Breast
Reconstruction
Breast reconstruction refers to the aesthetic reconstruction of one or both breasts that have been operated on due to cancer, using one's own tissue or implants. It can be performed in the same session immediately following cancer surgery or at a later date determined later. Depending on the joint decision of the patient and the doctor, a new breast tissue is constructed either entirely using the patient's own body tissue or using silicone materials such as implants and expanders.
Who is a suitable candidate for this surgery?
All mastectomised women who have made a definite decision for this operation, whose medical cancer treatment has been completed and who do not have any other serious disease that prevents surgery are candidates for Breast Reconstruction.
Which techniques are used?
Today, the main treatment options used for breast repair after mastectomy are as follows:
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Temporary tissue expander followed by a permanent implant (silicone prosthesis).
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Permanent expander implants (Becker prosthesis)
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Use of permanent expander or implant with muscle skin tissue
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Use of autogenous muscle-skin tissues only (repair with flaps)
Factors such as the type of mastectomy, skin quality, cancer treatment, the quality of the muscle-skin donor areas in the body, the patient's age and additional diseases determine which of these will be used.
How is the surgical procedure organised?
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Anesthesia: The operation is performed under general anaesthesia.
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Flap transposition of one's own tissue to form the breast mass or to cover an implant: TRAM flap or Latissimus dorsi flap are the most commonly used techniques for this purpose
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Tissue expansion: In patients with healthy skin tissue that has not been severely damaged by radiation or mastectomy, the existing tissue is expanded enough to accommodate an implant. A permanent implant (silicone prosthesis) is then placed in the formed pocket. This process is operationally easier than flaps, but the application takes longer.
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Permanent placement of the implant that will form the breast mass.
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Surgical creation of the nipple-areola (nipple area) 3-4 months after all procedures are completed. There are also surgeons who utilise tattooing at this stage.
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After everything is done, if necessary, revision surgeries with techniques such as reduction, mastopexy, fat grafting or liposuction may be required to achieve full symmetry.
How is the healing process?
At the end of Breast Reconstruction surgery, 1 or 2 silicone drains are placed to remove intra-tissue blood leaks. The patient is usually discharged after these drains are removed and the viability of the flaps is fully assured. This period is 2-4 days if there is no problem. Antibiotics and analgesic-anti-inflammatory plasters are used to treat infections during your hospitalisation. Washing is usually allowed 4-6 days after the operation. Surgical incision lines that heal without problems are left open after 6-7 days without dressing and can be followed only by applying wound pomade. Sutures are removed after 15-20 days. The breast is supported with an elastic bra for 1 month. What are the Risks of Breast Reconstruction? Apart from the risks that can be seen in all surgical operations such as infection, bleeding, poor healing of incisions and suture dehiscence, there are also serious risks such as necrosis of the flap tissue (partial or complete loss of tissue), healing problems in the donor area and the formation of a hard capsule around the implant used in the breast reconstruction operation. Breast Reconstruction has no effect on the possibility of cancer recurrence.