Timing in Breast Reconstruction: Delayed, Immediate, & Staged Immediate - Joshua L. Levine, MD, FACS скачать в хорошем качестве

Timing in Breast Reconstruction: Delayed, Immediate, & Staged Immediate - Joshua L. Levine, MD, FACS

Contact Dr. Levine and the Center for Breast reconstruction at 212.245.8140 Our New Location: 57 West 57th Street, Suite 1603, New York, NY 10019 The following presentation was delivered by Dr. Joshua L. Levine, Director of the Center for Breast Reconstruction. Dr. Levine has performed over 3,000 successful natural tissue breast reconstruction procedures since 2003. He is a pioneer and world-leading authority in perforator flap breast reconstruction and related perforator vessel mapping. Learn about other types of advanced Perforator Flap Procedures we offer: https://centerforbreastreconstruction... Learn more about Expert Breast Reconstruction Surgeon, Dr. Joshua L. Levine, including his C.V., Hospital Affiliations, and Surgical Teams. https://centerforbreastreconstruction... *** TRANSCRIPT OF AUDIO RECORDING *** The timing of breast reconstruction may be variabled depending on a patient’s circumstance. The most common circumstance in breast reconstruction is what we call Immediate Breast Reconstruction. This means that a patient’s breast reconstruction is performed at the time of the mastectomy, in other words, simultaneously. In these circumstances the patient typically has cancer, the patient comes into the hospital and undergoes a mastectomy either for one side or both sides, and while the mastectomy is being performed, the plastic surgeon will be preparing the donor site most commonly the abdomen for autologus breast recontruction. Once the mastectomy is completed, the tissue, or skin and fat from the abdomen, is harvested or transfered or transplanted to the chest, to reconstruct th breasts at that time, therefore making the reconstruction as we say, immediate. There are also circumstances in which we would have what’s called delayed reconstruction. Delayed breast reconstruction occurs if a patient has had a mastectomy in the past and no reconstruction, or mastectomy in the past and a reconstruction which didn’t work out, for example, an implant reconstruction which failed due to infection, or if they’ve had a reconstruction in the past that didn’t work out for some other reason. They come to the reconstructive plastic surgeon requiring a reconstruction but the mastectomy has already been done. In these cases, we call this a delayed breast reconstruction, and the patient comes in on the day of surgery and has the breast reconstruction on that day. The third category is called Staged or Delayed Immediate Breast Reconstruction. It’s a combination of the two terms. This is an opportunity for the patient to mix and match the patient’s practitioner. In other words, there are circumstances in which, a patient is in a situation where they’re very comfortable with their breast surgeon, and they want to maintain that relationship and continue to be seen by that breast surgeon and have that breast surgeon do the mastectomy. But it may be possible for the plastic surgeon and the breast surgeon to work together. In these circumstances, we would do what’s called a Delayed-Immediate, wherein the patient would have the mastectomy on one day, and then about a week later or more than that up to about 6 weeks, the patient will have already been scheduled for the reconstruction by the plastic surgeon at another hospital. This has several advantages. 1. The patient can choose the breast surgeon of her choice and the plastic surgeon of her choice, even if they’re in different locations. 2. It gives the skin and particularly in the case of nipple preservation, the nipple a chance to recover from mastectomy before further traumatizing it with a reconstruction. 3. It gives the plastic surgeon the opportunity to focus solely on the task at hand, which is the reconstruction and so that operation is quicker and potentially the outcome is better. 4. One other advantage, would be with respect to the oncology, if there’s any question about the pathology of the specimen that is removed with the mastectomy, by the time the reconstruction is done, we would know whether or not more surgery needs to be done, in order to treat the patient’s cancer. © 2023 THE CENTER FOR BREAST RECONSTRUCTION | JOSHUA L. LEVINE, MD, FACS