Breast reconstruction is one of the most collaborative operations of plastic and reconstructive surgery with other branches. It is a reconstruction surgery in which the breast tissue is completely removed, the breast is restructured and shaped. It is usually required due to breast cancer or other diseases after mastectomy.
Every patient diagnosed with breast cancer can present to a plastic surgeon for breast reconstruction. Breast reconstruction surgeries yield very successful results not only in terms of appearance but also in terms of psychological level, especially in women who are treated for a traumatic disease such as cancer.
Breast reconstruction is a reconstruction procedure rather than a cosmetic operation. Before the operation, the patient is evaluated by an expert team consisting of branches such as general surgery, plastic and reconstructive surgery, medical and radiation oncology. In addition, the most appropriate treatment option is selected and the operation process is advised.
In some cases, mastectomy surgery can be performed at the same time or postoperative reconstruction operations can also be performed. The new breast appearance created by reconstruction surgeries is almost no different from the natural breast. Breast reconstruction does not affect the recurrence of the cancer. In addition, it does not create a situation that prevents radiation therapy or chemotherapy.
Different techniques can be used in breast reconstruction operations. A special method is decided together with the patient according to her condition, expectations and physiology.
The surgery is performed under general anesthesia. The most commonly used technique in reconstruction surgery is the expansion of the skin and then the placement of an appropriate sized breast prosthesis (silicone implant). A tissue expander is placed under the breast skin and chest wall muscle during mastectomy, if breast repair is performed after mastectomy. Following the surgery, within few weeks or months the surgeon inflates the tissue expander by injecting saline through a port placed under the skin. When the skin reaches a sufficient width, the tissue expander is removed and replaced with a permanent breast implant during second operation. In some patients, the skin does not need to be expanded, and permanent implants can be placed at the same time as the mastectomy
In some cases, breast can be made by taking tissue from another part of the body (abdomen, back or hip) rather than breast implant. This method is known as “flap reconstruction”. Flap reconstruction is a more complex procedure than a breast implant. Following the operation, scars may remain in the areas where both the tissue is removed and the breast is made. In addition, the healing process takes longer than implant surgery. However, since the patient’s own tissue is used, the result may be more natural. In addition, patients can be even happier because they can get rid of the excesses in the areas such as abdomen and hips where the tissue will be used for breast reconstruction.
The average length of stay in hospital is 2 to 3 days. Post-operative pain can be reduced with painkillers. A drain is inserted to remove effusion or venous blood that accumulates between tissues. Drains are removed 2-3 days after the operation. The patient returns to her normal routine 1 to 2 weeks following the operation. In breast reconstruction operations with implants, this period may be shorter than breast reconstruction operations with autogenous tissues. Most of the post-operative scars disappear over time. Restructuring may be required in cases such as breast deformities and weight loss. In such cases, the implant can be replaced by re-cutting the existing incision. Loss of sensation after breast removal does not fully regain after breast reconstruction. However, over time, some feelings may be restored.
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