Various options are available for breast reconstruction. However, we can basically group them into two groups. The first group includes methods that use the patient's own tissue or autologous tissue. The second group includes methods using silicone breast prosthesis. Both methods have their own advantages and disadvantages. In suitable patients, the patient's own tissue should be preferred. Because, while years are on the patient's side in repairs made with the patient's own tissue, time is on our side in repairs made with silicone prosthesis.
Both methods have common points. First of all, both methods are performed under general anesthesia. Secondly, both surgeries are multistage. However, the first surgery is usually more extensive and longer. The other stages mostly involve making small corrections of the nipple, the dark ring around it called areole, and revision. Some of these can be performed under local anesthesia, but it should not be forgotten that these are generally performed under general anesthesia due to the comfort of the patient and the nature of the procedure.
How is breast reconstruction or breast reconstruction performed with a silicone prosthesis? The important point in answering this question is how breast cancer surgery is performed. Because the new breast will be built on the existing tissues. How breast cancer surgery is performed is a subject beyond this article and my area of expertise. Therefore, this issue will not be touched upon. If the remaining skin is insufficient, which is usually insufficient, a place should be prepared where the prosthesis can be placed. For near-natural and acceptable results, a tissue expander is usually placed in this area during the first surgery. This tissue expander is a temporary prosthesis whose outer wall is made of silicone and whose interior can be inflated with physiological saline. To make it easier to understand, we can compare it to a balloon. This tissue expander has an inflation port that is either integrated into it or placed slightly away from it. Starting at the appropriate time after the surgery, the aim is to expand the skin by inflating it at the appropriate time according to certain criteria, and to prepare a pocket into which the prosthesis of the required size will fit. This tissue expander is then replaced with a final silicone prosthesis during a second surgery. In this second stage Afterwards, nipple and areole construction, if necessary, intervention on the other breast to ensure symmetry, and mostly minor procedures, which we call revision, must be performed.
In breast repairs performed using the patient's own tissues, the tissue needed is provided using the patient's own tissues. There are several areas used for this. Of these, the most frequently used area in suitable patients is the abdominal area. The abdominal area is followed by the hip or waist area. In third place is the dorsal region, but its use is limited to selected cases due to technical reasons. There are important details that suitable patients should know about the use of tissue in the abdominal area. However, this method is multi-stage, not single-stage like the other one. Unlike tissue expanders, there is no need for an inflation period for the desired volume and a step where the tissue expander is removed and the silicone prosthesis is placed. However, in this method, there are stages of making the nipple and areole, revision or, if necessary, other breast intervention stages to ensure symmetry. As with the others, these are mostly performed under general anesthesia or local anesthesia.
There are two important points to emphasize. First of all, it should be known that in every option where all the patient's own tissues are used, except for the option where tissue expander and silicone prosthesis is used, there will be an additional surgery area other than the breast area and there will definitely be a scar due to the surgery. The second point that needs to be reminded is that while time is on our side in repairs with natural tissue, time will be against us when silicone prosthesis is used.
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