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Breast Reconstruction: Definition

Breast reconstruction: definition
Breast reconstruction is to reconstruct the breast volume after mastectomy (partial or total removal of the breast) to treat breast cancer.

Four techniques of breast reconstruction are possible:

Temporary breast prosthesis
Temporary breast prosthesis called "skin expander" is an inflatable balloon that will develop skin bag. He will be replaced after 2-3 months the final prosthesis. In breast reconstruction after cancer, the major constraints (cons-indication if radiotherapy, perfect skin quality, skin bag initially sufficient, regular visits to inflate the balloon, the need for a second operation to replace the expander ... ) make this technique is now abandoned in favor of those with tattered described below;

The prosthesis associated
The prosthesis (usually silicone) with or without abdominal flap or "pedicle" of the latissimus dorsi muscle (means that there is pedicle attached to its blood and lymph vessels, and nerves). Flap technique is required when the skin after mastectomy is insufficient and / or when the blood supply is poor after radiotherapy;

Without breast prosthesis
The third solution, without prosthesis, using a pedicled rectus muscle of the abdomen;

Lambeau "free"
The final solution uses a flap "free" feeder vessels are then cut and reconnected on the vessels in the armpit by microsurgery.

Three separate surgeries several months are needed before optimal results because it takes to make the new breast symmetric with respect to its neighbor (contralateral) intact.

It is necessary to reconstruct the nipple by full thickness skin graft taken at the inside of the upper part of the thigh, and also the nipple through plasty (remodeling) in place of the skin or a piece of the contralateral nipple (s it is large enough to provide material).

What are the uses (indications) for breast reconstruction?
The breast reconstruction after amputation (mastectomy) is now part of the treatment of breast cancer.

How are the interventions?
Radiotherapy and chemotherapy often complement mastectomy that removes the breast cancer. As these treatments alter the healing of the skin, wait 1 year before considering breast reconstruction, if there was no immediate reconstruction.

An anesthesia consultation is required one month before surgery, it is almost always performed under general anesthesia. Laboratory tests and additional tests are usually requested by the anesthetist.

Preoperative treatment with iron may be more prescribed in anticipation of autotransfusion. Smoking cessation is strongly advised. Preoperative mammography and histological examination of the breast (gland and skin) are systematic.

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