The breast, as the source from which we receive our first nourishment as soon as we are born, is, according to Freud's philosophy, a preliminary element of lifelong dependence on the female. As a matter of fact, it has been used as a symbol of abundance throughout history. From a psycho-social perspective, this organ, which is the mediator of the child's first contact with its mother, has gained value as a jewelry and ornament on the woman's body, as a distinct and important sign of femininity. Medicine has started a determined fight against a brutal disease such as cancer, which threatens such an important organ and women's life, and important developments have been made especially in recent years.
For example, the old principle of "get as much tissue as you can" While defending, the principle of "protect as much as you can" has now become valid. Beyond preservation, the effort to "replace what has been lost" has also led to the development of reconstruction methods and options.
Reconstructive Techniques:
If a lumpectomy (removal of a part of the breast tissue) has been performed, the remaining breast tissue is removed. It is possible to create aesthetic-looking breasts by shaping and shrinking the other healthy breast.
However, after larger mass removals, skin-sparing or complete mastectomies (complete removal of the breast), either implants (breast prostheses) are used or other breast implants are used. Other tissues obtained from its parts are used. When using implants, either a breast implant is placed directly, or a permanent breast prosthesis is placed underneath after the existing skin is expanded using tissue expanders, or two-component breast prostheses containing both tissue expanders and silicone gel are used. In recent years, significant developments have been made in breast implants and many options have been provided. In the methods that we call autologous reconstruction, using the own body tissues, either the obtained tissues are shaped and the breast is created, for example; The lower abdominal skin, upper hip or lower hip skin is lifted together with the fat layer and muscle under it to form a breast shape, or the back or thigh skin is lifted with the muscle underneath and transferred to the breast area along with its vein, and a breast prosthesis is placed under them and shaped into a breast shape. In a method that has been gradually introduced recently, the remaining skin after mastectomy is treated with negative pressure It is first expanded through a special bra, and then by applying liposuction, the fat tissue obtained from other areas is passed through a special process and injected under the expanded breast skin, thus creating the breast mass and shape.
When should it be done?
Reconstruction can be performed in the same session after breast cancer surgery or can be delayed and performed at a later time. Waiting time varies. In this decision, the type of cancer, its spread, the application of radiotherapy or chemotherapy, the condition of the skin and, in some cases, the patient's preferences are taken into consideration.
Can it be done after radiation?
The quality of the skin and how affected it is by radiation. Depending on your condition, the use of breast prostheses may be limited. However, many options may be suitable using one's own tissue.
The healing process?
It varies depending on the reconstruction method. While it takes a few days when a breast prosthesis is used, it may take a few weeks when, for example, abdominal skin and muscle are applied.
Follow-up tests after reconstruction?
Monitoring is very important. The patient's life is at stake here and should be taken seriously. In the first place, monthly examinations are carried out. At wider intervals, mammography, ultrasonography and MRI may be performed.
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