Creating a pocket for tissue flap after no skin sparing mastectomy. How is this done?
Doctor Answers 1
Pocket for flap
In this circumstance, there are two basic options. The first is to re open the incision and dissect the skin flaps to recreate the breast defect. The flap is then placed and blood vessels connected. Once connected, the flap is attached to the chest wall and shaped to match your other breast. The missing skin that was taken during your mastectomy is replaced by some of the skin from the DIEP flap.This results in a "football" or elliptically shaped patch of skin on the reconstruction.
Alternatively, if you want to avoid any skin from the abdomen on the chest, the skin would need to be expanded in order to allow the tissue to sit entirely beneath the skin, not unlike when the skin is expanded to place an implant.
Most of my delayed flap patients opt for the first option, as it will result in one less surgery. The best advice I can give you is to consult with a surgeon who has extensive experience in free flap breast reconstruction for an examination and advice on options. Best Regards.
PS: Dr Lucio Pavone and Dr David Song are 2 excellent options in Chicago!
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