Lesson 1Perioperative management and complication surveillance: flap failure, seroma, infection, donor-site morbidity, and long-term surveillanceThis part handles around-surgery care, like clot prevention, pain control, fluid balance, and watches for early and late issues like tissue fail, fluid, infection, donor harm, and long watch.
Enhanced recovery and analgesia pathwaysAntibiotic use and infection preventionRecognition and management of flap compromiseSeroma, hematoma, and wound dehiscenceDonor-site contour and functional issuesLong-term follow-up and imaging protocolsLesson 2Oncologic context and timing: immediate vs delayed reconstruction, impact of adjuvant therapy and recurrence surveillanceThis part explains how tumor type, stage, edges affect rebuild timing, comparing right away, later, and half-later ways, and how chemo, rays, watch needs shape plans.
Tumor stage and margin status considerationsImmediate vs delayed vs delayed-immediateCoordination with medical oncology teamEffects of chemotherapy on wound healingRadiation planning and field considerationsImpact on imaging and recurrence detectionLesson 3Implant-specific issues: capsular contracture, infection, implant rupture, and use of acellular dermal matrix and fat grafting adjunctsThis part focuses on implant problems like tightening, infection, break, wrong place, waves, and roles of skin matrix, mesh, fat add-ons to better hold and shape.
Risk factors for capsular contractureDiagnosis and management of implant infectionDetection and management of implant ruptureUse of acellular dermal matrix and meshFat grafting to improve contour and coveragePrevention and correction of implant malpositionLesson 4Comparative risks and benefits: surgical risk profiles, aesthetic outcomes, longevity, need for revisions, and sensory recoveryThis part compares implant and own-tissue rebuilds on surgery risks, recovery, beauty lasting, match, fix needs, body function effect, feeling return for patient talks.
Short-term surgical risks by techniqueHospital stay, recovery, and return to workAesthetic durability and ptosis over timeRevision rates and common secondary proceduresImpact on core strength and shoulder functionSensory changes and potential reinnervationLesson 5Influence of prior treatments: radiation effects on tissues, timing modification, and strategies to mitigate complicationsThis part checks how past lump removal, full removal, rays change tissue health, blood flow, risk, and talks timing changes, steps, add-ons to cut ray problems.
Assessment of irradiated skin and soft tissueImpact of prior lumpectomy and mastectomyTiming reconstruction around radiation therapyStaged approaches in high-risk patientsUse of fat grafting to improve radiated bedsWhen to favor autologous over implant optionsLesson 6Shared decision-making and expectation management: symmetry, revisions, scar patterns, and psychosocial support resourcesThis part details joint choice steps, getting patient values, real match and mark talks, fix chances, and adding mind support, survivor care, body image help.
Eliciting goals, lifestyle, and risk toleranceExplaining likely scars and breast symmetryDiscussing revision probability and timelinesUse of visual aids and before–after photosScreening for distress and body image issuesCoordinating psychosocial and peer supportLesson 7Implant-based reconstruction: direct-to-implant vs two-stage expander-implant — indications and surgical stepsThis part contrasts straight implant and two-step expander-implant, detailing when, patient pick, pocket making, device choice, during steps, safety, match, long results.
Patient selection and contraindicationsPrepectoral vs subpectoral pocket choiceTwo-stage expander fill protocolsIntraoperative implant sizing and selectionManagement of mastectomy skin flapsStrategies to reduce implant loss riskLesson 8Microsurgical principles for free flap reconstruction: anastomosis technique, ischemia time, flap monitoring methodsThis part reviews tiny surgery rules for free tissue breast rebuild, vessel pick, joining ways, cut blood time, during fixes, after checks with tools.
Recipient vessel selection and preparationEnd-to-end vs end-to-side anastomosisStrategies to minimize ischemia timeUse of couplers and microvascular suturesIntraoperative assessment of flap perfusionPostoperative flap monitoring protocolsLesson 9Autologous reconstruction: pedicled flaps (latissimus dorsi) and free flaps (DIEP, TRAM, SIEA) — flap selection principles and donor-site considerationsThis part outlines own-tissue choices, focusing on attached back flap and free belly flaps like DIEP, TRAM, SIEA, stressing pick, donor harm, blood, volume match.
Latissimus dorsi flap indications and limitsDIEP flap anatomy and perforator selectionTRAM flap variants and abdominal wall impactSIEA flap advantages and reliability issuesMatching flap volume to breast sizeManaging donor-site scars and contourLesson 10Preoperative evaluation for reconstruction: imaging, oncologic clearance, PET/CT/MRI role, vascular mapping (CTA) for perforator flapsThis part covers full before checks, history, exam, breast and donor scans, cancer clear, roles of PET/CT, MRI, CTA maps for safe implant and hole flap plans.
History, comorbidities, and risk stratificationBreast imaging review and oncologic clearanceAssessing abdominal and alternative donor sitesRole of MRI in implant and flap planningPET/CT for staging and treatment sequencingCTA mapping for perforator flap selection
