Fig. 6, Case1 - Delayed breast reconstruction
(a) This 47 year old woman presented with a request
for breast reconstruction,
following a right mastectomy
and axillary lymph node dissection. She
underwent
radiotherapy and chemotherapy. A free SIEA flap,
pedicled on the
left superficial inferior epigastric artery
and vein and anastomosis to the
internal mammary artery
and vein was used to perform a secondary autologous
breast reconstruction. (b,c): show her result after nipple
reconstruction
and tattoo.
Fig. 7, Case 2 - Immediate
bilateral breast reconstruction (a) This 53 year old woman presented with
mixed multi-focal invasive and in situ ductal carcinoma widely dispersed in both
breasts. A bilateral skin
sparing mastectomy was performed together with a bilateral axillary dissection.
A reconstruction was
performed by a bilateral DIEAP flap. Postoperatively she underwent adjuvant
chemotherapy. Six months
postoperatively she underwent a bilateral nipple
reconstruction but no further corrections to the flaps.
(b-d): Another three months later, a bilateral nipple areola tattoo was
performed.
Fig. 8, Case 3- Correction of an amputation
stump
(a, b) This 27 year old young man
underwent an upper leg amputation after
a
severe motor vehicle accident. In an
initial phase, to preserve the length of
the
amputation stump, the distal part of the
stump was covered by split
thickness skin
grafts. Two years later this patient presented
with an instable
scar and ulceration at the
point of maximum pressure of his prosthesis.
He
had no sensation in this area.
(c) In one
operative procedure the skin grafts were
removed and the ulcers
debrided. At the same
time a free DIEAP flap was used to provide
sufficient
padding and skin coverage. Sensory
re-innervation of the flap provided protective
sensation of the stump.