الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Salvage (tertiary) breast reconstruction is definitely a demanding surgery. It has been deemed challenging for a number of reasons related to the presenting patient and the intraoperative challenges.
These include older patient demographics with increased comorbidities, chronic or persistent implant related pain, and frustration with their suboptimal or symptomatic reconstructions. Patients referred for salvage reconstructions may have more complex issues such as irradiated skin, scarring, severe capsular contracture, and silicone lymphadenopathy.
Intraoperative challenges include difficulty in exposure of the internal mammary (recipient) vessels due to scarring, increased risk of bleeding during and after capsulectomies, risk of injury to the recipient vessels. Recently there is an increased risk of scarring due to the increase in the use of ADMs (Acellular dermal matrix) in the initial breast reconstruction. Rupture of the implant and extravasation of silicone adds to the intraoperative difficulties.
In these complex circumstances conversion to autologous reconstruction is considered the most favourable method of reconstruction. This has been objectively validated by the BCCT.core results.