Lesson 1Perioperative management and complication surveillance: flap failure, seroma, infection, donor-site morbidity, and long-term surveillanceThis part covers around-surgery prep like clot prevention, pain, fluids, and watching for flap fails, fluid, infections, donor pains, long-term checks.
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 section shows how cancer type, stage, edges affect rebuild timing, immediate vs later, chemo, rays, checks shaping 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 section looks at implant problems like tightening, infection, breaks, wrong place, ripples, roles of skin matrix, mesh, fat adds for 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 section compares implant and tissue rebuilds on op risks, recovery, lasting looks, match, redo needs, body function, 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 section checks how past lump removal, full removal, rays change tissue, blood flow, risks, timing changes, steps, extras to cut ray issues.
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 section details joint choices, getting patient values, real match and scar talks, redo chances, mind support, survivor care, body image helps.
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 section contrasts straight implant and two-step expander-implant, when to use, pick patients, pocket make, device pick, op order, safety, match, lasting plans.
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 section reviews tiny vessel basics for free tissue breast rebuild, vessel picks, joins, cut blood time, op fixes, post checks with exams and 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 section outlines own tissue options, back muscle flaps and free like DIEP, TRAM, SIEA, picking flaps, donor issues, blood flow, volume match to breast aims.
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 section covers full pre-op checks, history, exam, breast/donor scans, cancer clear, PET/CT, MRI, CTA maps for safe implant and vessel 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
