Plastic surgical procedures related to breast disease.

With rapid improvements in plastic surgery techniques over the past 15 years, breast reconstruction after mastectomy has become a reasonable option for most breast cancer patients. In most patients who have had a modified radical mastectomy, the breast can be easily reconstructed with a subpectoral Silastic implant. In those who have had more extensive resections of tissue or radiation damage of the skin, reconstruction can still be reliably carried out by using either a latissimus dorsi flap in addition to the implant or by using the transverse rectus abdominis myocutaneous flap reconstruction. In many patients who reject these more complicated options, breast reconstruction can still be carried out with tissue expanders and subsequent placement of a subpectoral Silastic implant. For patients who desire prophylactic removal of breast cancer with extensive fibrocystic disease or precancerous histologic changes, subcutaneous mastectomy with immediate reconstruction offers maximum removal of breast tissue with minimal distortion of body image.