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Tissue
Transfer |
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Areas of the
breast that could not be rebuilt by the previous methods can be
filled in and/or recontoured using tissues from the upper back,
abdomen or buttocks (tissue transfer).
One of the tissue transfer procedures rotates the back (latissimus
dorsi) muscle to the mastectomy site. The muscle carries the
overlying fat and skin which is maneuvered into its new position
on the upper chest. Still attached to its original blood supply,
this blend of tissues can build up the hollows created by some
radical mastectomy operations. This enables a prosthesis to be
inserted, thus reconstructing the breast mound. The transferred
portion of muscle and skin does not leave behind a significant
deformity or weakness of the back. It does, however, add a scar
to the upper back which some women may object to.
The Transverse Rectus Abdominis flap (TRAM) is a blend of
tissues taken from the abdomen or lower portion of the belly.
This, too, relies on a blood supply still attached to the
muscle. Portions of fat, muscle and skin are transferred to the
upper chest leaving behind a long lower abdominal scar. Unlike
the other procedures, a prosthesis is not always needed if this
tissue transfer method is used, as the lower abdomen usually has
more than ample amounts of fat and skin to build the breast
mound. But do not be misled--more is not always better, and the
fat in this region must be firm. Illnesses such as diabetes or
vascular disease, and even having had prior operations on the
abdomen, can prevent you from being a suitable candidate for
this type of reconstruction.
A third tissue transfer method uses portions of tissue from the
buttocks. This tissue is reconnected to the chest blood supply
using specialized microvascular techniques. This operation is
chosen in only a few selected cases and is by no means the usual
method for most reconstructions needing tissue transfer.
All tissue transfer procedures are extensive operations and have
a potentially higher complication risk. They are, however,
extremely valuable, offering alternative methods of
reconstruction, especially when simpler operations cannot be
performed.
BACK |
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Roses Grown and Photographed By
Dr. Jeffrey Rosenthal |
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