TRAM Revisions and Contralateral Mammaplasties: The Role of “Mirror Image” Skin Patterns

Symmetry is the sine qua non of breast reconstruction. A symmetrical result offers peace of mind, a healthy body image, and improved self-esteem to the patient and presents a sometimes elusive goal to the plastic surgeon. When symmetry comes with modest effort we are pleased, but more often the effort is prolonged through several operations over a period of time. This article addresses the management of both the reconstructed breast mound(s) as well as the contralateral breast at different stages of the reconstruction process. By approaching the reconstructed breast mound(s) and a remaining native breast as similar soft tissue structures with similar soft tissue envelopes, it may be possible to maximize the symmetry of the final result.

KEYWORDS

Breast reconstruction - mammaplasty - symmetry

REFERENCES

• 1 Hidalgo D A. Aesthetic refinement in breast reconstruction: complete skin-sparing mastectomy with autologous tissue transfer.  Plast Reconstr Surg. 1998;  102 63-70
• 2 Losken A, Carlson G W, Bostwick III J, Jones G E, Culbertson J H, Schoemann M. Trends in unilateral breast reconstruction and management of the contralateral breast: the Emory experience.  Plast Reconstr Surg. 2002;  110 89-97
• 3 Stevenson T R, Goldstein J A. TRAM flap breast reconstruction and contralateral reduction or mastopexy.  Plast Reconstr Surg. 1993;  92 228-233
• 4 Greco R J, Dascombe W H, Williams S L, Johnson R R, Kelly J L. Two-staged breast reconstruction in patients with symptomatic macromastia requiring mastectomy.  Ann Plast Surg. 1994;  32 572-579
• 5 Knowlton E W, Gorey R, Taekman J. Total immediate breast reconstruction with “peg” latissimus dorsi flap.  Contemp Surg. 1992;  41(3) 15-19
• 6 Restifo R J. Expanding the Indication for the Vertically Oriented Scar in Breast Surgery. Presented at the 68th Annual ASPRS Scientific Meeting New Orleans, LA; October 25, 1999