Surgical Definitions
Acellular dermis
Skin that is harvested from cadavers and then de-cellularized. This material is not recognized by the body because it no longer has cells within it. The chance of transmission of blood borne-diseases is extremely rare. This is used in breast reconstruction to eliminate the tissue expansion phase.
Alloplastic
Breast reconstruction using implants.
Autologous
Breast reconstruction using a patient's own tissue.
Bulge
If the abdominal wall is weakened, the intra-abdominal contents (intestines) can push outwards creating a protrusion that is less severe than a hernia. This may necessitate further surgery.
Capsular contracture
All implants cause a scar to form around them. In some patients the scar may become very tight. This causes the implant to feel firm, may cause the implant to shift in position and may even cause pain. The risk of capsular contracture is quite high in patients undergoing breast reconstruction and higher in patients that have had radiation therapy. If severe this may necessitate further surgery.
Delayed surgery
Reconstruction performed at some point (3 months - many years) after the mastectomy.
Diastasis
A widening between the rectus abdominis muscles of the abdomen. This is usually a result of pregnancy.
DVT
Deep vein thrombosis. This is a blood clot that can form in the veins of the legs during surgery. This causes swelling of the lower leg. This is treated with anticoagulant (blood thinning) medication for 3 months.
Fat necrosis
When the blood supply to the fat within a flap is not adequate, areas of fat may die and cause scarring which feels like a hard lump.
Flap
A piece of tissue that can include skin, fat, muscle and/or bone. This can remain connected to the body and be shifted to a new site (pedicled), or can be removed from the body with attached blood vessels to be reconnected to a distant site (free).
Flap failure
Loss of blood flow to a flap causing it to die requiring removal from the chest.
Hematoma
Blood that collects under the skin after surgery is finished. This may require an additional operative procedure to stop the bleeding.
Hernia
If the abdominal wall is weakened, the intra-abdominal contents (intestines) can protrude outwards creating a painful lump evident most commonly on straining or when performing a sit-up. This may necessitate further surgery.
Immediate surgery
Reconstruction performed at the same time as the mastectomy.
Inframammary fold
The point at which the lower part of the breast meets the chest (the crease).
Mastectomy flap necrosis
When a patient undergoes a mastectomy, the breast skin is left behind. If this skin does not have adequate blood supply it may die. This may require increased dressing changes, another surgical procedure or a skin graft.
Mastopexy
Breast lift.
Nipple necrosis
Rarely during breast surgery the blood supply to the nipple can become compromised causing the nipple to die.
Perforator
A small artery that tracks through a muscle to supply overlying skin and fat.
Ptosis
Descent of the breast tissue on the chest wall due to aging, weight loss or post-pregnancy changes. The nipple is located below the breast crease.
Pulmonary embolism (PE)
If a deep vein thrombosis (DVT) breaks apart, parts of the blood clot may travel through the blood stream and become lodged in the lung. This may cut off the blood supply to the lungs. In the worst cases this may cause death. If a patient survives a pulmonary embolism they require anticoagulant medication for 3 months.
Seroma
A collection of inflammatory fluid under the skin. This may need to be drained by a radiologist after surgery.
Tissue expander
A temporary implant used to stretch skin and muscle after a mastectomy.
