An approach to the repair of partial mastectomy defects

In many cases, breast deformity caused by partial mastectomy can be reduced or corrected by plastic surgery. Partial breast reconstruction is best per formed immediately after the partial mastectomy using an approach determine d by the size of the breast and the defect. Small defects in large breasts usually need no reconstruction. For larger defects in large breasts, breast reshaping (similar to reduction mammaplasty) combined with a contralateral breast reduction is usually the best option. For medium-sized or smaller b reasts with small to moderate-sized defects, local flaps from the subaxilla ry region are very useful. If the defect is too large for correction with l ocal tissue, a latissimus dorsi myocutaneous flap is usually the best choic e. Using these techniques, patients can achieve aesthetically better outcom es from breast-conservation therapy, even when larger tumors are being trea ted or when wider margins are taken to reduce the risk of tumor recurrence. By working together with an oncologic surgeon and facilitating the removal of larger tumors, the plastic surgeon can widen the indications for both b reast-conservation therapy and breast reconstruction at the same time.