Next level breast-contour preserving surgery

In this thesis, the concept of breast-contour preservation in women who previously underwent whole-breast irradiation is tested. In Chapter 2, the use of the internal mammary artery perforator (IMAP) flap is presented as an innovative technique of immediate breast contour restoration by oncoplastic volume replacement.
In Chapter 3, we present the result of direct implant reconstruction in patients with previous mantle-field irradiation compared to patients with previous whole-breast irradiation.
In Chapter 4 we compare the outcome of immediate latissimus dorsi and implant reconstructions after skin-sparing salvage mastectomy with the widely accepted secondary breast reconstruction by combined latissimus dorsi flap and implant.
In Chapter 5, a case is made for the innovative application of the same combined skin-sparing and hybrid approach as risk-reducing treatment after previous BCT.
In the study presented in Chapter 6, we determined the long-term effect of the LD breast reconstruction on the strength profiles of the upper extremity by measuring the isometric torque strength both in seven synergistic- and two contra-movement directions.
In Chapter 7, the first series of delayed de-epithelialization of the reconstruction flap in the setting of combined skin-sparing salvage mastectomy and immediate autologous breast reconstruction In Chapter 8, the foregoing chapters were put in mutual perspective. Additionally, some reflections on the challenges for future research were provided.