Long-term results of partial breast reconstruction following breast conserving surgery

Introduction: Breast-conserving treatments are currently prevailing in Japan. Among the several breast-conserving operations, we have chosen quadrantectomy for its minimal recurrence rate. But quadrantectomy leaves a moderate degree of deformity, which diminishes the quality of life for the patient. We have introduced immediate breast reconstruction following mastectomy. Procedure: According to the size or volume and location of the defect, we have selected several breast reconstruction methods: 1.) Latissimus dorsi (LD) muscle flap with endoscopic assistance, 2.) Rectus abdominis (RA) muscle flap with endoscopic assistance, 3.) Inferior gluteal muscle flap, 4.) Groin flap, and 5.) Latissimus dorsi (LD) muscle cutanious flap. These cases have been followed by irradiation therapy. Complications: Severe post-irradiation shrinkage of the reconstructed breast is a common occurrence. The muscle tissue retains elasticity, thus diminishing the volume. Also, the evidence of sclerosis and atrophy of the adipose tissue is frequently observed. Conclusion: Considering the cosmesis of a reconstructed breast, we have recommend the following solutions: 1.) It is preferable to use an ample amount of muscle tissue for the flap and not to use an excess volume of adipose tissue, 2.) It is important to reverse the implanted tissue to result in a comfortable feeling, 3.) It will be necessary to perform a modified surgery in case of atrophy and sclerosis.