Goals of Care Restore shape and function after cancer Aid in - PowerPoint PPT Presentation

Oct 08, 2023 •292 likes •391 views

Goals of Care Restore shape and function after cancer Aid in physiological and psychological benefit Relationship with significant other Self esteem and positive body image Feeling of a whole body Avoid having

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Goals of Care • Restore shape and function after cancer • Aid in physiological and psychological benefit – Relationship with significant other – Self esteem and positive body image – Feeling of a “whole body” – Avoid having to wear prosthesis
Timing for Breast Reconstruction Immediate Delayed Pros Pros • Better cosmetic results • Cancer treatment first • Less scarring • Less surgery Cons Cons • May delay cancer treatment • Mastectomy scars • Cosmetic result • Additional surgery compromised by radiation • Wait time for reconstruction
Latissimus Flap Reconstruction • Skin, fat, muscle, and blood vessels transferring from the back to the chest • Implant inserted – to replace missing volume – achieve desired shape, size, and projection • Back up option for patients with wound healing problems and prior radiation treatment
Reconstruction 6-9 months ¡
Latissimus Flap Reconstruction Advantage Disadvantage • Blood vessels remain attached • 2-4 day hospital stay • Natural appearance • Limited implant lifespan • Good option for patients after • Two operative sites (back and radiation therapy breast) • Incision on the back placed under • Possible partial loss of muscle bra stripe function • Quicker procedural time (3-4 • Possible revisions hours) • Visible/palpable implant • Short recovery time (3-4wk) • Risk for potential infection • Variable size • Risk of flap failure
Potential complications with Implants • Rupture/Deflation • Displacement • Infection • Capsular contracture • Difficulty with mammograms ¡ ¡ • Need for revisional surgery • Visible rippling • Unnatural feeling • Asymetry • Pain
Nipple Reconstruction • Patient’s preference • Nipple is reconstructed after the breast is healed (3-4 months after reconstruction surgery) – Use local tissue (projected nipple) + tattoo – Three dimensional tattoo (flat nipple)
Risks and Complications of ANY Surgery • Bleeding • Blood Clots • Infection • Respiratory problems • Scars • Problems with ambulation • Pain • Delayed wound healing • Loss of sensation • Need for more surgery • Asymetry

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