Abstract
Implant breast reconstruction has seen an upturn over the last decade leading to a rise in referrals of failed prosthetic cases that require salvage by conversion to autologous reconstruction, the most popular being free tissue transfer. This salvage breast reconstruction is complex because of the older patient population with increased comorbidities, effects of previous treatments and inevitable intraoperative challenges. Notable issues include irradiated and scarred skin, severe capsular contracture (CC) and silicone lymphadenopathy. There is also difficulty and potential vascular injury during internal mammary recipient vessel exposure due to scarring, and increased bleeding risk during and after the required capsulectomies. Breast Cancer Conservation therapy cosmetic results BCCT.core computer software program was initially used to assess objectively cosmetic outcomes for lumpectomies but it’s now used for total post mastectomy breast reconstructions. Whilst it is well established that free flap conversion addresses the pain, firmness and cold feel of prosthetic reconstructions (from severe CC) and subjectively improves the cosmetic results, there has hitherto been no objective documentation of the improvement in aesthetic outcomes.
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