Breast Reconstruction is the appropriate surgery for women who undergo breast amputation due to, usually, breast cancer. Newer techniques allow the surgeon to create a breast very similar to the natural one. Reconstruction can be performed during mastectomy (immediate restoration) or several months or years later (distant restoration). Breast Reconstruction
The Breast Reconstruction can be divided into two main categories:
(a) ” heterologous ” where materials foreign to the body are used: a dilator is inserted into the breast position, which is then replaced with an insert.
(b) ” autologous ” where materials from the body are used: breast reconstruction is done with tissues from other parts of the body.
The “heterologous” breast reconstruction is the most common because technically it is the most simple and short, with intra-day surgery and hospitalization 1-2 days, but as the main drawback, it always gives a natural shape. After the mastectomy, a balloon (dilator) is inserted under the skin and muscles of the chest. It has a special valve which can be filled with saline through the skin. THEThis dilator is gradually filled, until the skin is sufficiently stretched to insert the implant, about 3 months later. In the second stage, about 3-6 months later, the dilator is removed and an implant is inserted. There are a number of implants: the most widely used are silicone implants which have a silicone surface but also internally contain silicone gel. They come in different sizes and shapes. A type of implant (Becker) can also be used as dilators and thus the second stage of the operation is avoided. The advantage of this insert is the ability to adjust its shape to the woman’s body. It takes another 3-6 months for the breast to take on its final shape, and then the nipple can be reconstructed.
In “autologous” breast reconstruction, the breast can be restored with body tissues from areas with extra skin and fat, such as the back, abdomen or buttocks. The tissue is removed from its place and placed on the old breast. Can be used simultaneously with or without Becker dilator inserts. Tissues are usually taken from the lower abdomen and the incision is hidden in the panties, as when a tummy tuck is performed. Or from the back and the incision is hidden in the bra. In this case, (from the spine) because less tissue is used, the technique is accompanied by the use of implants. In rare cases (very thin body type) tissue from the buttocks is used. The second method (with body tissues) gives a completely natural shape, but is technically demanding surgery and long, with 3-7 days of hospitalization.
Υπάρχει όμως και η αυτόλογη μέθοδος Έγχυσης Λίπους που δίνει εξαιρετικά αποτελέσματα σε συνδυασμό με όλα τα παραπάνω. Γίνεται χρήση του λίπους των ασθενών αφού συλλεγεί με λιποαναρρόφηση. Το λίπος αφαιρείται από την κοιλιά ή τα ψωμάκια (ή από όπου μπορούμε να το συλλέξουμε), προετοιμάζεται και επανεγχύεται στο μαστό με πολύ μικρές βελόνες. Το μεγάλο πλεονέκτημα της τεχνικής είναι η ικανότητα να ενισχύσει μόνιμα αυτές τις περιοχές με το ίδιο το λίπος των ασθενών και να βελτιώσει το σχήμα αφού καλύπτει τις μικρές ανωμαλίες που έχουν δημιουργηθεί από τις επεμβάσεις. Το μειονέκτημα είναι η απρόβλεπτη επιβίωση του λίπους. Συνήθως περισσότερο από 50% περίπου του εγχυόμενου λίπους διασώζεται, όμως η επέμβαση μπορεί να χρειάζεται επανάληψη. Δεν υπάρχουν σχεδόν καθόλου πληγές και ανάλογα με την έκταση που διενεργείται, γίνεται με τοπική ή γενική αναισθησία.
Breast reconstruction is an excellent operation that restores a woman’s body to a normal shape, almost as it was before mastectomy. It should be noted, however, that minor surgeries are usually required to achieve a completely natural shape. In most cases of breast reconstruction, although there is a slight asymmetry between the breasts, most women report a significant improvement in their social life and self-esteem.