The need for breast reconstruction often accompanies the rehabilitation period after successful treatment of 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 mastectomy, does not affect the results of treatment of a malignant tumor. There is no relationship between breast reconstruction and survival rates (in calculating periods of any duration).
Silicone as the final stage of victory over cancer
One of the most common options for breast reconstruction is the placement of silicone implants. The most successful choice in favor of this option would be if radiation therapy was not carried out 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, which stretches the natural tissue. In fact, this spherical shape is an empty object, which is designed to increase the amount of organic tissue in a strictly defined place. Then, as can be seen from the photo reconstruction of the breast, implants made of silicone material are installed in this place.
The duration of the primary use of the expander is 14 days. After this period, the patient must visit a doctor to fill the device with special liquid. The processes are visible in the breast reconstruction photo - they are published by all self-respecting clinics, so that clients know what will happen to them at each stage. A special saline solution is used to fill the expander, and the pumping process is carried out through the hole intended for this.
What's next?
The expander must be filled with the solution several times. The doctor prescribes the frequency of visits to the clinic. Usually, breast reconstruction after a mastectomy involves two weeks between the receipt of new “servings”. The fabric must be stretched to the intended size, after which the preparatory stage is completed.
Further breast reconstruction after mastectomy involves the extraction of a temporary prosthesis. An implant intended for continuous use takes its place. In fact, this is a silicone shell filled with a special gel or liquid. The second option involves the presence of physiological saline, that is, sterile water with a high salt content.
Aloderm as a quick method
The multi-stage breast reconstruction described above after a mastectomy (reviews of such an operation performed in a reliable clinic are almost always positive) is not necessary in all cases. Much depends on the patient’s state of health and the overall clinical picture. The doctor, when examining and taking readings, analyzes the possibility of using an alternative option - aloderm. This term is used to denote 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, sterilizing all components. If breast reconstruction after surgery is performed using this material, the patient is usually explained in detail what the advantages and specifics of the case are. So, it must be borne in mind that aloderm is actually collagen and elastin, while the structure of the tissue is similar to human skin. It is necessary to process the material with physiological saline and fix in the correct position. Since muscle tissue does not change during such an operation, the method is considered more preferable than the previously described option. In addition, the reconstruction of the breast with an aloderm flap allows you to get a more aesthetic result.
Donation comes to the rescue
A fairly common technique for breast reconstruction after removal is the use of our own tissues. The result will have a flawless appearance for a long time. If many implants need to be changed with a frequency of at least fifteen years, then the use of donor tissues avoids this. In the work, doctors take into account that some tissues of the human body are very similar to the breast - for example, this is the structure of the skin on the stomach. 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 before the disease was natural. This is due to the imperfection of the methodology: at present, medicine simply does not have tools that can restore small nerve fibers, due to which the natural healthy female breast is so sensitive.
If you pay attention to the photo of the breast after reconstruction when applying the described technique, it becomes clear that the result is beautiful and effective. 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 (the doctor usually shows the patient the photo of the recovery process at the reception), tissues obtained not only from the abdomen, but also from the back, buttocks, and chest, can be used.
Features of the technique
The use of the patient’s donor tissue is most effective if the patient has been treated with radiation therapy. Also, the option is suitable for large breast sizes, rather large body shapes.
During the recovery process, large areas of the body are involved. This affects the duration of the operation: surgical measures are long. Consequently, the duration of the rehabilitation period is also growing. This is a significant drawback with the use of aloderm. However, according to many, the positive aspects of the method fully cover these disadvantages.
Breast reconstruction TRAM flap
TRAM is a term used to denote in the medical field located on the abdomen muscle tissue: transverse, straight. Currently, this method is one of the most common. Unlike breast reconstruction with an expander, it works great even with excess weight, especially when there is excess adipose tissue at the waist. Simultaneously with this operation, many patients also decide to have a tummy tuck. True, TRAM is not available to everyone: if there is not enough fatty tissue 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 the blood microcirculation, in the presence of this bad habit, a woman cannot undergo a breast reconstruction with the TRAM method.
During surgery, the doctor excises an oval element from the lower abdomen - this is the surface of the skin, 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 blood vessels, all of them are still attached to the flap. The doctor forms the correct size, sews on the site. The duration of surgery is about three hours. It is allowed to combine this technique with the installation of a silicone implant. If the patient has undergone 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.
DIEP FLAP
It is customary to resort to the technique if the woman’s body has enough tissue to form a flap and transplant it in the chest area. This option is applicable if the woman has previously experienced surgery in the abdomen. You can resort to it in case of removal of the uterus, intestinal surgery, removal of the appendix or liposuction. However, with a lean 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 DIEP FLAP method when restoring the breasts of smoking women, since a bad habit negatively affects the blood microcirculation, as a result of which the flap takes root with great difficulty and complications. High risk of unsuccessful outcome of surgical intervention.
The result will be successful only if you go to a clinic specializing in this method, since the technology is relatively new and at the present time only a limited number of surgeons on the entire planet have a sufficient qualification level for its implementation. The technique of microscopic surgery is used, during which a section of the skin, to which fiber, vessels, and artery are adjacent, is excised from the lower abdomen. A distinctive feature in comparison with TRAM is the preservation of the integrity of the muscle tissue of the abdomen. The flap is free. The surgeon gives him a conceived shape and fastens in the proper place. A connection requires tiny blood vessels. Achieve this using the technology of microscopic surgery. The final stage is abdominoplasty.
Some features
DIEP FLAP usually lasts at least five hours, if you need to restore one half of the chest. During the reconstruction of both parts, the operation stretches for eight hours, and sometimes even longer. Compared with the TRAM method described earlier, it is a longer process, but muscle tissue does not suffer in it, so regeneration is quite easy, 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 pretty good option for breast reconstruction after a mastectomy is to use the latissimus dorsi. The method is suitable for those patients who are characterized by a thin physique, there is neither excess fat, nor excess skin. Also, the option is applicable for those who have undergone radiation therapy. As the main material for surgical use of the spinal muscle.
The operation process involves the creation of an oval cut over the latissimus 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 this operation (as far as possible) the integrity of the vessels is maintained. The surgeon forms the correct forms, the type of flap, and then fixes it to a permanent new place. If during the operation blood vessels were damaged, the technique of microscopic surgery is used to restore. The duration of this procedure is up to three hours, sometimes less.
Method Features
As can be seen from the numerous statistics, mainly when accessing this technique, it is impossible to get a flap on the back containing the necessary amount of adipose tissue. This forces the combination of a tissue transplant operation with the installation of silicone implants. As a result, the breast will have a beautiful shape and the volume desired by the patient.
The operation 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 are significantly different from normal female breasts. A small area of ​​the back during visual inspection will detect imbalance. At the same time, the functional load of the spinal muscles is fully preserved. Such operations are carried out in numerous clinics, but it is important to choose a good, reliable option, and not to chase the lowest price. With a low qualification of the surgeon, even with this method, undesirable complications may arise. This can be avoided if you work with a well-established doctor.
Buttocks as a source of material for transplantation
With a mastectomy, breast reconstruction can be performed using tissues obtained from the buttocks of a woman. The method is quite difficult to implement, in some cases it gives undesirable complications. They resort to it infrequently and only in cooperation with an experienced surgeon, but the result with high-quality performance will be excellent.
During surgery, the doctor selects a suitable oval area on the buttocks and excises the skin, subcutaneous tissue and muscle tissue. This flap is attached to the intended place of the chest, during the process they give it the necessary volume and the desired shape. To enlarge the breast, you can optionally install a silicone implant. The main problems of using this method are related to the intersection of blood vessels. When transplanted, they are first trimmed, then restored. For this, it is necessary to use high-precision technologies of microscopic surgery. The duration of the surgical intervention reaches 12 hours. With significant damage to the blood vessel, the flap will be rejected in a new place.
How else can I restore my breasts?
TDL stands for Thoracodorsal Flap. Its source is the woman’s chest on the side, on the back side. Neither cosmetic nor functional defects were observed after such surgical intervention, but the method is applicable only when working on small breast reconstruction.
An alternative is to receive 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 is also engrafted.
The most innovative techniques involve the use of synthetic protein matrices. These materials are similar in structure and appearance to human tissue. The accumulated experience with such surgical interventions has shown that the likelihood of an allergic reaction is minimized. You can also resort to donor tissues, implanting them.
An important point!
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 patches 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 restoration was chosen by installing a silicone implant, then the rehabilitation period is 14 days. After this time period, in the absence of complications, you can return to your usual life. Doctors advise using 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’t 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 mother underwent the operation, it is necessary to seek help to care for them - the woman herself is categorically not recommended to do this.
Complications: what to prepare for?
During breast reconstruction after a mastectomy, there is a possibility of swelling, pain, provoked by excessive hemorrhage. This usually happens when the implant is inserted. Also, near the implanted silicone site, an inflammatory process can provoke an infection. The chest may become stiff due to the capsule effect. The term is used to denote such “wrappers” created by scars that surround the implant.
When choosing an surgical intervention with the use of own tissues, there is a chance of healing with the formation of scars in those places where the sites for transplantation were received from. In some cases, the muscles of the abdominal cavity can weaken; fluid can accumulate in this area when using spinal tissues. Up to five percent of all operations fail. The likelihood of complications and a negative outcome of surgery with increased smoking and a history of diabetes is increased.