Autologous mastectomy reconstruction: Communication among the breast surgery team to maximize aesthetic and oncologic outcome

Breast J. 2020 Sep;26(9):1771-1780. doi: 10.1111/tbj.13874. Epub 2020 May 16.


Mastectomy breast reconstruction with autologous tissue is challenging. Oncologic and aesthetic goals face previous surgical scars, radiation, chemotherapy, or other comorbidities. We describe a simple approach for autologous mastectomy reconstruction so that breast and plastic and reconstructive surgeons can maximize aesthetic outcomes and minimize wound complications. A retrospective chart review was done on patients who underwent mastectomy and autologous reconstruction. The surgical flight plans were reviewed to delineate an approach, and pre- and postoperative photographs were examined to create a step-by-step process. The most encountered mastectomy and autologous flap reconstruction scenarios were categorized to create a step-by-step process. Successful autologous mastectomy reconstruction to optimize aesthetic outcome and minimize complications requires team communication. Creation of a surgical flight plan using information from the physical examination, MRI and adjunctive imaging, and preoperative photographs is imperative. Thoughtful incision choice and exposure approach are paramount.

Keywords: autologous; breast; cancer; mastectomy; reconstruction.

MeSH terms

  • Breast Neoplasms* / surgery
  • Communication
  • Esthetics
  • Female
  • Humans
  • Mammaplasty*
  • Mastectomy
  • Retrospective Studies