Secondary Touch Surgery Following Breast Reconstruction with Free TRAM Flap

Choi, Eun Kyu; Ahn, Hee Chang

Abstract

It is very difficult to reconstruct perfectly symmetrical breast in one stage operation. Therefore, it is not uncommon that the surgeons perform secondary touch surgery following breast reconstruction to get more satisfactory results. The purpose of this article is to recognize various morphologic problems which could be occurred following breast reconstruction and to present the secondary touch surgery which can solve this problem for more symmetrical and natural breast reconstruction. From August 1995 to August 2001, breast reconstruction with free TRAM flap had been performed in 53 patients. Among them, 26 patients underwent secondary touch surgery. The patient's age ranged between 26 and 56 years with a mean of 41.3 years. The average time of the operation after breast mound reconstruction was 8.9 months. The nipple-areolar reconstruction was performed at the same time in all cases. There were liposuction in 9 cases, fat mobilization in 7 cases, correction of inframammary fold in 5 cases, scar revision in 11 cases, augmentation mammoplasty for normal side in 3 cases, reduction mammoplasty for normal side in 1 case, and mastopexy in 6 cases. In addition, adjuvant surgeries were performed coincidentally such as abdominal liposuction, and facial resurfacing. The result was effective. The author could make a more symmetrical and natural breast after secondary touch surgery. The advantage of this surgery is to reconstruct a more symmetrical and natural breast by a relatively simple procedure with concomitant nipple-areolar reconstruction