Breast cancer is seen in one in every eight women today. The primary treatment for breast cancer in most patients is removal of part or all of the breast. This surgery is performed in some patients after chemotherapy (drug therapy) and radiotherapy (radiation therapy).
After breast cancer surgery, there is always a deformity left in the breast due to the surgery.
In cases where the breast is completely or partially removed due to breast cancer, plastic surgery is used to correct this deformity or create a new breast. The first point that patients with the disease should know is this; Simply placing a silicone prosthesis into the space created when the breast is removed and creating a bulge there is not breast reconstruction (repair). Similarly, closing the breast in a way that creates deformity in the breast after removing a part of the breast is not a breast reconstruction.
For an acceptable breast reconstruction, the newly constructed breast must be similar to the patient's other breast in shape, size and position. There should also be a nipple and a dark ring around it (areole).
It will help patients to make healthy decisions by asking the doctor they consult for breast reconstruction or breast aesthetics after breast cancer to show pictures of similar surgeries he has performed before. It will also allow them to understand how competent their doctor is in this regard. Because breast reconstruction is a special surgery. For this reason, the person who will perform the surgery must not only be a plastic surgeon but also be experienced in breast reconstruction.
The timing of repair or plastic surgery after breast cancer is important. These surgeries can be performed simultaneously in most patients. This is called simultaneous repair. In suitable patients, breast repair or aesthetics can be completed in one go during breast cancer surgery.
However, in cases where simultaneous surgery cannot be performed for some reasons, these procedures are performed after breast cancer surgery. This is called delayed repair.
To perform breast reconstruction on the patient after breast cancer, either silicone prostheses or implants are used. The patient's own tissues are used. The plastic surgeon decides which method will be suitable for the patient by evaluating the patient according to his experience.
Silicone prostheses are used in two types in breast surgeries after breast cancer. If the patient's remaining skin after breast cancer surgery is sufficient to create an aesthetic breast, a silicone prosthesis can be placed in one go. However, if it is not sufficient, a tissue expander (balloon method) is placed here. This tissue expander is inflated over a period of 4-6 weeks. After sufficient skin is obtained, it is removed in a second surgery and replaced with a silicone prosthesis. The main disadvantage of this method is; Since the silicone prosthesis is not a part of the patient's body, its symmetry with the other breast may deteriorate over time as the patient gains or loses weight or ages. Another disadvantage is that these silicone prostheses must be replaced every 7-10 years.
Another method applied for breast reconstruction or aesthetics after breast cancer is the flap (autologous) method, in which the patient's own tissues are used. The autologous method is the transfer of tissue taken from one part of the body to another body part, preserving its own nutrition, in order to create form and function. In the autologous method, the ideal region is usually the abdomen. However, in patients who do not have enough tissue in the abdominal area, breasts can be made by preparing tissues from the back, inner thigh and hip area.
Among all breast-related surgeries after breast cancer, the most ideal method is to use the patient's own tissues. The DIEP flap method, in which the patient's abdominal tissue is used without damaging the abdominal muscle, is the gold standard among all methods. With this method, if the patient's armpit lymph nodes have been removed, they can also be replaced.
The nipple and the dark ring around it are usually removed after 3-6 months in both methods.
The points that patients who will have breast reconstruction or aesthetics after breast cancer should pay attention to are as follows;
No matter what method is used, these surgeries usually have several stages.
Concerns about silicone prosthesis, especially in patients who have received or will receive radiotherapy (radiation therapy). The probability of experiencing serious problems is over 40%. In these patients, their own tissues must be used.
Flap surgeries performed with the patient's own tissues are permanent and the patient can carry it for life.
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