Surgery of the Breast

Contributing Authors vii

Foreword xv

Foreword to 1st Edition xvii

Foreword to 2nd Edition xix

Preface xxi

Acknowledgments xxiii

Volume 1

SECTION I:

Oncology and

1

  Incidence and Risk Factors . . . . . . .
The Epidemiology of Breast Cancer:3

CELIA BYRNE

  2

  Diagnosis . . . . . . . . . . . . . . . . . .
Breast Cancer Screening and11

COSTANZA COCILOVO

  3

  Breast . . . . . . . . . . . . . . . . . . . . .
Imaging of the Surgically Altered16

ERINI MAKARIOU AND ANOUSHEH SAYAH

  4

and Treatment in Augmented

Women . . . . . . . . . . . . . . . . . . . .
Breast Cancer Diagnosis, Prognosis,35

NEAL HANDEL

  5
Pathology of Breast Disorders . . . . 48

BALJIT SINGH

  6

  High-risk Patient . . . . . . . . . . . . .
Defining and Managing the62

THERESE S. CERMAK AND JENNIFER ENG-WONG

  7

Oncoplastic Treatment Approach . . .
Ductal Carcinoma In Situ: An71

MELVIN J. SILVERSTEIN

  8
Mastectomy for Breast Cancer . . . . 96

SHAWNA C. WILLEY AND

  DONNA-MARIE E. MANASSEH

  9

Dissection . . . . . . . . . . . . . . . . .
Sentinel Node Biopsy and Axillary107

HIRAM S. CODY III

  10

Issues . . . . . . . . . . . . . . . . . . . .
Breast Conservation: Oncologic118

COSTANZA COCILOVO

  11

Common and Challenging

Problems . . . . . . . . . . . . . . . . . .
Oncoplastic Surgery: Managing123

ALEXANDRE MENDONÇA MUNHOZ

  12

Mastectomy Defects: Classifications

and Methods . . . . . . . . . . . . . . .
Reconstruction of Partial140

ALBERT LOSKEN

  13

and Reconstruction of Breast

Cancer . . . . . . . . . . . . . . . . . . . .
Special Problems in the Treatment165

ALBERT LOSKEN

  14

Reconstruction of the Partial

Mastectomy Defect . . . . . . . . . . .
The Osnabrueck Experience With177

KLAUS E. BRUNNERT

  15

Conservation Patient . . . . . . . . .
Reconstruction of the Breast198

SUMNER A. SLAVIN

  16

of Breast Conservation Therapy

of the Large-breasted Patient . . .
Reduction Mammaplasty as Part213

SCOTT L. SPEAR, KETAN M. PATEL, AND

  PRANAY M. PARIKH

  17

Breast Cancer: Breast-conserving

Therapy and Mastectomy . . . . . .
Follow-up After Surgery for Primary218

ELIZABETH D. FELDMAN AND WAFA ALKHAYAL

  18
Adjuvant Systemic Therapy . . . . . 228

MINAL SHAH, CLAUDINE J. D. ISAACS, AND

  MINETTA C. LIU

  Contents

19

Breast-conserving Surgery . . . . .
Radiation Therapy Following242

LAURIE W. CUTTINO AND FRANK A. VICINI

  20

Therapy After Mastectomy . . . . .
Invasive Carcinoma: Radiation255

JEFFERSON E.C. MOULDS

  21

Assessment, Genetic Testing, and

Management Options . . . . . . . . .
Hereditary Breast Cancer: Risk264

BETH N. PESHKIN

  22

Reconstruction, Including Prosthetic,

Latissimus, and Transverse Rectus

Abdominus Myocutaneous Flap

Techniques . . . . . . . . . . . . . . . .
Prophylactic Simple Mastectomy and277

DENNIS C. HAMMOND

  23

Reconstruction: Indications,

Techniques, and Outcomes . . . . .
Nipple-sparing Mastectomy and287

SCOTT L. SPEAR, SHAWNA C. WILLEY,

CATHERINE M. HANNAN, AND

COSTANZA COCILOVO

  24
Nipple-sparing Mastectomy . . . . . 298

G. PATRICK MAXWELL, PAT WHITWORTH, AND

ALLEN GABRIEL

  25

Reconstructive Considerations . .
Breast Cancer in Men: Oncologic and308

MAURICE Y. NAHABEDIAN

  26

Treatments for Breast Cancer . . .
Psychological Impact of313

JULIA H. ROWLAND

  SECTION II:

Reconstruction
Breast

27

Considerations in Breast

Surgery . . . . . . . . . . . . . . . . . . .
Informed Consent: Medicolegal331

NEAL R. REISMAN

  28
Silicone Gel Breast Implants . . . . 337

MICHAEL J. MILLER

  29

Manufacturing Past, Present, and

Future . . . . . . . . . . . . . . . . . . . .
Breast Implants: Materials and344

WILLIAM P. ADAMS, JR AND JASON K. POTTER

  30

Reconstruction With Adjustable

Implants . . . . . . . . . . . . . . . . . .
One-stage Immediate Breast357

HILTON BECKER

  31

Reconstruction With Shaped

Adjustable Implants . . . . . . . . . .
Immediate and Delayed Breast376

MICHAEL SCHEFLAN

  32

Reconstruction Using a Tissue

Expander and Implant . . . . . . . .
Immediate Two-stage Breast388

LOUIS L. STROCK

  33

Reconstruction . . . . . . . . . . . . . .
Acellular Dermis-assisted Breast406

SCOTT L. SPEAR, PRANAY M. PARIKH, AND

NATHAN G. MENON

  34

Reconstruction With Acellular

Dermal Matrix . . . . . . . . . . . . . .
Direct-to-Implant Breast412

C. ANDREW SALZBERG AND R. MICHAEL KOCH

  35

Implant Breast

Reconstruction . . . . . . . . . . . . . .
Delayed Two-stage Tissue Expander–420

F. FRANK ISIK

  36

Form-stable Implants . . . . . . . . .
Breast Reconstruction With429

MAURIZIO NAVA, ANGELA PENNATI,

ANDREA SPANO, AND GIUSEPPE CATANUTO

  37

Breast Reconstruction . . . . . . . .
Skin-preserving Delayed-Immediate438

STEVEN J. KRONOWITZ AND

GEOFFREY L. ROBB

  38

  Reconstruction Using Semilunar

  Expander and Purse-string

  Closure . . . . . . . . . . . . . . . . . . .
Immediate Two-stage Breast450

GINO RIGOTTI AND ALESSANDRA MARCHI

  39

  Radiated Breast . . . . . . . . . . . . .
Prosthetic Reconstruction in the460

SCOTT L. SPEAR AND M. RENEE JESPERSEN

  40
Secondary Prosthetic Cases . . . . . 476

SCOTT L. SPEAR, M. RENEE JESPERSEN, AND

  ADAM D. SCHAFFNER

  41

  The External Approach . . . . . . . .
Recreating the Inframammary Fold:492

JAMES J. RYAN

  42

  The Internal Approach . . . . . . . .
Re-creating the Inframammary Fold:497

SCOTT L. SPEAR, ALI N. MESBAHI, AND

  MICHAEL BECKENSTEIN

  43

  Fold With the Superficial

  Fascial System . . . . . . . . . . . . . .
Recreating the Inframammary512

MAURIZIO NAVA, JOSEPH OTTOLENGHI, AND

  EGIDIO RIGGIO

  44

  Flap Breast Reconstruction . . . . .
Latissimus Dorsi Musculocutaneous535

DENNIS C. HAMMOND

  45

  Autologous Reconstruction with

  Latissimus Muscle Only Flaps . . .
Endoscopic Delayed-Immediate555

NEIL A. FINE AND KRISTINA O’SHAUGHNESSY

  46

  in Reconstruction of the

  Radiated Breast . . . . . . . . . . . . .
The Latissimus Dorsi Flap563

SCOTT L. SPEAR, JAY BOEHMLER, AND

  MARK W. CLEMENS

  47

  Autologous Latissimus Dorsi

  Flap With and Without Immediate

  Nipple Reconstruction . . . . . . . .
Breast Reconstruction With an571

EMMANUEL DELAY

  48

  Breast . . . . . . . . . . . . . . . . . . . .
Aesthetic Subunits of the597

STEVEN P. DAVISON AND MARK W. CLEMENS

  49

  Breast . . . . . . . . . . . . . . . . . . . .
Reconstruction of the Irradiated607

SCOTT L. SPEAR, MATTHEW L. IORIO, AND

  PRANAY M. PARIKH

  50

  Breast Using Autologous Tissue

  With Immediate Nipple

  Reconstruction . . . . . . . . . . . . . .
One-stage Reconstruction of the623

LAWRENCE B. COLEN AND JOHN M
CCRAW

51

  Reconstruction . . . . . . . . . . . . . .
Bipedicle TRAM Flap639

KENNETH C. SHESTAK

  52

  Myocutaneous Flap Reconstruction:

  The Single-pedicle, Whole-muscle

  Technique . . . . . . . . . . . . . . . . .
Transverse Rectus Abdominis652

MICHAEL R. ZENN AND JAMES W. MAY, JR.

  53

  Unipedicle TRAM Operation: The

  Muscle-splitting Technique . . . . .
Breast Reconstruction With the660

SCOTT L. SPEAR, CHRISTIAN A. PRADA,

  DEREK L. MASDEN, AND J. WILLIAM LITTLE

  54

  Myocutaneous Flaps . . . . . . . . . .
Bilateral Transverse Rectus Abdominus670

ONELIO GARCIA, JR.

  55

  Myocutaneous Flap Breast

  Reconstruction . . . . . . . . . . . . . .
Free Transverse Rectus Abdominis681

CHET L. NASTALA, STEVEN M. PISANO,

  MINAS T. CHRYSOPOULO, AND PETER R. LEDOUX

  56

  Skin-sparing Mastectomy Through

  a Periareolar Approach . . . . . . . .
Immediate Reconstruction After693

JOAN E. LIPA

  57

  Mastectomy Using the Omental

  Flap and Synthetic Mesh . . . . . . .
Immediate Reconstruction After Skinsparing705

JOÃO CARLOS SAMPAIO GÓES AND

  ANTONIO LUIZ V. MACEDO

  58
Abdominal Flaps and Implants . . 712

MAURICE Y. NAHABEDIAN

  59

  Myocutaneous Flaps With

  Preoperative Delay . . . . . . . . . . .
Transverse Rectus Abdominis720

PAUL R. CALLEGARI

  60

  Tissue Transfer: An Algorithmic

  Approach . . . . . . . . . . . . . . . . . .
Breast Reconstruction With Free727

JULIE E. PARK AND DAVID H. SONG

  61

  Reconstruction . . . . . . . . . . . . . .
Perforator Flaps in Breast736

MARK W. CLEMENS AND

  MAURICE Y. NAHABEDIAN

  62

  Flaps . . . . . . . . . . . . . . . . . . . . .
Anatomic Basis of Perforator745

MICHEL SAINT-CYR

  63

  in Breast Reconstruction . . . . . . .
Pedicled Perforator Flaps757

MOUSTAPHA HAMDI

  64

  Rectus Abdominis Musculocutaneous

  Flaps . . . . . . . . . . . . . . . . . . . . .
Musculofascial-sparing Transverse770

MICHAEL J. MILLER

  65

  Artery Perforator Flap Breast

  Reconstruction . . . . . . . . . . . . .
Deep Inferior Epigastric778

MARK W. CLEMENS AND

  MAURICE Y. NAHABEDIAN

  66

  Perforator Flap in Breast

  Reconstruction . . . . . . . . . . . . . .
The Superior Gluteal Artery790

JULIE V. VASILE, ROBERT J. ALLEN, AND

  JOSHUA L. LEVINE

  67

  Flap for Microsurgical Breast

  Reconstruction . . . . . . . . . . . . . .
The Inferior Gluteal Artery Perforator803

CONSTANCE M. CHEN, MARIA M. LoTEMPIO,

  AND ROBERT J. ALLEN

  68

  Epigastric Artery Flap in Breast

  Reconstruction . . . . . . . . . . . . . .
The Superficial Inferior808

PIERRE M. CHEVRAY

  69

  Reconstruction . . . . . . . . . . . . . .
Gracilis Flaps for Breast818

KAREN M. HORTON

  70

  Breast in Breast Reconstruction . . .
Options for Managing the Opposite830

JAMES D. NAMNOUM AND DAVID OTTERBURN

  71

  Outcomes in Bilateral Breast

  Reconstruction . . . . . . . . . . . . . .
Issues, Considerations, and838

ELISABETH K. BEAHM AND

  ROBERT L. WALTON

  72
Nipple-Areola Reconstruction . . . 855

SCOTT L. SPEAR AND JUSTIN E. WEST

  73

  Augmentation in Subsequent

  Breast Reconstruction . . . . . . . .
Considerations of Previous875

SCOTT L. SPEAR, MARK W. CLEMENS, AND

  MICHAEL A. HOWARD

  74

  Breast Reconstruction . . . . . . . .
The Second Stage in Autologous884

DAVID W. CHANG

  75

  Following Breast Reconstruction

  With Abdominal Flaps . . . . . . . .
Biomechanical Considerations894

MAURICE Y. NAHABEDIAN, SCOTT L. SPEAR, AND

  CHRISTOPHER L. HESS

  76

  Deformities in the Reconstructed

  Breast . . . . . . . . . . . . . . . . . . . .
Fat Injection to Correct Contour904

SCOTT L. SPEAR AND ALI AL-ATTAR

  77

  Breast . . . . . . . . . . . . . . . . . . . .
Lipomodeling of the Reconstructed912

EMMANUEL DELAY

  78

  Reconstruction . . . . . . . . . . . . . .
Surveillance Following Breast930

VALERIE LEMAINE, COLLEEN M. M

  AND ANDREA PUSIC
CCARTHY,

79

  Following Tumor Recurrence . . .
Reconstruction of the Breast934

MELISSA A. CROSBY AND DAVID W. CHANG

  80
Stem Cells and the Breast . . . . . . 940

EDWARD P. BUCHANAN, VICTOR W. WONG, AND

  GEOFFREY C. GURTNER

  81

  Postoperative Breast Pain . . . . . .
Management of Chronic947

IVICA DUCIC, ETHAN E. LARSON, AND

  MATTHEW L. IORIO

  Volume 2

  SECTION III:

  Mammaplasty and Mastopexy
Reduction

82

  and Mastopexy: General

  Considerations . . . . . . . . . . . . . .
Reduction Mammaplasty955

DENNIS C. HAMMOND

  83

  and Reduction: The “Round

  Block” . . . . . . . . . . . . . . . . . . . .
Periareolar Benelli Mastopexy960

LOUIS C. BENELLI

  84

  Wall–based Flap and Pectoralis

  Muscle Loop . . . . . . . . . . . . . . .
Mastopexy With Chest972

RUTH GRAF, ANDRÉ RICARDO DALL’OGLIO

  TOLAZZI, THOMAS BIGGS, AND

  MARIA CECÍLIA CLOSS ONO

  85

  Implants: Superolaterally Based

  Rotation Flap . . . . . . . . . . . . . .
A Mastopexy Technique Without985

BARBARA B. HAYDEN

  86

  and Mastopexy Without

  Undermining . . . . . . . . . . . . . . .
Vertical Scar Breast Reduction990

CLAUDE LASSUS

  87
Vertical Mastopexy . . . . . . . . . . 1007

JUAN DIEGO MEJIA AND FOAD NAHAI

  88

  Reduction and Mastopexy . . . . .
Vertical Mammaplasty for Breast1016

ALBERT DE MEY, DIANE FRANCK, AND

  CHRISTOPHE ZIRAK

  89

  Short Horizontal Scar . . . . . . .
Vertical Mammaplasty With a1025

DANIEL A. MARCHAC

  90

  Alone . . . . . . . . . . . . . . . . . . .
Breast Reduction by Liposuction1035

MARTIN MOSKOVITZ

  91

  the Superomedial Pedicle . . . . .
Vertical Breast Reduction Using1045

ELIZABETH J. HALL-FINDLAY

  92

  Inferior Pedicle Reduction

  Mammaplasty . . . . . . . . . . . . . .
The Short Scar Periareolar1063

DENNIS C. HAMMOND

  93

  Reduction Technique . . . . . . . .
The Circumvertical Breast1078

A. ALDO MOTTURA

  94

  Reduction: Basic Concepts . . . .
Inferior Pedicle Technique in Breast1088

NAVIN K. SINGH AND MARWAN R. KHALIFEH

  95

  Reduction: Practical Steps . . . . .
Inferior Pedicle Technique in Breast1097

SAUL HOFFMAN

  96

  Using the Central Mound

  Technique . . . . . . . . . . . . . . . .
Reduction Mammaplasty1107

DANIEL P. LUPPENS AND MARK A. CODNER

  97

  Medial Pedicles and Inverted-T

  Incisions . . . . . . . . . . . . . . . . .
Reduction Mammaplasty Using1116

ETHAN E. LARSON AND MAURICE Y. NAHABEDIAN

  98
The L Short-scar Mammaplasty . 1128

ARMANDO CHIARI, JR. AND JAMES C. GROTTING

  99

  Reduction . . . . . . . . . . . . . . . .
The No-vertical-scar Breast1144

SIMON G. TALBOT AND JULIAN J. PRIBAZ

  100

  Free Nipple Graft Technique . . .
Breast Reduction With the1156

SCOTT L. SPEAR AND M. RENEE JESPERSEN

  101

  in the Irradiated Breast . . . . . . .
Reduction Mammoplasty1170

SCOTT L. SPEAR AND AMER SABA

  102

  After Massive Weight Loss . . . .
Breast Reduction and Mastopexy1174

J. PETER RUBIN AND JOSEPH MICHAELS

  103

  and Mastopexy After Massive

  Weight Loss . . . . . . . . . . . . . . .
Strategies in Breast Reduction1185

DENNIS J. HURWITZ

  104
Gynecomastia . . . . . . . . . . . . . . 1205

FRANK LISTA AND JAMIL AHMAD

  105

  Corrections After Breast

  Reduction and Mastopexy . . . . .
Complications and Secondary1211

SCOTT L. SPEAR AND KAREN KIM EVANS

  SECTION IV:

  Mammaplasty
Augmentation

106

  General Considerations . . . . . . .
Augmentation Mammaplasty:1227

G. PATRICK MAXWELL, MATTHEW B. BAKER, AND

  ALLEN GABRIEL

  107

  Tissue-based Planning for

  Breast Augmentation . . . . . . . .
The High Five Process:1246

WILLIAM P. ADAMS JR.

  108

  Patient: Psychological Issues . . .
The Augmentation Mammoplasty1254

REBECCA COGWELL ANDERSON AND

  JASON C. LEVINE

  109

  Augmentation . . . . . . . . . . . . .
Patient Education in Breast1261

CAROLINE A. GLICKSMAN

  110

  Augmentation Mammaplasty . . .
The Inframammary Approach to1271

DENNIS C. HAMMOND

  111

  Augmentation Mammaplasty . . .
The Periareolar Approach to1277

SCOTT L. SPEAR, JEFFREY M. JACOBSON, AND

  ELAN REISIN

  112

  Augmentation . . . . . . . . . . . . .
Subfascial Breast1283

RUTH MARIA GRAF, MARIA CECÍLIA CLOSS ONO,

  AND ANDRÉ RICARDO DALL’OGLIO TOLAZZI

  113

  Augmentation . . . . . . . . . . . . . .
Transaxillary Breast1290

LOUIS L. STROCK

  114

  Augmentation . . . . . . . . . . . . .
Transumbilical Breast1300

RICHARD V. DOWDEN AND

  MARIANNE A. FULLER

  115

  Anatomic, High-cohesiveness

  Silicone Gel Implants (European

  Experience) . . . . . . . . . . . . . . .
Breast Augmentation With1322

PER HEDÉN

  116

  Form-stable Gel Implant for Primary

  Breast Augmentation . . . . . . . .
The Highly Cohesive, Style 4101346

BRADLEY P. BENGTSON

  117
Lipoaugmentation . . . . . . . . . . 1366

SYDNEY R. COLEMAN AND ALESIA P. SABOEIRO

  118

  Reconstruction Using BRAVA

  External Breast Expansion

  and Autologous Fat Grafting . .
Breast Augmentation and1374

ROGER K. KHOURI AND DANIEL DEL VECCHIO

  119

  Patient With Tuberous Breasts and

  Other Complex Anomalies . . . .
Augmentation Mammaplasty in the1401

DENNIS C. HAMMOND

  120

  in Women With Thoracic

  Hypoplasia . . . . . . . . . . . . . . .
Augmentation Mammaplasty1410

SCOTT L. SPEAR, JESSE A. GOLDSTEIN, AND

  CHRISTOPHER V. PELLETIERE

  121

  With Poland Syndrome . . . . . . .
Breast Reconstruction in Patients1416

JAMES D. NAMNOUM

  122

  Mastopexy . . . . . . . . . . . . . . . .
Augmentation With Periareolar1425

SCOTT L. SPEAR AND MARK L. VENTURI

  123

  General Considerations . . . . . . .
Augmentation Mastopexy:1434

DENNIS C. HAMMOND

  124

  Augmentation Mammaplasty . . .
Managing Complications of1447

NEAL HANDEL

  125

  Implant Malposition . . . . . . . . .
Neo-subpectoral Technique for1473

SCOTT L. SPEAR, M. RENEE JESPERSEN, AND

  SAMIR S. RAO

  126

  Distortion Following Submuscular

  Breast Augmentation . . . . . . . .
Outcome Assessment of Breast1481

SCOTT L. SPEAR AND JAIME SCHWARTZ

  127

  Surgery of the Breast . . . . . . . .
Bioprosthetic Materials for Plastic1488

G. PATRICK MAXWELL AND ALLEN GABRIEL

  128

  Treatment and Prevention of

  Implant-associated Breast

  Deformities . . . . . . . . . . . . . . .
Acellular Dermal Matrix for the1495

SCOTT L. SPEAR AND MITCHEL SERUYA

  129

  After Augmentation Mammaplasty

  by Conversion to the Subpectoral

  or “Dual-plane” Position . . . . .
Correction of Capsular Contracture1503

SCOTT L. SPEAR AND MICHAEL COHEN

  130

  and Anatomic Description,

  Classification and Definitions,

  and Options for Repair and

  Reinforcement . . . . . . . . . . . . .
The Inframammary Fold: Histologic1510

BRADLEY P. BENGTSON

  131

  Anatomic Form-stable Silicone

  Gel Implants . . . . . . . . . . . . . .
Revision Augmentation With1516

MITCHELL H. BROWN

  132

  Augmented Breast . . . . . . . . . .
Correction of Ptosis in the Previously1532

NEAL HANDE

Oncoplastic Surgery