Contributing Authors vii

Foreword xv

Foreword to 1st Edition xvii

Foreword to 2nd Edition xix

Preface xxi

Acknowledgments xxiii

Volume 1

SECTION I:

Oncology and

Incidence and Risk Factors . . . . . . .
The Epidemiology of Breast Cancer:3

CELIA BYRNE

Diagnosis . . . . . . . . . . . . . . . . . .
Breast Cancer Screening and11

COSTANZA COCILOVO

Breast . . . . . . . . . . . . . . . . . . . . .
Imaging of the Surgically Altered16

ERINI MAKARIOU AND ANOUSHEH SAYAH

and Treatment in Augmented

Women . . . . . . . . . . . . . . . . . . . .
Breast Cancer Diagnosis, Prognosis,35

NEAL HANDEL

5
Pathology of Breast Disorders . . . . 48

BALJIT SINGH

High-risk Patient . . . . . . . . . . . . .
Defining and Managing the62

THERESE S. CERMAK AND JENNIFER ENG-WONG

Oncoplastic Treatment Approach . . .
Ductal Carcinoma In Situ: An71

MELVIN J. SILVERSTEIN

8
Mastectomy for Breast Cancer . . . . 96

SHAWNA C. WILLEY AND

DONNA-MARIE E. MANASSEH

Dissection . . . . . . . . . . . . . . . . .
Sentinel Node Biopsy and Axillary107

HIRAM S. CODY III

Issues . . . . . . . . . . . . . . . . . . . .
Breast Conservation: Oncologic118

COSTANZA COCILOVO

Common and Challenging

Problems . . . . . . . . . . . . . . . . . .
Oncoplastic Surgery: Managing123

ALEXANDRE MENDONÇA MUNHOZ

Mastectomy Defects: Classifications

and Methods . . . . . . . . . . . . . . .
Reconstruction of Partial140

ALBERT LOSKEN

and Reconstruction of Breast

Cancer . . . . . . . . . . . . . . . . . . . .
Special Problems in the Treatment165

ALBERT LOSKEN

Reconstruction of the Partial

Mastectomy Defect . . . . . . . . . . .
The Osnabrueck Experience With177

KLAUS E. BRUNNERT

Conservation Patient . . . . . . . . .
Reconstruction of the Breast198

SUMNER A. SLAVIN

of Breast Conservation Therapy

of the Large-breasted Patient . . .
Reduction Mammaplasty as Part213

SCOTT L. SPEAR, KETAN M. PATEL, AND

PRANAY M. PARIKH

Breast Cancer: Breast-conserving

Therapy and Mastectomy . . . . . .
Follow-up After Surgery for Primary218

ELIZABETH D. FELDMAN AND WAFA ALKHAYAL

18
Adjuvant Systemic Therapy . . . . . 228

MINAL SHAH, CLAUDINE J. D. ISAACS, AND

MINETTA C. LIU

Contents

Breast-conserving Surgery . . . . .
Radiation Therapy Following242

LAURIE W. CUTTINO AND FRANK A. VICINI

Therapy After Mastectomy . . . . .
Invasive Carcinoma: Radiation255

JEFFERSON E.C. MOULDS

Assessment, Genetic Testing, and

Management Options . . . . . . . . .
Hereditary Breast Cancer: Risk264

BETH N. PESHKIN

Reconstruction, Including Prosthetic,

Latissimus, and Transverse Rectus

Abdominus Myocutaneous Flap

Techniques . . . . . . . . . . . . . . . .
Prophylactic Simple Mastectomy and277

DENNIS C. HAMMOND

Reconstruction: Indications,

Techniques, and Outcomes . . . . .
Nipple-sparing Mastectomy and287

SCOTT L. SPEAR, SHAWNA C. WILLEY,

CATHERINE M. HANNAN, AND

COSTANZA COCILOVO

24
Nipple-sparing Mastectomy . . . . . 298

G. PATRICK MAXWELL, PAT WHITWORTH, AND

ALLEN GABRIEL

Reconstructive Considerations . .
Breast Cancer in Men: Oncologic and308

MAURICE Y. NAHABEDIAN

Treatments for Breast Cancer . . .
Psychological Impact of313

JULIA H. ROWLAND

SECTION II:

Reconstruction
Breast

Considerations in Breast

Surgery . . . . . . . . . . . . . . . . . . .
Informed Consent: Medicolegal331

NEAL R. REISMAN

28
Silicone Gel Breast Implants . . . . 337

MICHAEL J. MILLER

Manufacturing Past, Present, and

Future . . . . . . . . . . . . . . . . . . . .
Breast Implants: Materials and344

WILLIAM P. ADAMS, JR AND JASON K. POTTER

Reconstruction With Adjustable

Implants . . . . . . . . . . . . . . . . . .
One-stage Immediate Breast357

HILTON BECKER

Reconstruction With Shaped

Adjustable Implants . . . . . . . . . .
Immediate and Delayed Breast376

MICHAEL SCHEFLAN

Reconstruction Using a Tissue

Expander and Implant . . . . . . . .
Immediate Two-stage Breast388

LOUIS L. STROCK

Reconstruction . . . . . . . . . . . . . .
Acellular Dermis-assisted Breast406

SCOTT L. SPEAR, PRANAY M. PARIKH, AND

NATHAN G. MENON

Reconstruction With Acellular

Dermal Matrix . . . . . . . . . . . . . .
Direct-to-Implant Breast412

C. ANDREW SALZBERG AND R. MICHAEL KOCH

Implant Breast

Reconstruction . . . . . . . . . . . . . .
Delayed Two-stage Tissue Expander–420

F. FRANK ISIK

Form-stable Implants . . . . . . . . .
Breast Reconstruction With429

MAURIZIO NAVA, ANGELA PENNATI,

ANDREA SPANO, AND GIUSEPPE CATANUTO

Breast Reconstruction . . . . . . . .
Skin-preserving Delayed-Immediate438

STEVEN J. KRONOWITZ AND

GEOFFREY L. ROBB

Reconstruction Using Semilunar

Expander and Purse-string

Closure . . . . . . . . . . . . . . . . . . .
Immediate Two-stage Breast450

GINO RIGOTTI AND ALESSANDRA MARCHI

Radiated Breast . . . . . . . . . . . . .
Prosthetic Reconstruction in the460

SCOTT L. SPEAR AND M. RENEE JESPERSEN

40
Secondary Prosthetic Cases . . . . . 476

SCOTT L. SPEAR, M. RENEE JESPERSEN, AND

ADAM D. SCHAFFNER

The External Approach . . . . . . . .
Recreating the Inframammary Fold:492

JAMES J. RYAN

The Internal Approach . . . . . . . .
Re-creating the Inframammary Fold:497

SCOTT L. SPEAR, ALI N. MESBAHI, AND

MICHAEL BECKENSTEIN

Fold With the Superficial

Fascial System . . . . . . . . . . . . . .
Recreating the Inframammary512

MAURIZIO NAVA, JOSEPH OTTOLENGHI, AND

EGIDIO RIGGIO

Flap Breast Reconstruction . . . . .
Latissimus Dorsi Musculocutaneous535

DENNIS C. HAMMOND

Autologous Reconstruction with

Latissimus Muscle Only Flaps . . .
Endoscopic Delayed-Immediate555

NEIL A. FINE AND KRISTINA O’SHAUGHNESSY

in Reconstruction of the

Radiated Breast . . . . . . . . . . . . .
The Latissimus Dorsi Flap563

SCOTT L. SPEAR, JAY BOEHMLER, AND

MARK W. CLEMENS

Autologous Latissimus Dorsi

Flap With and Without Immediate

Nipple Reconstruction . . . . . . . .
Breast Reconstruction With an571

EMMANUEL DELAY

Breast . . . . . . . . . . . . . . . . . . . .
Aesthetic Subunits of the597

STEVEN P. DAVISON AND MARK W. CLEMENS

Breast . . . . . . . . . . . . . . . . . . . .
Reconstruction of the Irradiated607

SCOTT L. SPEAR, MATTHEW L. IORIO, AND

PRANAY M. PARIKH

Breast Using Autologous Tissue

With Immediate Nipple

Reconstruction . . . . . . . . . . . . . .
One-stage Reconstruction of the623

LAWRENCE B. COLEN AND JOHN M
CCRAW

Reconstruction . . . . . . . . . . . . . .
Bipedicle TRAM Flap639

KENNETH C. SHESTAK

Myocutaneous Flap Reconstruction:

The Single-pedicle, Whole-muscle

Technique . . . . . . . . . . . . . . . . .
Transverse Rectus Abdominis652

MICHAEL R. ZENN AND JAMES W. MAY, JR.

Unipedicle TRAM Operation: The

Muscle-splitting Technique . . . . .
Breast Reconstruction With the660

SCOTT L. SPEAR, CHRISTIAN A. PRADA,

DEREK L. MASDEN, AND J. WILLIAM LITTLE

Myocutaneous Flaps . . . . . . . . . .
Bilateral Transverse Rectus Abdominus670

ONELIO GARCIA, JR.

Myocutaneous Flap Breast

Reconstruction . . . . . . . . . . . . . .
Free Transverse Rectus Abdominis681

CHET L. NASTALA, STEVEN M. PISANO,

MINAS T. CHRYSOPOULO, AND PETER R. LEDOUX

Skin-sparing Mastectomy Through

a Periareolar Approach . . . . . . . .
Immediate Reconstruction After693

JOAN E. LIPA

Mastectomy Using the Omental

Flap and Synthetic Mesh . . . . . . .
Immediate Reconstruction After Skinsparing705

JOÃO CARLOS SAMPAIO GÓES AND

ANTONIO LUIZ V. MACEDO

58
Abdominal Flaps and Implants . . 712

MAURICE Y. NAHABEDIAN

Myocutaneous Flaps With

Preoperative Delay . . . . . . . . . . .
Transverse Rectus Abdominis720

PAUL R. CALLEGARI

Tissue Transfer: An Algorithmic

Approach . . . . . . . . . . . . . . . . . .
Breast Reconstruction With Free727

JULIE E. PARK AND DAVID H. SONG

Reconstruction . . . . . . . . . . . . . .
Perforator Flaps in Breast736

MARK W. CLEMENS AND

MAURICE Y. NAHABEDIAN

Flaps . . . . . . . . . . . . . . . . . . . . .
Anatomic Basis of Perforator745

MICHEL SAINT-CYR

in Breast Reconstruction . . . . . . .
Pedicled Perforator Flaps757

MOUSTAPHA HAMDI

Rectus Abdominis Musculocutaneous

Flaps . . . . . . . . . . . . . . . . . . . . .
Musculofascial-sparing Transverse770

MICHAEL J. MILLER

Artery Perforator Flap Breast

Reconstruction . . . . . . . . . . . . .
Deep Inferior Epigastric778

MARK W. CLEMENS AND

MAURICE Y. NAHABEDIAN

Perforator Flap in Breast

Reconstruction . . . . . . . . . . . . . .
The Superior Gluteal Artery790

JULIE V. VASILE, ROBERT J. ALLEN, AND

JOSHUA L. LEVINE

Flap for Microsurgical Breast

Reconstruction . . . . . . . . . . . . . .
The Inferior Gluteal Artery Perforator803

CONSTANCE M. CHEN, MARIA M. LoTEMPIO,

AND ROBERT J. ALLEN

Epigastric Artery Flap in Breast

Reconstruction . . . . . . . . . . . . . .
The Superficial Inferior808

PIERRE M. CHEVRAY

Reconstruction . . . . . . . . . . . . . .
Gracilis Flaps for Breast818

KAREN M. HORTON

Breast in Breast Reconstruction . . .
Options for Managing the Opposite830

JAMES D. NAMNOUM AND DAVID OTTERBURN

Outcomes in Bilateral Breast

Reconstruction . . . . . . . . . . . . . .
Issues, Considerations, and838

ELISABETH K. BEAHM AND

ROBERT L. WALTON

72
Nipple-Areola Reconstruction . . . 855

SCOTT L. SPEAR AND JUSTIN E. WEST

Augmentation in Subsequent

Breast Reconstruction . . . . . . . .
Considerations of Previous875

SCOTT L. SPEAR, MARK W. CLEMENS, AND

MICHAEL A. HOWARD

Breast Reconstruction . . . . . . . .
The Second Stage in Autologous884

DAVID W. CHANG

Following Breast Reconstruction

With Abdominal Flaps . . . . . . . .
Biomechanical Considerations894

MAURICE Y. NAHABEDIAN, SCOTT L. SPEAR, AND

CHRISTOPHER L. HESS

Deformities in the Reconstructed

Breast . . . . . . . . . . . . . . . . . . . .
Fat Injection to Correct Contour904

SCOTT L. SPEAR AND ALI AL-ATTAR

Breast . . . . . . . . . . . . . . . . . . . .
Lipomodeling of the Reconstructed912

EMMANUEL DELAY

Reconstruction . . . . . . . . . . . . . .
Surveillance Following Breast930

VALERIE LEMAINE, COLLEEN M. M

AND ANDREA PUSIC
CCARTHY,

Following Tumor Recurrence . . .
Reconstruction of the Breast934

MELISSA A. CROSBY AND DAVID W. CHANG

80
Stem Cells and the Breast . . . . . . 940

EDWARD P. BUCHANAN, VICTOR W. WONG, AND

GEOFFREY C. GURTNER

Postoperative Breast Pain . . . . . .
Management of Chronic947

IVICA DUCIC, ETHAN E. LARSON, AND

MATTHEW L. IORIO

Volume 2

SECTION III:

Mammaplasty and Mastopexy
Reduction

and Mastopexy: General

Considerations . . . . . . . . . . . . . .
Reduction Mammaplasty955

DENNIS C. HAMMOND

and Reduction: The “Round

Block” . . . . . . . . . . . . . . . . . . . .
Periareolar Benelli Mastopexy960

LOUIS C. BENELLI

Wall–based Flap and Pectoralis

Muscle Loop . . . . . . . . . . . . . . .
Mastopexy With Chest972

RUTH GRAF, ANDRÉ RICARDO DALL’OGLIO

TOLAZZI, THOMAS BIGGS, AND

MARIA CECÍLIA CLOSS ONO

Implants: Superolaterally Based

Rotation Flap . . . . . . . . . . . . . .
A Mastopexy Technique Without985

BARBARA B. HAYDEN

and Mastopexy Without

Undermining . . . . . . . . . . . . . . .
Vertical Scar Breast Reduction990

CLAUDE LASSUS

87
Vertical Mastopexy . . . . . . . . . . 1007

JUAN DIEGO MEJIA AND FOAD NAHAI

Reduction and Mastopexy . . . . .
Vertical Mammaplasty for Breast1016

ALBERT DE MEY, DIANE FRANCK, AND

CHRISTOPHE ZIRAK

Short Horizontal Scar . . . . . . .
Vertical Mammaplasty With a1025

DANIEL A. MARCHAC

Alone . . . . . . . . . . . . . . . . . . .
Breast Reduction by Liposuction1035

MARTIN MOSKOVITZ

the Superomedial Pedicle . . . . .
Vertical Breast Reduction Using1045

ELIZABETH J. HALL-FINDLAY

Inferior Pedicle Reduction

Mammaplasty . . . . . . . . . . . . . .
The Short Scar Periareolar1063

DENNIS C. HAMMOND

Reduction Technique . . . . . . . .
The Circumvertical Breast1078

A. ALDO MOTTURA

Reduction: Basic Concepts . . . .
Inferior Pedicle Technique in Breast1088

NAVIN K. SINGH AND MARWAN R. KHALIFEH

Reduction: Practical Steps . . . . .
Inferior Pedicle Technique in Breast1097

SAUL HOFFMAN

Using the Central Mound

Technique . . . . . . . . . . . . . . . .
Reduction Mammaplasty1107

DANIEL P. LUPPENS AND MARK A. CODNER

Medial Pedicles and Inverted-T

Incisions . . . . . . . . . . . . . . . . .
Reduction Mammaplasty Using1116

ETHAN E. LARSON AND MAURICE Y. NAHABEDIAN

98
The L Short-scar Mammaplasty . 1128

ARMANDO CHIARI, JR. AND JAMES C. GROTTING

Reduction . . . . . . . . . . . . . . . .
The No-vertical-scar Breast1144

SIMON G. TALBOT AND JULIAN J. PRIBAZ

100

Free Nipple Graft Technique . . .
Breast Reduction With the1156

SCOTT L. SPEAR AND M. RENEE JESPERSEN

101

in the Irradiated Breast . . . . . . .
Reduction Mammoplasty1170

SCOTT L. SPEAR AND AMER SABA

102

After Massive Weight Loss . . . .
Breast Reduction and Mastopexy1174

J. PETER RUBIN AND JOSEPH MICHAELS

103

and Mastopexy After Massive

Weight Loss . . . . . . . . . . . . . . .
Strategies in Breast Reduction1185

DENNIS J. HURWITZ

104
Gynecomastia . . . . . . . . . . . . . . 1205

FRANK LISTA AND JAMIL AHMAD

105

Corrections After Breast

Reduction and Mastopexy . . . . .
Complications and Secondary1211

SCOTT L. SPEAR AND KAREN KIM EVANS

SECTION IV:

Mammaplasty
Augmentation

106

General Considerations . . . . . . .
Augmentation Mammaplasty:1227

G. PATRICK MAXWELL, MATTHEW B. BAKER, AND

ALLEN GABRIEL

107

Tissue-based Planning for

Breast Augmentation . . . . . . . .
The High Five Process:1246

WILLIAM P. ADAMS JR.

108

Patient: Psychological Issues . . .
The Augmentation Mammoplasty1254

REBECCA COGWELL ANDERSON AND

JASON C. LEVINE

109

Augmentation . . . . . . . . . . . . .
Patient Education in Breast1261

CAROLINE A. GLICKSMAN

110

Augmentation Mammaplasty . . .
The Inframammary Approach to1271

DENNIS C. HAMMOND

111

Augmentation Mammaplasty . . .
The Periareolar Approach to1277

SCOTT L. SPEAR, JEFFREY M. JACOBSON, AND

ELAN REISIN

112

Augmentation . . . . . . . . . . . . .
Subfascial Breast1283

RUTH MARIA GRAF, MARIA CECÍLIA CLOSS ONO,

AND ANDRÉ RICARDO DALL’OGLIO TOLAZZI

113

Augmentation . . . . . . . . . . . . . .
Transaxillary Breast1290

LOUIS L. STROCK

114

Augmentation . . . . . . . . . . . . .
Transumbilical Breast1300

RICHARD V. DOWDEN AND

MARIANNE A. FULLER

115

Anatomic, High-cohesiveness

Silicone Gel Implants (European

Experience) . . . . . . . . . . . . . . .
Breast Augmentation With1322

PER HEDÉN

116

Form-stable Gel Implant for Primary

Breast Augmentation . . . . . . . .
The Highly Cohesive, Style 4101346

BRADLEY P. BENGTSON

117
Lipoaugmentation . . . . . . . . . . 1366

SYDNEY R. COLEMAN AND ALESIA P. SABOEIRO

118

Reconstruction Using BRAVA

External Breast Expansion

and Autologous Fat Grafting . .
Breast Augmentation and1374

ROGER K. KHOURI AND DANIEL DEL VECCHIO

119

Patient With Tuberous Breasts and

Other Complex Anomalies . . . .
Augmentation Mammaplasty in the1401

DENNIS C. HAMMOND

120

in Women With Thoracic

Hypoplasia . . . . . . . . . . . . . . .
Augmentation Mammaplasty1410

SCOTT L. SPEAR, JESSE A. GOLDSTEIN, AND

CHRISTOPHER V. PELLETIERE

121

With Poland Syndrome . . . . . . .
Breast Reconstruction in Patients1416

JAMES D. NAMNOUM

122

Mastopexy . . . . . . . . . . . . . . . .
Augmentation With Periareolar1425

SCOTT L. SPEAR AND MARK L. VENTURI

123

General Considerations . . . . . . .
Augmentation Mastopexy:1434

DENNIS C. HAMMOND

124

Augmentation Mammaplasty . . .
Managing Complications of1447

NEAL HANDEL

125

Implant Malposition . . . . . . . . .
Neo-subpectoral Technique for1473

SCOTT L. SPEAR, M. RENEE JESPERSEN, AND

SAMIR S. RAO

126

Distortion Following Submuscular

Breast Augmentation . . . . . . . .
Outcome Assessment of Breast1481

SCOTT L. SPEAR AND JAIME SCHWARTZ

127

Surgery of the Breast . . . . . . . .
Bioprosthetic Materials for Plastic1488

G. PATRICK MAXWELL AND ALLEN GABRIEL

128

Treatment and Prevention of

Implant-associated Breast

Deformities . . . . . . . . . . . . . . .
Acellular Dermal Matrix for the1495

SCOTT L. SPEAR AND MITCHEL SERUYA

129

After Augmentation Mammaplasty

by Conversion to the Subpectoral

or “Dual-plane” Position . . . . .
Correction of Capsular Contracture1503

SCOTT L. SPEAR AND MICHAEL COHEN

130

and Anatomic Description,

Classification and Definitions,

and Options for Repair and

Reinforcement . . . . . . . . . . . . .
The Inframammary Fold: Histologic1510

BRADLEY P. BENGTSON

131

Anatomic Form-stable Silicone

Gel Implants . . . . . . . . . . . . . .
Revision Augmentation With1516

MITCHELL H. BROWN

132

Augmented Breast . . . . . . . . . .
Correction of Ptosis in the Previously1532

NEAL HANDE

Oncoplastic Surgery

Table of Contents