Today the problem of oncological diseases is one of the most acute around the world. Cancer takes the first place among the total number of breast diseases. The work of plastic surgeons and masters of general surgery is now becoming synchronous, because every second case of breast cancer becomes a cause for it’s further reconstruction.
Modern medicine allows women to undertake operations using gentle methods and assures the absolute success of the operation. However, daring to restore breasts, many women do not really understand the essence of surgical intervention and its main methods. Breast reconstruction – is a complex surgical procedure that involves the use of microsurgical stages and special equipment. Your task – is to know all the aspects and nuances of the operation, and postoperative recovery, and to get ready for this serious step.
When do you need breast reconstruction?
The most common reason for a mastectomy is breast cancer. It is diagnosed each year in tens of thousands of women. Partial or total mastectomy becomes a major part of the treatment of tumor and often saves the lives of many patients. However, after severe and prolonged therapy, women remain alone with a huge complex – the absence of breast. For a time, the only way out was to wear a special bra with inserts simulating symmetrical breasts, or just put up with flat bust.
Breast prostheses help take away disproportion while wearing clothes and significantly reduce the level of psychological discomfort. But in this case, a sense of usefulness is still not coming, because every day a woman sees herself in the mirror and gets upset. In addition, a normal sexual life is out of the question. The only optimal solution in this situation is a complete breast reconstruction, which will allow a woman to feel beautiful and desirable as before.
Breast reconstruction is achieved by plastic surgery that restores the normal shape, appearance, size of the breast after a mastectomy. The operation can be carried out simultaneously with the removal of the breast. Besides the main intervention, it may take a number of additional micro operations.
The benefits of an immediate breast reconstruction are understandable. Women do not have to experience negative psychological aspects connected with the absence of chest and undergo physiological difficulties in the case of additional intervention. At the same time, deferred plastic gives an opportunity to recuperate, adjust yourself to the fight against serious disease, study the information about breast reconstruction more carefully, and only then make a deliberated decision.
Types of operations
Today there are 2 types of interventions:
- With the help of a prosthesis (prosthetic)
- With the help of the patient’s own tissue (endogenous)
The choice of the appropriate type of operation depends on the condition and the remaining amount of breast tissue, the desired result, and the preferences of a woman. In the case of prosthetic reconstruction the implant is placed between the chest and the muscles. Often special prostheses are used, which are gradually extended over a certain period of time (3-6 months), and form the desired breast size.
Endogenous type of operation involves the use the patient’s own tissue, which is taken from different parts of the body. Basically, they are the anterior abdominal wall, buttocks, thighs, sometimes, back. The advantages of this type of intervention are that the breast takes the necessary natural size immediately, and the risk of tissue rejection is relatively low. Breast shape in this case may change over time, but slightly. After the breast takes the final form and size, nipple reconstruction is carried out.
In addition to these types of plastic surgery, the surgeon may apply a mixed type of operation when tissues are used in conjunction with implants.
Pros and cons of both types of breast reconstruction surgery
Reconstruction can restore the shape and form of the chest, but patients are not always satisfied with the results. Firstly, the restored breast is not so sensitive, and secondly, the incision lines from a mastectomy and reconstruction will be visible. Some surgical procedures leave traces of incisions in the donor area, usually located near the less open areas of the body such as the back, abdomen or buttocks.
About the symmetry: if the mastectomy affected only one breast, then the operation is carried out only on it. Furthermore, you may need the tightening, increase or decrease of the opposite breast to improve the symmetry, size and position of both breasts.
The prosthetic type
- Easy operation
- Mild postoperative period
- No additional stitches
- Delayed results
- The possibility of asymmetry
- Failure to use in large breast size
- High risk of infection
- The probability of rupture of the implant
The endogenous type
- Natural look
- Minimal risk of infection
- The duration and extensiveness of the intervention
- The presence of additional stitches
- Possible complications
- long recovery period
Breast reconstruction steps
Analgesics are injected for comfort during the surgery. It may be intravenous or general anesthesia. The anesthesiologist, together with the patient selects the best option.
The method of using a free flap
This method involves the movement of intrinsic muscles, fat and skin to create a volume or cover the chest area. Sometimes a mastectomy or radiation therapy leaves insufficient tissue on the chest to cover and support the breast implant. Using a prosthesis for reconstruction almost always requires the method of plastics patchwork technique TRAM Flap or tissue extension.
TRAM flap procedure uses muscle, fat and skin from the abdomen of a woman for breast reconstruction. The tissues can be attached to the original source of blood supply and be tunneled through the chest walls, or completely detached and then form the contour of the breast. In addition, the surgeon may choose the methods of DIEP or SGAP without using the muscles, but transferring tissues from the abdomen or buttocks.
This method of reconstruction has a less long process of recovery after the operation, but the process of intervention is longer. It requires repeated visits to the surgeon for 4-6 months after the implantation of the stretcher. You will also need a second operation to replace thr expander if it will serve as a permanent implant.
The placement of the prosthesis
This step creates a contour and breast volume. An implant may be addition or alternative to the patchwork technique. Breast reconstruction with using implants usually requires the stretching of tissues. Saline or silicone implants are used.
The restoration of the nipple and areola
After the breast reconstruction, the restoration of the nipple and areola is carried out. To do this, surgeons use several methods such as tattooing, donor tissues or transplantation of the patient’s pigmented skin.
Recovery after breast reconstruction surgery
The elastic bandage or a supportive bra will minimize swellings and maintain the reconstructed breasts. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid. Physical activities, bathing and sunrays during this period will be canceled. The stitches are removed after 7-12 days at a regular medical examination. The final results of the reconstruction can be seen after 2-3 months of rehabilitation.
The absence of a breast after a mastectomy – is a difficult experience for every woman who underwent breast cancer. To restore again the beauty and harmony of your own body, as well as normalize the psychological discomfort, just win your own fear and make an appointment with a plastic surgeon.