Postmastectomy reconstruction in patients with significant macromastia and/or large chest wall dimensions can be challenging. Implants have a limited size range and may not be large enough to adequately reconstruct a wide, obese patient. Abdominally based flaps may be unsafe in these patients if they have significant obesity and or other comorbidities and may still be insufficient to adequately fill a very large breast footprint. These problems are compounded in the patient who is not a candidate for an abdominal flap and who undergoes unilateral mastectomy as the contralateral breast, even after aggressive reduction, may still require volume and dimensions that cannot be easily replicated with prosthetic methods alone. Therefore, it seems reasonable to supplement our implant-based reconstructions with additional autologous tissue to reconstruct the breast after mastectomy to obtain acceptable symmetry with the large, contralateral native breast. Here, we report a case of combining the largest available anatomic implant with an extended lateral intercostal artery perforator flap to reconstruct a large breast and obtain symmetry with the native breast.
From Georgia Breast Surgery, PC, Lawrenceville, Ga.
Published online 11 February 2019.
Received for publication November 20, 2018; accepted December 18, 2018.
Disclosure: The author has no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the author.
Jean-Claude Schwartz, MD, PhD, Georgia Breast Surgery, PC, 631 Professional Drive, Suite 300, Lawrenceville, GA 30046, Email: email@example.com
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