Breast ReconstructionWrite a comment
Breast cancer is the most widespread disease among oncological ones in women worldwide. In most cases, treatment presumes full (mastectomy) or partial (lumpectomy) removal of breast. While finding themselves in such a difficult situation, women no longer feel themselves attractive and sexual. Luckily, modern plastic surgery can offer ways to return lost attractiveness with the help of surgical operations for reconstruction of breast.
Operation of breast restoration
Reconstruction of breast is a plastic operation which enables artificial restoration of initial shape of breast. Reconstruction can be immediate, i.e. carried out straight after removal of breast within one surgical operation or postponed i.e. done over some time. The reason of postponement is often the need to pass the full course of treatment (aggressive type of tumor, high risk of relapse of the disease etc.).
Photo: Anatomy of Polytech polyurethane. Augmentation is done by implants of various sizes, 20 days after surgery. Patient is getting prepared to restoration of areola and nipple with the help of tattooing. This is a very complex case. Condition after one-sided mastectomy. Removal of breast and suture on breast done by another doctor 4 years ago.
While preserving skin pocket of breast, as a rule, esthetic result of reconstruction is better though it is not always possible to preserve nipple and areolar complex. Here, it is important to choose the method of restoration that will produce the best result.
Contraindications to breast reconstruction:
- Relapse of an oncological disease
- Less than one month after the end of a course of chemo and radio therapy
- Contagious diseases
- Disturbance of blood coagulation
- Uncompensated diabetes mellitus
- Overall hard condition of the patient
Photo: Breast Reconstruction Surgery After Mastectomy. Anatomy of Polytech polyurethane. Augmentation is done by implants of various sizes, 20 days after surgery
Methods of breast restoration
A plastic surgeon defines a method of reconstruction based on plan of treatment, volume of breast, availability of own tissues, condition and feeling of the patient. Restoration of breast may take place with the help of expanders and implants, musculocutaneous flap taken from another part of the body of the patient and with the help of own fat of the patient. Such operations are often carried out in combination with each other.
Reconstruction with the help of implants and expanders
This operation consists of restoration of shape of breast with the help of installation of an implant or expander (temporary implant) into the place of removed breast. This method provides for the best esthetic result. One can achieve nice symmetric look of breastby right selection of size and shape of implants.
Photo: One-step breast reconstruction, 6 months after the gland is removed. Polytech polyurethane anatomy under the muscle. Augmentation is done by implants of various sizes, 14 days after surgery. Already possible to go work. After a few months, the patient will be given a tattoo - an imitation of the nipple and areola. And then, when the tension of the tissues decreases, the nipple will be reconstructed
Implants are often combined with lipofilling. Also one can make operation on lifting or reduction of the second breast if necessary.
Sufficient quantity of skin and muscles is necessary for formation of the pocket while installing a breast implant. If they are not sufficient, an expander should be installed first (extender of skin and scar tissues). Expander is placed above greater pectoral muscle, is initially of flat shape and is partially filled with saline. A special port is connected to expender where the surgeon injects 30-40 ml of saline in every 2-3 weeks thus increasing the volume and extending the tissues. These procedures are provided under out-patient conditions.
Expander is replaced with breast implant when the skin together with subcutaneous fatty tissue is sufficiently expanded.
Rehabilitation: the same as in breast augmentation with implants
Application of expander is also important before reconstruction by lipofilling. Fat is not capable of creating right shape and volume in stretched scar tissues with lack of skin as it is very fluid.
Breast TRAM Flap Reconstruction
This method presumes use of own tissues of the patient i.e. transplantation of musculocutaneous flap taken from the area of abdomen, back or buttocks into the area of breast. Flap reconstruction is efficient in case when part of breast was removed together with pectoral muscle.
Photo: Reconstruction of breast with the use of own tissues of the patient
This method is rather traumatic and has a complex rehabilitation with lengthy healing of donor and acceptor zones.
Breast Reconstruction with Lipofilling
Operation consists of restoration of shape of breast with the help of own fat of the patient transplanted from donor areas (abdomen, hips, back). Immediately I would like to discuss drawbacks of this method which are not written about in the Internet:
- for achievement of visible results, one needs at least 3-4 operations of lipofilling of breast as on average 50% of fat is taken and it is not possible to inject too large volume at a time
- often patients simply do not have the necessary quantity of fat for operation and a lot of it is needed
However, lipofilling suits ideally for correction of pits, deeps, small asymmetry. Therefore I recommend doing it in addition to operation of restoration of breast with implants if necessary.
Imitation of presence of nipple and areola is possible with 3d tattooing (permanent make-up). One can choose a pigment fully identical to color of areola of the other breast.
Breast Reconstruction Cost (Kyiv, Ukraine)
Breast reconstruction with implants (price includes: surgery, anesthesia, hospitalization, implants, compression underwear, dressing)
|5 200 euro|
|Breast reconstruction with implants + reduction mammoplasty||6 000 euro|