Autologous and alloplastic breast reconstruction--overview of techniques, indications and results.

It is important for any woman undergoing mastectomy to make an informed decision about reconstruction and to be provided with information about the technique, advantages and disadvantages. There is a high degree of patient satisfaction with breast reconstruction, but high levels of preoperative information and psychological support are necessary. Close collaboration between oncological and reconstructive surgeons or management by an oncoplastic breast surgeon, careful patient selection and counseling, and refinements in surgical techniques can provide a range of safe and predictable techniques for breast reconstruction. After modified radical mastectomy breast reconstruction involves replacement of breast skin and breast volume; after skin-sparing mastectomy only the replacement of breast volume is necessary. The most commonly used surgical techniques are tissue expansion, latissimus dorsi myocutaneous flap with or without implants, and the use of lower abdominal tissue. Until today, the pedicled TRAM flap is the standard method for autologous breast reconstruction.