Breast Surgeries –Breast Reconstructions
THE” PLUG-FLAP”– ISLAND FLAPS OF THE BREAST 

Plastic surgeons prepared themselves for total breast reconstructions but they were not prepared for partial reconstructions.   

When mastologists adopted more conservative conducts that produced smaller wounds on the breast, named Quadrantectomias, much less traumatic than radical mastectomies, its simple closure resulted in distorted outcomes and aesthetically unacceptable. 

Always very dedicated to this chapter of plastic surgery, I came across a case of partial amputation, of very difficult solution, where the mastologist had removed the whole central quadrant (nipple and areola, projected in a great cylinder reaching the muscular plane in the anterior wall of the thorax).

On this day and with this case, and in a moment of divine illumination, I conceived a procedure that would later change into a technique that aided and still aids many plastic surgeons all over the world and has benefit hundreds of patients.

Of the contributions that I provided to Medicine, this is the one that has greatest importance: The Breast Island Flaps also known as “Plug-Flaps.” 

This technique is applied when the mastologist removes a segment of the breast generally attached to a segment of the skin closest to the tumor (or even without the skin fragment).

For better visualization, imagine a deep cylindrical perforation, in the shape of a bottle neck that crosses the entire breast, from the skin to the ribs. 

At this time the plastic surgeon reaches some area of the inferior pole of the breast, preferably where there is abundant or exceeding tissue, and draws and sculpts a tissue “cylinder” with skin at the top (or not, depending on the wound left by the mastologist), and this cylinder is anchored to the deep plane where arteries and veins penetrate, giving them life.

Following, the surgeon will free the extremity from this cylinder and cross the healthy tissues of the breast through a small tunnel to fill in the amputated area as a cork that wedges into the bottle neck or a plug that fits into the socket that it is inserted in its opening. That is the “PLUG”, which fits as a socket opening.   

After repairing the wound originated by the removal of the tumor, we finish up by modeling the breast in its best aesthetic form, aiming at a graceful cone harmonious with the other breast, using the classic breast plastic techniques and, if necessary, work on the opposite breast for greater balance.

It is a technique of extreme simplicity that, after conceived, was based on anatomical researches of the vessels that emerge from the wall of the thorax, having been developed by me and confirmed by several researchers.