Lesson 1Perioperative management and complication surveillance: flap failure, seroma, infection, donor-site morbidity, and long-term surveillanceThis part handles around-operation better, including blood clot stop, pain control, and fluid handle, and details early and late problem watch for flap fail, fluid, infection, give-site sickness, and long-time rebuild follow.
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 life, stage, and edges change rebuild time, comparing now, later, and later-now ways, and looks 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 focuses on implant problems, including hard cover, infection, break, wrong place, and wave, and looks at roles of no-cell skin layer, net, and 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 compares implant and own-body rebuild in work risk, get better, beauty last, match, need fix, effect on body work, and feel get back, helping fit 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 checks how past lump cut, full cut, and ray change tissue kind, blood flow, and problem risk, and talks time changes, step ways, and 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 details step shared choice, including get patient values, talk real match and mark types, outline fix chance, and mix mind-social help, live care, and body see talk 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 grow-implant rebuild, detailing rules, patient pick, pocket make, tool choice, during-work order, and ways to better safety, match, and long result.
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 looks at main tiny surgery rules for free flap breast rebuild, including vessel pick, join ways, no-blood time cut, during-work fix, and after flap watch using 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 sets out own-body rebuild choices, focusing on tied back flap and free flaps like DIEP, TRAM, SIEA, with stress on flap pick, give-site sickness, blood flow, and match flap size to breast aim.
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-work check, including story, body exam, breast and give-site pictures, cancer clear, and roles of PET/CT, MRI, and CTA blood map in plan 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
