm results, natural appearance, natural feel, and the best opportunity for sensory restoration. These factors lead many patients to choose autologous tissue over implant-based reconstruction. With improved anatomic and technical knowledge, the donor site morbidity previously associated with abdominally based autologous reconstruction has been significantly reduced. Today, the DIEP flap is the preferred autologous method allowing restoration of a "natural," aesthetic breast with potential for sensation while simultaneously minimizing abdominal donor site morbidity. Alternative flaps and adjunctive procedures provide options when dealing with patients who present with challenging clinical scenarios because of an inadequate abdominal donor site. This paper reviews current methods employed by a high volume breast reconstruction practice to achieve these goals.
对于任何面临乳房切除术的患者，乳房重建都是一个应予以考虑的选择。自体乳房重建具有长期效果极佳、外观自然、触感自然以及感觉恢复机会最佳等优点。这些因素使得许多患者选择自体组织而非植入物重建。随着解剖学和技术知识的不断完善，先前与腹部自体重建相关的供区并发症已显著减少。如今，腹壁下动脉穿支皮瓣（DIEP瓣）是首选的自体方法，它能够恢复“自然”、美观的乳房，具有感觉恢复的潜力，同时将腹部供区并发症降至最低。当处理因腹部供区不足而出现具有挑战性临床情况的患者时，替代皮瓣和辅助手术提供了多种选择。本文回顾了一家大型乳房重建机构为实现这些目标所采用的当前方法。
