Table Of ContentBREAST RECONSTRUCTION 
– CURRENT TECHNIQUES 
 
Edited by Marzia Salgarello
Breast Reconstruction – Current Techniques 
Edited by Marzia Salgarello 
 
 
Published by InTech 
Janeza Trdine 9, 51000 Rijeka, Croatia 
 
Copyright © 2012 InTech 
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Technical Editor Teodora Smiljanic 
Cover Designer InTech Design Team 
 
First published January, 2012 
Printed in Croatia 
 
A free online edition of this book is available at www.intechopen.com 
Additional hard copies can be obtained from [email protected]  
 
 
Breast Reconstruction – Current Techniques, Edited by Marzia Salgarello   
    p. cm.  
ISBN 978-953-307-982-0
Contents 
 
Preface  IX 
Part 1  Oncology and Breast Reconstruction   1 
Chapter 1  Oncological Considerations 
for Breast Reconstruction  3 
Grant W. Carlson 
Part 2  Prosthetic Breast Reconstruction  21 
Chapter 2  Implant and Implant 
Assisted Breast Reconstructions  23 
Sarah S.K. Tang and Gerald P.H. Gui 
Chapter 3  One-Stage Immediate Breast Reconstruction  
with Implants in Conservative Mastectomies  49 
Marzia Salgarello, Giuseppe Visconti 
and Liliana Barone-Adesi 
Chapter 4  The Effect of Breast Reconstruction on Maintaining 
a Proper Body Posture in Patients After Mastectomy  83 
Sławomir Cieśla and Małgorzata Bąk 
Part 3  Autogenous Breast Reconstruction  103 
Chapter 5  Modified Extended Latissimus Dorsi Myocutaneous 
Flap with Added Vascularised Chest Wall Fat in 
Immediate Breast Reconstruction After 
Conservative (Sparing) Mastectomies  105 
Adel Denewer and Omar Farouk 
Chapter 6  Breast Reconstruction with DIEP and S/IGAP  129 
Maria M. LoTempio, Grace Lucta Gerald 
and Robert J. Allen
VI  Contents 
 
Chapter 7  Preoperative Computed Tomographic Angiogram 
for Deep Inferior Epigastric Artery Perforator Flap 
for Breast Reconstruction: The Imaging Mapping Era  159 
Jaume Masia, Carmen Navarro, 
Juan A. Clavero and Xavier Alomar 
Chapter 8  The Superficial Inferior Epigastric Artery (SIEA) 
Flap and Its Applications in Breast Reconstruction  171 
Zachary Menn and Aldona Spiegel 
Chapter 9  Double-Pedicle DIEP and SIEA Flaps and 
Their Application in Breast Reconstruction  177 
Marzia Salgarello, Liliana Barone-Adesi 
and Giuseppe Visconti 
Chapter 10  The Omentum Flap  195 
Sirlei dos Santos Costa and Rosa Maria Blotta 
Part 4  Fat Graft in Breast Reconstruction  215 
Chapter 11  Autologous Fat Transplantation –  
A Paradigm Shift in Breast Reconstruction  217 
Daniel Del Vecchio and Hetal Fichadia 
Part 5  Breast Reconstruction 
After Conservative Treatment  241 
Chapter 12  Breast Reconstruction 
Approach to Conservative Surgery  243 
Egidio Riggio and Valentina Visintini Cividin
Preface 
 
Breast  reconstruction  is  an  evolving  art  that  challenges  surgeons  to  combine 
reconstructive and aesthetic principles in the search for the best results possible. 
The goal of breast reconstruction after mastectomy and after conservative treatment, is 
to restore the appearance of the breast and to improve a woman's psychological health 
after  cancer  treatment.  Similarly,  rebuilding  the  breast  after  severe  breast 
malformation such as Poland syndrome, is similar to breast reconstruction after 
oncologic treatment. In this way the book joins together breast reconstruction after 
cancer treatment, and after a serious congenital condition that may even result in  the 
absence of the breast and the deformity of the homo-lateral chest.  Although the 
technical strategies for breast reconstruction are getting increasingly sophisticated, the 
two main options can still be summarized as autogenous and/or prosthetic, both now 
reaching a high standard of results. Having this in mind, the purpose of this book is to 
examine many of the modern techniques for breast reconstruction, and also giving 
some insight into specific topics.  
The text consists of five sections. The first is an introduction to the oncologic aspects of 
breast reconstruction. In brief, this chapter introduces the issue of immediate breast 
reconstruction, of which the main benefit is superior aesthetic results compared to 
those of delayed reconstruction, together with a gain in psychological, social, and 
sexual well-being, and a significant cost reduction. The book goes on to examine the 
topic of detection and treatment of local recurrences after breast reconstruction, and 
the relationship between immediate breast reconstruction and adjuvant therapies. This 
chapter  also  provides  significant  information  on  the  safety  of  conservative 
mastectomies. Section two focuses on prosthetic breast reconstruction, which contains 
chapters for two-stage and one-stage implant-assisted reconstruction together with a 
chapter examining the effect of mastectomy and implant breast reconstruction on the 
maintenance of proper body posture after surgery. Section three is about autogenous 
breast  reconstruction,  and  has  several  chapters  covering  the  main  topics  from 
latissimus dorsi and abdominal flaps to omentum flap. Section four analyzes breast 
reconstruction with the use of a fat graft. Finally, section five covers the current
X  Preface 
 
approaches  to  breast  reshaping  after  conservative  treatment,  mainly  modified 
reduction mammaplasty, and adjacent tissue rearrangement.  
 
Dr. Marzia Salgarello 
University Hospital “Agostino Gemelli”, 
University of “Sacro Cuore”, 
Rome, 
Italy