The need for breast reconstruction often accompanies the rehabilitation period after successful treatment for breast cancer. Quite often, the operation is carried out simultaneously with the removal of damaged organic tissues, but it can easily be postponed. Some patients decide on breast reconstruction only months and even years after the victory over cancer. Reconstruction in no way affects the mastectomy, does not affect the results of the treatment of a malignant tumor. There is no relationship between breast reconstruction and survival rates (in terms of periods of any length).
Silicon as the final step in the fight against cancer
One of the most common options for breast reconstruction is the installation of silicone implants. The most successful choice in favor of this option will be if radiation therapy has not been performed and there is no need for it. Implants are more suitable for patients with small breasts, with low weight. The procedure involves the introduction of a special expander that stretches natural tissues. In fact, this is an empty object of a spherical shape, which is designed to increase the amount of organic tissue in a strictly defined place. Then, as you can see from the photobreast reconstruction, silicone implants are placed in this place.
The duration of the initial use of the expander is 14 days. After this period, the patient must visit a doctor to fill the device with a special liquid. The processes are visible in the photo of breast reconstruction - they are published by all self-respecting clinics so that clients know what will happen to them at each stage. To fill the expander, a special saline solution is used, and the pumping process itself is carried out through the hole intended for this purpose.
What's next?
The expander must be filled with the solution several times. The doctor prescribes the frequency of visiting the clinic. Typically, breast reconstruction after a mastectomy involves a two-week interval between receiving new “portions”. The fabric must be stretched to the intended size, after which the preparatory phase is completed.
Further breast reconstruction after mastectomy involves the removal of a temporary prosthesis. Its place is taken by an implant intended for permanent use. In fact, this is a silicone shell filled with a special gel or liquid. The second option involves the presence of saline, that is, sterile water with a high s alt content.
Aloderm as a quick method
The multi-stage breast reconstruction after mastectomy described above (reviews of such an operation performed in a reliable clinic are almost always positive) is not necessary in all cases. A lot depends onthe he alth status of the patient and the overall clinical picture. When examining and taking readings, the doctor analyzes the possibility of using an alternative option - aloderma. This term is used to denote a special material used for surgical intervention. With its use, breast reconstruction surgery is performed in just one approach. Unfortunately, you need to understand that this option is not always applicable.
Aloderm is to some extent human skin. The production process of the material requires a rather long time period: first, it is necessary to obtain donor tissues, then create connective tissue by sterilizing all components. If breast reconstruction after surgery is performed using this material, the patient is usually explained in detail what are the advantages and specifics of the case. So, it must be borne in mind that aloderm is actually collagen and elastin, while the tissue structure is similar to human skin. It is necessary to treat the material with saline and fix it in the correct position. Since during such an operation the muscle tissue does not change, the method is considered more preferable than the previously described option. In addition, breast reconstruction with an aloderma flap allows for a more aesthetic result.
Donation will help
A fairly common technique for breast reconstruction after removal is the use of own tissues. The result for a long time will have an impeccable appearance. If many implants need to be replaced with a frequency of at least fifteen years, thenthe use of donor tissues avoids this. In their work, doctors take into account that some tissues of the human body are very similar to the chest - for example, this is exactly the structure of the skin on the abdomen. As can be seen from the reviews, breast reconstruction in this way results in a beautiful breast, but its sensitivity is lower than it was natural before the disease. This is due to the imperfection of the methodology: at present, medicine simply does not have the tools to restore small nerve fibers, due to which the natural he althy female breast is so sensitive.
If you pay attention to the photo of the breast after reconstruction using the described technique, it becomes clear that the result is beautiful and spectacular. Doctors pay attention: you can combine this technique with the use of silicone implants. This allows you to get the desired breast volume as a result. As a material for breast reconstruction after a mastectomy (a photo of the recovery process itself is usually shown to the patient by the doctor at the reception), you can use tissues obtained not only from the abdomen, but also from the back, buttocks, and chest.
Features of the technique
Using a patient's donor tissue is most effective if the patient has been treated with radiation therapy. Also, the option is suitable for large breasts, fairly large body shapes.
During the recovery process, large areas of the body are involved. This affects the duration of the operation: surgical procedures are lengthy. Therefore, it growsduration of the rehabilitation period. This is a significant drawback against the background of the use of Aloderm. However, according to many, the positive aspects of the method fully cover these disadvantages.
TRAM flap breast reconstruction
TRAM is a medical term used to denote muscle tissue located on the abdomen: transverse, straight. Currently, this method is one of the most common. Unlike breast reconstruction with an expander, it is perfectly suitable even for overweight, especially in the presence of excess adipose tissue at the waist. Simultaneously with this operation, many patients also decide to have a tummy tuck. True, TRAM is not available for everyone: if there are not enough fatty tissues in the body, it is impossible to apply the technique. In addition, if there are scars in the abdomen caused by previous operations, such tissues are also not suitable for transplantation. Since smoking greatly disrupts blood microcirculation, a woman with this bad habit cannot undergo breast reconstruction using the TRAM method.
During surgery, the doctor excised an oval element from the bottom of the abdomen - this is the surface of the skin, and adipose tissue, muscle, fascia. A tunnel is formed through which the site is transferred to the chest. In this case, there is no intersection of the vessels, all of them are still attached to the flap. The doctor forms the correct dimensions, sews the site. The duration of the surgical intervention is about three hours. It is allowed to combine this technique with the installation of a silicone implant. If the patient has had a double mastectomy,then the TRAM operation lasts at least six hours. The rehabilitation period after such an intervention is quite long, many women experience it hard.
DEEP FLAP
It is customary to resort to the technique if the woman's body has enough tissues to form a flap and transplant it in the breast area. This option is applicable if the woman has previously experienced surgery in the abdomen. It can be used in case of hysterectomy, bowel surgery, appendix removal or liposuction. However, with a thin physique, this method is still not suitable - there are too few tissues in the body that could be transplanted. It is also impossible to use the DEEP FLAP method when restoring the breasts of smoking women, since a bad habit negatively affects blood microcirculation, as a result of which the flap takes root with great difficulty and complications. High risk of surgical failure.
The result will be successful only if you contact a clinic specializing in this method, since the technology is relatively new and at present only a limited number of surgeons on the entire planet have a sufficient qualification level to carry it out. The technique of microscopic surgery is used, during which a section of skin is excised from the bottom of the abdomen, to which cellulose, vessels, and an artery are adjacent. A distinctive feature in comparison with TRAM is the preservation of the integrity of the abdominal muscle tissue. The flap is free. The surgeon gives it the intended shape and fixes it in the right place. Connection requires atiny blood vessels. This is achieved by using the technology of microscopic surgery. The final stage is abdominoplasty.
Some Features
DEEP FLAP usually lasts at least five hours if one half of the breast needs to be reconstructed. With the reconstruction of both parts, the operation stretches for eight hours, and sometimes lasts even more. Compared to the previously described TRAM method, it is a longer process, but muscle tissue is not affected in it, so regeneration proceeds quite easily, it is not too long, as in the case of the TRAM flap. By resorting to DIEP FLAP, the patient reduces the risk of weakening of the muscles supporting the abdominal cavity. Also, after the operation, there will be pain, but noticeably weaker than with alternative methods of surgical intervention.
Spinal muscles to help with recovery
A fairly good option for breast reconstruction after a mastectomy is the use of the latissimus dorsi. The method is suitable for those patients who are characterized by a lean physique, there is neither excess fat nor excess skin. It is also an option for those who have undergone radiation therapy. The back muscle is used as the main material for surgical intervention.
The operation process involves the creation of an oval incision over the latissimus dorsi muscle. In this case, the surgeon allocates a flap of muscle and adipose tissue. A subcutaneous tunnel is formed through which the selected area is transferred to the chest. With such an operation (as far as possible) preserve the integrityvessels. The surgeon forms the correct shape, the type of flap, and then fixes it to a permanent new place. If blood vessels were damaged during the operation, the technique of microscopic surgery is used to restore. The duration of such a procedure is up to three hours, sometimes less.
Features of the method
As can be seen from numerous statistical data, mainly when referring to this technique, it is impossible to obtain a flap on the back containing the required amount of adipose tissue. This makes it necessary to combine tissue grafting with the installation of silicone implants. As a result, the breast will have a beautiful shape and the volume desired by the patient.
The operating process itself is quite simple, so for this option, the risk of complications is minimal. At the same time, you need to understand that on the back, the texture, skin tone significantly differs from normal female breasts. A small area of the back during visual inspection will detect disproportion. At the same time, the functional load of the spinal muscles is fully preserved. Such operations are performed in numerous clinics, but it is important to choose a good, reliable option, and not chase the lowest price. With a low qualification of the surgeon, even when operating in this way, undesirable complications may occur. This can be avoided by working with a well-established doctor.
Buttocks as a source of material for transplantation
In mastectomy, breast reconstruction can be performed using tissue obtained fromwoman's buttocks. The method is quite difficult to implement, in some cases it gives undesirable complications. They resort to it infrequently and only with the cooperation of an experienced surgeon, but the result with high-quality performance will be excellent.
During the surgical intervention, the doctor selects a suitable oval area on the buttocks and excised the skin, subcutaneous tissue and muscle tissue. This flap is attached to the intended place of the breast, during the process it is given the necessary volume and the desired shape. To increase the breast, you can additionally install a silicone implant. The main problem of using this method is related to the intersection of blood vessels. When transplanted, they are first cut off, then restored. For this, it is necessary to use high-precision technologies of microscopic surgery. The duration of the surgical intervention reaches 12 hours. In case of significant damage to the blood vessel, the flap in the new place will be rejected.
How else can you restore the chest?
TDL stands for thoracodorsal flap. Its source is the chest of a woman from the side, from the back. There are no cosmetic or functional deficiencies after such a surgical intervention, but the method is applicable only when working on small breast reconstruction.
An alternative is to get donor tissue from the thigh, from the inside. In many ways, this method is similar to the implantation of gluteal tissues, while a flap consisting of skin layers, subcutaneous fat and muscle tissue is also engrafted.plots.
The most innovative techniques involve the use of synthetic protein matrices. These materials are similar in structure and appearance to human tissues. The accumulated experience in carrying out such surgical interventions has shown that the likelihood of an allergic reaction is minimized. You can also resort to donor tissues by implanting them.
Important moment
The methods described above allow you to restore the breast, but in no way affect the presence of nipples. This stage of reconstruction requires a separate surgical intervention, as well as the formation of the areola. Typically, skin areas obtained from the inside of the thigh are used. To make the color exactly what the client wants, the fabrics are additionally dyed - in fact, this is a tattoo.
Rehabilitation: what and how?
If breast reconstruction was chosen by installing a silicone implant, then the duration of the rehabilitation period is 14 days. After this time period, in the absence of complications, you can return to your usual life. Doctors advise wearing a supportive sports top for the first month after surgery.
If the operation involved the transplantation of the patient's own tissues, then rehabilitation lasts at least one and a half months. The first three to four weeks you can not lift anything heavy, it is not recommended to even raise your hands above head level. More or less serious physical activity is prohibited. If the operation was carried out by a mother of small children,it is necessary to seek help in caring for them - it is categorically not recommended for a woman to do this herself.
Complications: what to prepare for?
When reconstructing the breast after mastectomy, there is a possibility of swelling, pain, provoked by excessive hemorrhage. This usually happens when an implant is placed. Also, an inflammatory process provoked by an infection may begin near the implanted silicone site. The chest may become stiff, which is caused by the capsular effect. The term is used to refer to these scarred "wraps" that surround the implant.
When choosing a surgical intervention using own tissues, there is a possibility of healing with the formation of scars in those places from which the transplant sites were received. In some cases, abdominal muscles may weaken, and fluid may accumulate in this area when spinal tissues are applied. Up to five percent of all surgeries fail. The likelihood of complications and a negative outcome of surgical intervention is increased with constant smoking and a history of diabetes mellitus.
