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Breast Reconstruction


Reconstructive breast surgery offers bodily and psychological joy to a woman who has lost her breast either due to a mastectomy or due to another condition (injury, burn, congenital abnormality).

It usually includes more than one surgical procedures, which are performed at different stages. Reconstruction may begin along with mastectomy, or at a later phase and after the patient has recovered from the procedure any possible radiotherapy (completed or planned).

Classic reconstruction methods

Use of flaps:

tissues from the same patient are transferred from one part of the body to the front part of the chest. These flaps (tissues) may include muscles, fat and skin and have autonomous blood supply. Flaps are able to create a more normal breast both in terms of appearance and feel compared to implants. They are particularly useful after a radiotherapy where the use of implants is not advisable. The disadvantage of these procedures is that they are more time-consuming, the patient has to remain hospitalised for more days and will have scars at the donor area.

Use of silicon implants:

These implants are similar to those used in breast augmentation. They provide a relatively safe reconstruction method which however requires several phases. First an implant is inserted and is gradually "inflated" with saline like a "balloon", during a period of approximately three months, aiming at causing skin and pectoralis muscle dilation. A second procedure includes the final prosthesis. This method is not advisable after radiotherapy.

Nipple reconstruction procedures: these are performed with transfer of skin transplants and local flaps, as well as with the use of cartilage pieces. The tattoo method may also prove useful.

New reconstruction methods

Simple hypodermic mastectomy and modern reconstruction:

during this method used mainly in prophylactic mastectomies, the breast is removed along with the nipple, the areola mammae and a very small ring of skin around the areola mammae. This way almost no skin is removed and incisions are restricted to the nipple limits. Reconstruction is best performed with a pedicular or free abdominal flap. This method gives the best aesthetic results.

Reconstruction with free flap of perforans arteries (abdominal or gluteae) – (DIEP or SIEA flap).

This is a microsurgery procedure (use of surgical microscope), where these last generation flaps consist only of skin and fat from the abdomen without abdominal muscle. Their great advantage is that no muscle is lost, the pain is less, hernias are reduced and the patient recovers faster while less days in hospital are required.

Reconstruction with fourth generation implants:

these are implants made of more compact silicon, that does not create problems similar to those of older generation implants. Moreover, implants have an anatomically-enhanced shape that looks a lot like the normal breast.