What is Breast Reconstruction?
It is the remodeling of the breast removed by mastectomy. It can be done concurrently with mastectomy (up to stage II) or after some time, usually after 6 months - 1 year, especially in cases where breast irradiation is needed. In the first case of reconstruction at the same time as the mastectomy, the woman has the advantage of waking up after surgery and having two breasts again, having the new breast in place of the old one while in the second case we hold a waiting position so as to make sure good skin condition after radiation sessions.
What is the purpose of the operation?
Breast reconstruction after mastectomy offers women psychological support and avoidance of the image of amputation immediately after surgery. Also helps the woman in her movements and in her clothing since there is no possibility of her breast pseudoprosthetsis being gone. Nowadays, these surgeries work very well as new surgical techniques, specialization of plastic surgeons and new intentions help in this regard.
What Are Breast Reconstruction Techniques?
There are many ways of reconstruction, others simpler and others more complicated to use as appropriate. Some of these methods are:
Reconstruction with silicone implants - tissue expanders
Reconstruction with flaps, such as the dorsal flap, the rectal abdominal muscle (TRAM and DIEP flap), fat grafting.
But of course, which method will be used is a matter for every woman to discuss with her doctor.
What are the complications of surgery?
Theoretically, all surgeries involve some risks, and in theory almost all women can undergo breast reconstruction after mastectomy. Risks to recovery can be summarized in bleeding, fluid collection, hypertrophic scarring, infection and rupture of the capsule. Breast rehabilitation has no effect on relapses and does not prevent post-operative prophylactic chemotherapy or radiotherapy.
Reconstruction techniques
1. Silicone implants - Tissue expanders
The most common procedure is to place a tissue expander (Becker type) or permanent silicone implants. It is usually preferred that the tissue expander which is positioned under the major pectoralis muscle, and 15 days after surgery by a valve every 10 days begins to expand with saline. When the expansion reaches the desired volume, the expander (if simple) is replaced with a silicone implant. Some expanders (Becker's) remain permanent, so no second intervention is needed in this case. Reconstruction of the nipple-areola complex is performed in a second stage (after 3-6 months) with local anesthesia
2. Reconstruction with flaps
Another method is to use the so-called muscle or skin flaps, that is, parts of the skin with plenty of subcutaneous fat that is taken from another part of the body such as the back, abdomen or buttocks and are specially placed in place of the removed breast. These are usually complex and long-lasting procedures (8-10 hours) that leave more scars, but in some cases they are the only solution.
3. Fat Grafting
A new and very promising technique is fat / stem cell grafting. This is a second stage technique that requires simultaneous liposuction. In this way fat is obtained, which, after undergoing a special prepeartion with the Coleman method, is injected into the breast area. Also some of the fat can be stored and re-processed to produce stem cells, so they can be used to further complement breast growth. Finally, it is possible to apply a new breakthrough device (Brava System) prior to transplantation to the breast area that better prepares the tissues and increases the survival rates of the transplanted fat.
4. Other interventions
Usually the other breast needs either a reduction, an augmentation or a lift to finally have symmetry between the two breasts. In the majority of cases, the aesthetic effect after surgery is very satisfactory and greatly contributes to a better quality of life for women.