Breast reconstruction is performed after removal of the breast due to a tumor or a different disease. Breast reconstruction surgery, which makes women feel better psychologically, can also be performed simultaneously with mastectomy, that is, breast removal surgery.
Breast repair or breast reconstruction is a surgical procedure performed after mastectomy, lumpectomy or congenital deformities to restore one or both breasts to a near-normal shape, size, appearance and symmetry.
Breast reconstruction is applied to almost everyone who has had a mastectomy for any reason, as long as there is no medical obstacle. Patients whose cancer has completely disappeared with mastectomy are considered to be the most suitable candidates for breast reconstruction surgery. Although it is possible to apply breast reconstruction to some patients during mastectomy, in some cases it is necessary to wait after mastectomy. In addition, breast repair surgery can be performed on people who have impaired breast integrity for any reason and who do not have a single or double breast.
Breast reconstruction surgery is a patient-specific procedure and can be applied with different techniques by evaluating the patient’s condition and physiology. The most commonly used technique is skin augmentation and prosthesis placement. For this, a tissue expander is placed under the skin and chest wall muscle after mastectomy. The tissue expander, which works with a valve mechanism and is placed under the skin, is inflated with saline injection after the operation. When adequate expansion is achieved, the tissue expander should be removed and the permanent prosthesis placed. The areola and nipple are then made. If the patient does not need to expand the skin, the prosthesis can be placed together with the mastectomy operation.
In flap reconstruction, which is another method, tissue is taken from the abdomen, back or hip of the patient and the breast is made. In this method, in which the skin, subcutaneous fat layer and muscle tissue remain connected to the original attachment area with a vascular stem, a tunnel made under the skin is used to shift the breast to the area where the breast will be formed. As the breast can be created alone, it can also be preferred to place a silicone prosthesis under the tissue.
In another technique used in flap reconstruction, the tissue is completely separated from the abdomen, back or hip region to which it is attached. The veins are sutured to the veins in the recipient area and they are kept alive. However, since suturing thin vessels to each other can only be done under a microscope, the plastic surgeon who will apply this technique should have experience in microvascular surgery.
Before breast reconstruction surgery to be performed after breast cancer, the patient’s condition should be evaluated by the plastic surgeon and oncologist, and the most appropriate time for the operation should be preferred for the patient. Before breast reconstruction surgery, blood thinners should be discontinued, and alcohol and cigarette use should be discontinued.
After breast reconstruction surgery, the patient usually needs to stay in the hospital for 2-5 days. Pain after the operation can be controlled by using painkillers prescribed by the doctor.
A drain is placed during the operation to prevent fluid accumulation after breast repair surgery. These drains are removed a few days after the operation. Although the recovery period varies from person to person, it is usually possible for patients to return to their normal lives between 2 and 4 weeks after the operation. The recovery time after breast repair surgeries performed with silicone prosthesis placement is shorter than breast repair surgeries performed with the use of autogenous tissue.
After the operation, heavy lifting, compelling movements, exercise, driving and sexual intercourse should be avoided for 4-8 weeks. In addition, the patient should be careful against situations that may cause an increase in intra-abdominal pressure.
Breast reconstruction surgery can be applied to patients with congenital breast defect or underdevelopment of the chest wall, who have deformities in their breasts due to trauma or burns, as well as breast cancer patients.
Breast reconstruction surgery cannot be performed on people who have serious medical problems, who cannot handle anesthesia, whose cancer is very advanced and metastasized, or who are very old.
Patients who have all of their breast tissue removed by total mastectomy cannot breastfeed, even if they have undergone breast reconstruction surgery.
Breast reconstruction is a surgical procedure performed under general anesthesia.
