Lesson 1Perioperative management and complication surveillance: flap failure, seroma, infection, donor-site morbidity, and long-term surveillanceThis part we handle around operation bettering, like blood clot stop, pain help, fluid handle, and detail early and late problem watch for flap fail, fluid, infection, donor place issues, and long watch for rebuild.
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 we explain how tumor grow, stage, edges affect rebuild timing, comparing now, later, and half-later ways, and look at how chemo, ray, and watch needs shape rebuild plan.
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 we focus on implant problems, like hard cover, infection, break, wrong place, waves, and review roles of skin matrix, mesh, fat add 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 we compare implant and own tissue rebuild for op risk, recovery, beauty last, match, need fix, body work effect, and feeling back, to help personal patient talk.
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 we look at how past lump cut, full cut, ray change tissue good, blood, problem risk, and talk timing change, step ways, add ways 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 we detail planned shared choosing, getting patient values, talking real match and scar ways, outline fix chance, and mix mind support, survivor care, body see 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 we contrast straight implant and two-step expander-implant rebuild, detailing when, patient pick, pocket make, device choice, during op order, ways to better 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 we review tiny surgery ideas for free flap breast rebuild, including vessel pick, join ways, cut blood time, during op fix, after flap watch with clinic and add tech.
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 we outline own tissue rebuild ways, focusing on attached back flap and free like DIEP, TRAM, SIEA, with stress on flap pick, donor issues, blood, match flap size to breast goal.
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 we cover full before op check, including story, exam, breast and donor picture, cancer clear, roles of PET/CT, MRI, CTA blood map in planning safe implant and hole flap rebuild.
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
