Breast Reconstruction

Goal: To replace or reconstruct the missing breast tissue after the surgery of malignancy or in cases of under or undeveloped breast.

Operative technique: Amputated breast can be reconstructed in 3 ways.

1.- With the use of silicone implant or with the autologous (own) tissue. The use of implant is easier and simpler method, but since there is always a skin deficiency problem, it must be solved using tissue expander in the first operative time or expandable breast implant for delayed breast reconstruction. During the next few weeks after the surgery, the patient is obliged come to the office every 3 - 5 days for the graduate saline filling of the implant through the subcutaneous valve, which is easily removed after desired volume is achieved .
2.- Transverse rectus abdominis musculocutaneous (TRAM) flap and latissimus dorsi flap are most commonly used for the autologous breast reconstruction. On the other hand, immediate breast reconstruction just after the surgery of malignancy is today widely accepted everywhere.
3.-Few months after the surgery, the reconstruction of the nipple - areola complex is performed using groin skin, skin of the opposite areola or tattoo, or eventually opposite breastlift or reduction to obtain symmetry.

Duration and anesthesia: Both techniques are performed under general anesthesia, the former lasts 3 hours, the latter much longer

 

Recovery: Very short in cases where expandable mammary implants are put, except that the frequent office visits are necessary for the implant filling during next few weeks. On the other hand, the use of large musculocutaneous flaps in breast reconstruction usually requires much longer recovery time.

Rare complications: Edema, prolonged seroma formation, breast asymmetry and eventually abdominal wall hernia in TRAM flap reconstruction or the temporary loss of sensibility.

Pre-operatory evaluation: To proceed with this surgery the patient has to take a blood and heart test. Along with a mammogram. In case there is a problem with the exams the surgery could not be done to the patient.