breast recon and breast reduction

-
marking for breast reduction

Partial mastectomy scar

Tram flap marked out

internal mammary vessel dissected out


Microvascular anastomosis done

primary closure and lateral muscle mass


Lie of vascular pedicle before final closure


final closure 

both breast shape
40 year old female developed right breast cancer which was excised partilly . Hence completion mastectomy and right axillary dissection was done . Right breast was reconstructed with muscle sparing tram flap and left breast was reduced by lejour method. Lejour method is superior pedicle reduction technique which results in linear scar well accepted by patients.

Tram flap was raised by sparing lateral muscle and including only medial component . Inferior epigastric artery of flap was connected to internal mammary vessels .  Drains were placed and flap was monitored for vascularity for 5 days and patient discharged there of.

Nipple reconstruction and any other revision are done one year post op.


Dr Adhishwar Sharma

MBBS , MS General Surgery PGIMER Chandigarh
Mch Plastic Surgery
Fellowship in hand and microvascular surgery
91 8860650846, adhishwar7@gmail.com
brahmanandclinic.com















Comments

Post a Comment

Popular posts from this blog

Pseudo bursa following abdominoplasty

-
Image
At six months post op Six months Post op six months Bursa fluid Final closure MRI Scan MRI Scan showing pseudobursa pre op pre op photo pre op wound A young Tanzanian doctor who was ENT surgeon by training went to Korea for training and decided to get abdominoplasty done in 2015. Post operative he was fine . In 2016 he noticed swelling in abdomen which was increasing in size. It made breathing difficult, it was pain ful and interfere in daily activities.  In 2017 he came to us in India and requested a solution to his problem. A physical examination was done, and a MRI scan was ordered. MRI scan showed a cystic swelling in the abdominal wall .  Patient was taken up for surgery and that pseudo bursa was excised. Post op was uneventful, at six months patient was showing normal profile. Dr Adhishwar Sharma MBBS ,MS General Surgery PGIMER Chd Mch Plastic Surgery Fellowship in Hand
Read more

TKR

-
Image
Patient was a 75 years old lady from Iraq who under went joint replacement surgery in India. She developed post operative wound dehiscence which resulted in exposed implant.For two months orthopedic surgeon and plastic surgeon for some reason or another kept the wound open did took no decision to close it .Patient under went one debridement and VAC therapy. Then I received a call from interpreter and I saw the patient.We decided that few days of VAC therapy and in consultation with ortho surgeon we decided date of surgery. We operated and after debridement I did a medial gatrocnemius flap cover and skin grafting. Post operative patient had fever for two days and dressing was soaked. We had placed a drain which did not worked ,so we removed drain and started daily dressing and betadine, hydrogen peroxide irrigation of the wound. Wound culture showed klebsiella P sensitive to meropenam . I told patient where to purchase generic meropenam and  we also instilled meropenam in the wound. Gr
Read more