Breast Surgery

BREAST RECONSTRUCTION AFTER MASTECTOMY WITH EDGES OR PROSTHESIS

Following radical surgery for breast cancer, the plastic surgeon can take action to rebuild the breast removed from breast specialist general surgeon, the chances of rehabilitation are varied, from reconstruction with implants, prosthetic limbs, or just use more of the patient's own tissues (skin and fat of the abdomen), the Surgery remains the first choice, unless specific contraindications, the prosthetic.

The methods of reconstruction are three main types: reconstruction late: If you have previously performed mastectomy, you begin the process of reconstruction with tissue expander breast implant (a balloon under the skin that gradually dilate the skin) that after a period of expansion, usually weekly will then replaced by a permanent prosthesis. If there is no need for chemotherapy contraindication to reconstruction with expander and implant, but this time the expansion will be a bit 'more evenly over time and in any case, between the first and second reconstruction should not spend more than six months.

There 's also the so-called delayed reconstruction, namely the possibility of expander breast implant surgery demolitive concurrently, thus saving the patient an operative time, in a subsequent intervention, after adequate expansion may ultimately be implanted with the device.

Finally there is the possibility of a so-called immediate reconstruction, ie the system directly with the final prosthesis in place of mastectomy without passing through the expansion, this procedure is mostly only possible in case of mastectomy with adequate savings skin (skin sparing mastectomy, Reducing skin, nipple sparing mastectomy). In special cases may be performed with a so-called Immediate reconstruction prosthesis Expandable (or Becker's ProRes), which can allow good skin expansion and shall be left on our premises.

These two surgical procedures require the simultaneous presence and close collaboration between surgeon and breast specialist plastic surgeon.

The reconstruction of 'the nipple and areola will be possible with a little further after outpatient surgery performed under local anesthesia assisted, using a skin graft groin or a tattoo for the areola and a small sampling from the contralateral breast or a small local flap the nipple.

The use of skin flaps as the flap myocutaneous Latissima muscle of the back is generally adopted in cases where there has been no previous history of radiotherapy or complications from previous special prosthetic surgery.

In Poland syndrome, a rare malformation (about one case per 25,000 births) which can affect the chest and upper limb, there may be interest (underdevelopment) of the female breast with possible absence of some muscles of the chest and areola complex cepezzolo, in which case you can make a proper breast reconstruction with different techniques depending on the seriousness of the case (The Poland syndrome-Riv. Ital Chir. Plastic-A . Massei, G. Salimbeni, D. Gandini, 26.1994)

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