Abstract:

The discovery of modern techniques of breast reconstruction paralleled two major advancements in plastic and reconstructive surgery. The first was the identification of areas of cutaneous perfusion through underlying muscles, and the recognition that entire muscles could be rotated into new positions on a vascular pedicle of one dominant artery and vein. The use of the latissimus dorsi musculocutaneous flap and a silicone breast implant to simulate the breast mound was the first truly elegant solution to a problem that had perplexed reconstructive surgeons for centuries. The second discovery was the Radovan tissue expander. The placement of the tissue expander underneath the chest wall muscles and its gradual expansion with stretching of the overlying tissues also provided a theoretically simple technique for breast mound reconstruction.

Authors:

Harold I. Friedman, M.D., Ph.D., F.A.C.S., Frederick L. Greene, M.D., F.A.C.S.

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