Post-mastectomy breast reconstruction: the soft tissue alternative.

Abstract

The available methods of soft tissue reconstruction of the breast are described. They are usually preferable to the use of a prosthesis. For unilateral reconstruction the appropriate method depends on the age of the patient and the size of the breast. In an elderly patient with large breast, a two-stage breast-sharing procedure is advocated. In a young patient with a small breast, an extended latissimus dorsi myocutaneous flap provides a suitable reconstruction. In a middle-aged woman with a breast of moderate size and an adequate amount of abdominal subcutaneous tissue, the most appropriate method of reconstruction is a rectus abdominis myocutaneous flap. For bilateral reconstruction where the consistency is less important, a prosthesis, with or without a latissimus dorsi flap for cover, is the method of first choice.