The surgery was quite dramatic. We had to remove all the skin that was involved, perform a radical neck, as well as remove the clavicle, the upper pectoralis major muscle, the deltoid muscle and part of the trapezius muscle. The capsule of the shoulder joint was completely exposed. We had a big hole! Using a somewhat radical solution to fill the hole, we mobilized the breast, removed most of the breast tissue and used the resulting skin as a cutaneous flap. In a few days we will cover the rest of the wound with a contralateral pectoralis flap. I hope this will be her last surgery.

Addendum (10/21/11) : After her big surgery, this patient was not nutritionally well enough to tolerate more operations so we dressed her wound and fed her well. She slowly improved. and her wound started granulating. At the time of my departure she is almost ready for discharge. Dr. Mike has agreed to do a skin graft in the near future.
Specimen including deltoid and pectoralis |
Addendum (10/21/11) : After her big surgery, this patient was not nutritionally well enough to tolerate more operations so we dressed her wound and fed her well. She slowly improved. and her wound started granulating. At the time of my departure she is almost ready for discharge. Dr. Mike has agreed to do a skin graft in the near future.