Breast Reconstruction

It is the reconstruction of the breast removed surgically (mastectomy) because of breast cancer. For this purpose methods and varying choices from the point of timing are present. Reconstruction is realized by the help of prosthesis (implant) which contains silicon or physiological serum or by the use the patient’s own tissue (autogeneous). As of timing it can be applied at early stage after the surgery or even years after at a later stage.

Technically in the reconstructions performed through prosthesis, after the expansion of the skin in 2-6 months by the help of a tissue expansion prosthesis second and final prosthesis containing silicon or physiological serum is placed. In the use of the prosthesis another method is the placement of the prosthesis containing physiological serum and can be expandable in the first operation and leaving of it in place after the breast skin has been expanded. This method renders a second prosthesis change operation unnecessary.

Technically in the reconstructions where the patient’s own tissue (autogeneous) is used varying tissues of skin and under skin (flap) can be utilized. In the use of TRAM flap, which is the most frequently applied, the skin at the lower abdominal region is removed with the underlying fat tissue and the blood carrying muscle tissue to the breast area and placed either as connected to its root (with pedicule) or as free flap by the microsurgery method. Here since the patient’s own tissue is used, both a breast with more natural appearance and with appropriate consistency can be formed, also the excess skin-fat tissue is eliminated by abdominal stretching (abdominoplasty).

After both methods, in the 2nd. stage operation realized within nearly 2 -3 months, the other breast is formed by being in general elevated or enlarged or made smaller and its adaptation to the newly constructed breast is provided. Also in this operation or in the 3rd stage operation realized 2-3 months later the breast nipple is constructed.

Duration of the operation is 1-2 hours in the use of the prosthesis, 3-5 hours in the use of flap and is applied under general anesthesia. Duration of hospital stay is 1-2 days in prosthesis use, 3-5 days in flap use. Going back to work is nearly after 1-2 weeks, in the use of the prosthesis 3-4 weeks after in the use of flap. In nearly 4-6 weeks heavy exercises can be started with after the use of the prosthesis, in 8 weeks after the use of flap. It is generally not required to stay in the hospital in the operations after the first reconstruction and returning to work and activities is shorter.

Main risks are infection, bleeding, lessening of feeling, asymmetry, skin damage and the distinctiveness of scars. After the prosthesis use painful capsule may be formed around the prosthesis or prosthesis may get smaller by leaking out. After the use of flap on the abdominal wall hernia or rupture may form.