Breast Reconstruction
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 it is technically the simplest and shortest, with short surgery and 1-2 days of hospitalization, but as a main drawback, it does not always give 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. THE
This 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 it is technically demanding operation and long, with 3-7 days of hospitalization.
But there is also the autologous method of Fat Injectionwhich gives excellent results in combination with all the above. Patients’ fat is used after being collected by liposuction. The fat is removed from the belly or the buns (or where we can collect it), prepared and re-injected into the breast with very small needles. The great advantage of the technique is the ability to permanently enhance these areas with the patients’ own fat and to improve the shape as it covers the small abnormalities created by the operations. The disadvantage is the unpredictable survival of the fat. Usually more than 50% of the injected fat is saved, but the operation may need to be repeated. There are almost no wounds and depending on the extent it is performed, it is done under local or general anesthesia.
Breast reconstruction is an excellent operation that restores a woman’s body to a normal shape, almost as it was before the 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.
Breast Reconstruction
