Breast loss as a result of an oncological disease is very hard endured by women since the breast is one of the most important components of female appeal. Breast loss can become the reason of a deppression in the postoperative period. New medical techniques and devices have made it possible for surgeons to create a breast that can come close in form and appearance to matching a natural breast. Frequently, reconstruction is possible immediately following the breast removal (mastectomy), so the patient wakes up with a breast mound already in place, having been spared the experience of seeing herself with no breast at all.
During breast reconstruction, consideration is also given to treating the opposite breast. Sometimes a breast lift, breast reduction or breast augmentation may be indicated on the unaffected side, to improve symmetry.
Breast reconstruction – is intended to restore the female breast after a mastectomy. There are several different methods of achieving this goal, but each is intended to mitigate the stigmatizing effects of breast cancer and breast removal. There are three general techniques plastic surgeons utilize for breast reconstruction: using an implant, using patient's own tissues and combined technique. It can range from a simple one-step procedure to a series of complicated surgeries.
Reconstruction with existing tissues – is recommended when there are few own tissues left after the mastectomy. There are several methods that use skin, fat or muscle to form a 'tissue flap' that helps recreate the breast:
TRAM – the transverse rectus abdominis muscle flap – uses abdominal tissue as a donor site. The procedure is comparable to an abdominoplasty.
Latissimus dorsi – this tissue flap uses tissue of the upper back as a donor site.
DIEP – the deep inferior epigastric artery perforator tissue flap – is comparable to the TRAM, but handles tissues of the abdominal muscles differently.
SGAP – the superior gluteral artery perforator tissue flap – uses the buttocks as a donor site.
Recommended to perform at the time of the mastectomy, termed immediate breast reconstruction.
The technique is not indicated
- to thin patients without the sufficient volume of abdominal tissues;
- to smoking patients;
- to patients with numerous postoperative herms in the abdominal wall.
To advantages of this techniques can refer good results to matching a natural breast.
Reconstruction with breast implant – is recommended when the pectoralis major muscle is left. Requirement of new breast skin is accomplished with staged tissue expansion. During the surgery, a tissue expander is placed under the breast skin ore muscle. Then it is gradually filled with saline solution within 2-3 months to allow the skin to stretch. Once enough skin is available, the expander is replaced with breast implant.
Nowadays there are combined implants-expanders which are not neede to be replaced. They consist of two tubes: the external is filled with silicone gel, and the internal is filled with saline solution that allows the skin to stretch.
To advantages of this technique can refer a technical simplicity of the surgery, the minimum risks.
To disadvantage of this technique can refer possible risks caused by the presence of an implant: abnormal response of the immune system to foreign materials (an infection, capsular contracture), the implant rupture.
Combined reconstruction – the use of an implant and tissue flap both. At this technique the surgeon primary uses a tissue flap, and necessary volume is achieved by placing an implant.
Once the breast mound is made, a nipple and areola are reconstructed. It is carried out by using skin from areola of an opposite breast or skin taken from the genital areas.
IMPORTANT TO KNOW!
Breast reconstruction does not influence on repeated development of diseases. Periodic MRI screening examinations are recommended.
Features of the surgery
- is carried out under general anesthesia;
- you can leave the clinic in 3-5 days after the surgery;
- lasts from 1,5 to 3 hours;
- drains are removed within 1 week after the surgery;
- stitches are removed within 2 weeks;
- the convalesce period – from 1 to 2 weeks;
- surgical dressing should be worn.
- the early postoperative period is accompanied by the temporary painful feelings passing within several days, decrease in sensitivity of some sites of skin, puffiness of fabrics and the asymmetry of mammary glands connected with it can be observed;
- it is possible to take a shower within 2-3 days after the surgery;
- you should avoid physical and sports activities, sunbathing within 1 month after the surgery.
You will see the final result in 2-3 months
- diseases of an internal;
- infectious diseases;
- cardiovascular diseases;
- violation of blood coagulability.