Breast Reconstruction after Tumor Surgery

The consultation is important for deciding the pros and cons of a breast reconstruction after a tumor surgery.
The patient should be advised by a Plastic Surgeon who is experienced and can offer all methods of reconstruction (including the micro technical reconstruction techniques TRAM and DIEP) He should also show pictures to give the patient a concept of the expected results.

Reconstruction with Innate Tissue

In this field the greatest progress has been achieved in plastic breast reconstruction. While in the beginning only muscles of the back and later fat tissue from the stomach where available for reconstruction of the breast tissue, today markedly refined methods of operation are possible.
The most common operation for reconstruction of the breast is rebuilding it with the fat tissue from the lower stomach. In this procedure the excess of skin and subcutanwous fat tissue many women have accumulated is used.
Removing this excess during the operation can have a positive side effect. Only a small slice of muscle (TRAM) or even only the supplying vessels (DIEP) with the tissue have to be removed. By refining this operational technique the negative effect on the stomach surface is minimized.
Advantages:The reconstructed breast reacts like the normal breast tissue, it takes part in the natural changes of the tissue. There is no feeling of a foreign body. This method is the most natural breast reconstruction. At the same time the stomach is tightened.
Disadvantages: Long lasting operation (up to 6 hours) scars where the tissue is taken. In rare cases weakness of stomach at this point .

Reconstruction with foreign tissue which means building up the breast with a silicone implant. For shaping a normal falling breast sufficient skin is needed. When rebuilding the breast with implants this skin is gained by extension. To achieve this it is necessary first to apply a skin expander.
This is a silicone balloon which can be filled with a saline solution through the valve. The skin is thus expanded step by step. This expander can be employed right after the tumour surgery or also later.
After the skin has been sufficiently expanded it needs a rest of 3 months in order to prevent shrinkage of the skin. After this in another operation the final implant is deposited which always has to be smaller then the previous expansion. With this operation the most natural breast is formed.
Advantages: The different operations are short and seldomly last longer than an hour.
Disadvantages:The reconstructed breast will always be firmer and in time also be raised compared to the healthy side because it “hangs” less than the not operated breast. This is why often the patients ask for a correction of the opposite side. This possibility is suitable for patients who have other sicknesses or who do not want to go through the long lasting process of building up their own tissue.

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