Autologous breast reconstruction

Steven H. Williams, MD answers: Breast reconstruction for infected breasts?

I have had breast infections due to Gamella bacteria first, then had a bilateral periductal fistula on both breast 3 times, then contracted HA MRSA. I underwent surgery for that. I still have infection but my breasts look terrible now. They are scarred from the many procedures, and the right nipple is actually at an angle now instead of horizontal.

I was wondering if there's any type of corrective surgery that would be helpful for my situation. We are still treating an infection, although unknown. The last culture was " normal skin flora". Thank you for your time.

10 months ago

By Steven H. Williams, MD - Bay Area Plastic Surgeon

You have a complicated problem. The first issue should be can a partial mastectomy removing the scar tissue create a resonable breast mound or is it necessary to perform a larger resection.

When dealing with breast reconstruction there is an important choice between using your own tissue (an autologous breast reconstruction) and using implants.

In an individual with multiple infections sometimes implants are the best choices. Implants are not resistant to infections the way your own tissue would be.

For both partial mastectomy (lumpectomy type) defects lat. dorsi (using a portion of your back muscle and possibly (depending on the defect) skin) can be effective ways to reconstruct small defects.

For larger defects pedicled TRAM, free TRAM and DIEP reconstructions all work very well.

I do agree with Dr. Cambre that it will likely require several surgeries and that you would be well served by clearing the infection first.

I hope this helps.

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Steven H. Williams, MD answers: Breast reconstruction for infected breasts?

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