BILATERAL TRAM FLAPS FOR THE RECONSTRUCTION OF THE POST IMPLANTECTOMYCAPSULECTOMY BREAST DEFORMITY/

The surgical management of patients desiring removal of silicone mamma ry prostheses can be controversial. Patients fearful of implants may c hoose not to undergo implant exchange with saline implants. This fear is well documented and has been influenced by the media. Anecdotal rep orts attempting to link silicone mammary prostheses to human adjuvant diseases have exacerbated this fear. Large outcome studies refute thes e claims. Significant breast deformity can result after implantectomy/ capsulectomy. Various autogenous tissues have been used in the post ma stectomy group of patients. Recently, latissimus dorsi muscle has been used in breast augmentation. This case report delineates the thought process involved in patient selection, describes the techniques employ ed, and suggests that bilateral deepithelialized TRAM flaps can be uti lized in the aesthetic reconstruction of a growing population of patie nts: those who decline implant exchange but desire to maintain or impr ove the aesthetic appearance of their breasts.