Breast Reconstruction
Breast cancer is a serious illness, which we unfortunately encounter more and more, affecting an increasing number of young women. Although it belongs to the category of malignant diseases, it is one of the cancers, which have been discovered and treated early, can be cured.
Mastectomy (surgical removal of the mammary gland) is the salvage solution. On the other hand, mastectomy is a mutilation surgery.
The breast can now be rebuilt. The Department of Plastic and Reconstructive Surgery of “SANCOS” Clinic has many surgical solutions that can help you regain your lost breast. You will be able to return to a normal life, being a winner in the fight against cancer.
In the planning of breast reconstruction surgery, the surgeon is guided by oncological principles, on the basis of which rationalism, terms and methods of reconstructive plastic surgery are strictly dependent on the type and spread of the tumor and the planning of specialized treatment.
Choosing the method of breast reconstruction is discussed with each patient. It explains the advantages and disadvantages of each method of breast reconstruction. Local tissue features, patient’s attitude to one method or another are taken into account.
Innovative methods of reconstructive surgery allow for the creation of maximum breasts of similar shape and appearance to the healthy ones.
Planning the operation
Planning for the reconstruction of the mammary gland can be done immediately after the diagnosis of breast cancer. The surgeon will examine you and choose the optimal reconstructive surgery method, based on your health, anatomy, age, and goals. The ideal solution would be that the plastic surgeon and the oncologist work together.
Reconstruction of breast shape can be done by different methods:
- Reconstruction with its own tissues using muscular cutaneous flaps (TRAM lamophore, DIEP flap, use of a dorsal large muscle flap , buttock flap);
- Endoprosthesis of the mammary gland (with silicone or physiological saline implant);
- Combining the two methods.
Breast reconstruction with the use of the implant is performed in the mammary gland resection with the keeping of the pectoral muscle. The first step is to apply the expander, which is a special silicone construction in the form of an empty bag, which implants under the pectoral muscle. After surgery, small portions of physiological saline are introduced through a special device for 2-3 months. The expander gradually enlarges, stretching the muscle and the skin above it, then moves to the two-stage operation when the expander is removed, and a breast prosthesis is implanted into the cavity.
Breast reconstruction using the patient’s own tissues.
If the mammary gland is extirpated with the pectoral muscle or in the case of a skin induration (fibrosis) after the ray therapy, then surgery is recommended using the patient’s own tissues.
The TRAM Lamb (transversal flap of the right muscles of the abdomen) is one of the famous achievements of modern plastic surgery, considered to be the best method of reconstruction of the mammary gland. The skin of the lower segments of the anterior abdominal wall is ideal for color and consistency to restore the mammary gland. The lamb allows for a sufficient volume of tissues and a skin surface with minimal damage to the donor area. This method of reconstruction of the mammary gland is more complicated than the extent of the skin. On the other hand, when breasts are fully restored using their own tissues, they have a natural look.
In some cases, a toraco-dorsal flap is used to reconstruct the mammary gland, which is selected from the back, and then moves to the chest wall. This method can be combined with the application of a breast implant.
The peculiarities of the operation
- Always remain visible scars on the restored breasts, as well as on the donor area (if the flap transfer method is applied);
- Absolute symmetry is impossible, so it is recommended that further surgery be performed on the healthy mammary gland to achieve the symmetry of the forms;
- The operation does not influence the possibility of breast cancer;
- Difficulties in medical examination usually do not occur;
- The operation improves the appearance and, importantly, helps to overcome the psychological discomfort.
The breast reconstruction operation is completed with the nipple reconstruction and the cosmetic tattoo of the areole.
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