How is the reconstructed breast reduced?

Updated: Jul 29, 2021
  • Author: Mark F Deutsch, MD; Chief Editor: James Neal Long, MD, FACS  more...
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When it is necessary to reduce the reconstructed breast, the surgeon has several options. Both direct excision of excess fat and liposuction can achieve the desired result. It may be premature to recommend ultrasonic liposuction. This is an ideal time to resect areas of fat necrosis and to trim both abdominal and breast "dog ears." As previously mentioned, axillary fullness from a wide flap or from improper suture closure of the axilla is a common problem. In mild cases, liposuction and/or excision can correct this problem.

In more severe cases, dissecting the flap off the chest wall and moving it medially may be necessary. Confirm symmetry of the IMF. This often is caused by violation of this boundary during the resection. If the IMF is lower on the reconstructed side, the flap needs to be elevated and suspended along its inferior portion while the new IMF is sutured to the chest wall.

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