Breast reconstruction after mastectomy
The need for breast reconstruction often accompanies the rehabilitation period after the successful treatment of breast cancer. Quite often the operation is carried out simultaneously with the removal of damaged organic tissues, but you can easily postpone it. Some patients decide on breast reconstruction only months and even years after the victory over the cancer. Reconstruction in no way affects mastectomy, does not affect the results of treatment of a malignant tumor. There is no correlation between breast reconstruction and survival rate( in the calculation of periods of any duration).
Silicone as the final stage of victory over 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 would be if radiation therapy was not conducted 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 natural tissues. In fact it is a spherical-shaped empty object, which is designed to increase the amount of organic tissue in a strictly defined place. Then, as can be seen from the breast reconstruction photo, implants of silicone material are placed on this place.
The duration of primary use of the expander is 14 days. At the end of this period the patient must visit the doctor to fill the device with a special liquid. The processes are visible on the breast reconstruction photo - they are published by all self-respecting clinics so that clients know what will happen to them at each of the stages. To fill the expander a special physiological solution is used, and the pump process itself is performed through the hole intended for this purpose.
What's next?
The expander must be filled with the solution several times. The doctor appoints the frequency of visits to the clinic. Usually breast reconstruction after mastectomy involves two-week intervals between receiving new "portions".The fabric must be stretched to the intended size, then the preparatory stage is completed.
Further breast reconstruction after mastectomy involves the extraction of temporary prosthesis. Its place is occupied by a permanent implant. In fact, it is a shell of silicone, filled with a special gel or liquid. The second option assumes the presence of a physiological solution, that is, sterile water with a high salt content.
Aloderm as a fast method
The above multi-stage breast reconstruction after mastectomy( feedback on such an operation performed in a reliable clinic is almost always positive) is not necessary in all cases. Much depends on the health of the patient and the overall clinical picture. The doctor, when examining and taking readings, analyzes the possibility of using an alternative variant - aloderm. This term is used to designate a special material used for surgical intervention. When it is used, 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 process of producing the material requires a fairly long time interval: first it is necessary to obtain donor tissues, then create a connective tissue by sterilizing all the 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, you need to consider that aloderm is actually collagen and elastin, while the tissue structure is similar to human skin. It is necessary to treat the material with physiological saline and fix it in the correct position. Since the muscle tissue does not change during this operation, the method is considered more preferable than the previously described variant. In addition, the reconstruction of the breast flap aloderm allows you to get a more aesthetic result.
Donation will come to the rescue of
Quite common method of breast reconstruction after removal is the use of own tissues. The result will have a perfect appearance for a long time. If many implants need to be changed at a frequency of not less than fifteen years, 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, the reconstruction of the breast in this way gives, as a result, even a beautiful breast, but its sensitivity is lower than it was before the natural disease. This is due to the imperfection of the technique: currently, medicine simply does not have the tools to restore small nerve fibers, due to which the natural healthy female breast is so sensitive.
If you pay attention to the breast photo after reconstruction using the described technique, it becomes clear that the result is beautiful and spectacular. Doctors pay attention: it is possible to combine this technique with the use of implants from silicone. This allows you to get the desired amount of breast as a result. As a material for reconstruction of the breast after a mastectomy( the photo of the recovery process itself is usually shown by the doctor at the reception), tissues obtained not only from the abdomen but also from the back, buttocks, and thorax can be used.
Features of the
methodology The use of the patient's donor tissue is most effective if the patient underwent radiation therapy. Also, the option is suitable for large breasts, rather large body shapes.
During the recovery process, large areas of the body are involved. This affects the duration of the operation: surgical procedures are long. Consequently, the length of the rehabilitation period also increases. This is a significant drawback against the background of the application of aloderm. However, according to many, the positive aspects of the method fully cover these disadvantages.
Breast reconstruction TRAM flap
TRAM is a term commonly used in the medical field for 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 excess weight, especially if there is excess fat at the waist. Simultaneously with this operation, many patients also decide to make the plastic of the abdomen. True, TRAM is not available for everyone: if the fat tissue in the body is not enough, 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 severely disrupts blood microcirculation, in the presence of this harmful habit, a woman can not perform breast reconstruction using the TRAM method.
During surgery, the doctor excludes the oval element from the bottom of the abdomen - this is the surface of the skin, and fat tissue, muscle, fascia. A tunnel is formed through which the site is transferred to the chest. At the same time, there is no crossing of the vessels, all of them are still attached to the flap. The doctor forms the right sizes, sews the site. The duration of the surgical procedure is about three hours. It is possible to combine this technique with the installation of an implant of silicone. If the patient underwent a double mastectomy, then the TRAM operation lasts at least six hours. The rehabilitation period after such an intervention is quite long, many women are hard at it.
DIAP FLAP
It is customary to apply the technique if the woman has enough tissues to form a flap and transplant it in the chest area. This option is applicable if the woman had previously experienced abdominal surgery. It can be resorted to in case of removal of the uterus, surgery on the intestines, removal of an appendix or liposuction. However, with a lean physique, this method still does not fit - the body has too few tissues that could be transplanted. Also, the DIAP FLAP method can not be used to restore breasts of women who smoke, since a bad habit has a negative effect on the microcirculation of the blood, as a consequence of which the flap takes root with great difficulty, complications. The risk of an unsuccessful outcome of surgical intervention is high.
The result will be successful only if you contact a clinic specializing in this method, since the technology is relatively new and currently only a limited number of surgeons on the entire planet have sufficient qualification level for conducting it. The technique of microscopic surgery is used, during which the abdomen is excised from the area of the skin, to which lie fiber, vessels, artery. A distinctive feature in comparison with TRAM is the preservation of the integrity of the abdominal muscle tissue. The flap is free. The surgeon attaches it to the intended form and fastens it to the right place. The connection requires the presence of tiny blood vessels. Achieve this by applying microscopic surgery technology. The final stage is abdominoplasty.
Some features of
DIAP FLAP usually last at least five hours, if it is necessary to restore one half of the breast. When reconstructing both parts, the operation stretches for eight hours, and sometimes lasts even more. In comparison with the previously described TRAM method, a longer process, but it does not suffer from muscle tissue, so regeneration proceeds fairly easily, it is not too long, as in the case of a TRAM flap. By resorting to DIAP FLAP, the patient reduces the risk of weakening of the abdominal muscles supporting the abdominal cavity. Also after the surgery, there will be pain, but noticeably weaker than with alternative surgical techniques.
Spinal muscles to help with the recovery of
A fairly good option for breast reconstruction after mastectomy is the use of the widest muscle. The method is suitable for those patients who have a lean physique, there is neither excess fat nor excess skin. Also, the option is applicable for those who underwent radiation therapy. As the main material for surgical intervention, use the dorsal muscle.
The operation process involves the creation of an oval incision above the latissimus muscle. Thus the surgeon allocates a flap of a muscular and fatty fabric. A subcutaneous tunnel is formed through which the selected site is transferred to the breast. In this operation( as far as possible) retain the integrity of the vessels. The surgeon forms the correct forms, the kind of flap, and then fixes it to a permanent new place. If blood vessels were damaged during the operation, microscopic surgery is used to restore it. The duration of such a procedure is up to three hours, sometimes less.
Features of the
method As can be seen from the numerous statistical data, it is not possible to obtain on the back a flap containing the necessary volume of adipose tissue, when referring to this technique. This forces the combination of a transplant surgery 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 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, the shade of the skin, varies significantly with the normal female breast. A small area of the back with a visual inspection will detect a disproportion. At the same time, the functional load of the spinal muscles is preserved to the full. Such operations are carried out 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 with this method of manipulation, unwanted complications can arise. You can avoid this if you work with a well-established doctor.
Buttocks as a source of material for transplantation
In mastectomy, breast reconstruction can be performed using tissues obtained from the buttocks of a woman. The method is rather complicated in implementation, in some cases gives unwanted complications. They resort to it infrequently and only with the cooperation of an experienced surgeon, but the result with a quality performance will be excellent.
During the surgical intervention, the doctor chooses a suitable oval area on the buttocks and cuts the skin, the subcutaneous layer of the cellulose and the muscle tissue. This flap is attached to the conceived place of the breast, during the process it is given the necessary volume and desired shape. To increase the breast, you can additionally install a silicone implant. The main problematic of the application of this method is associated with the intersection of blood vessels. When transplanting, they are first cut off, then restored. To do this, it is necessary to use high-precision technology of microscopic surgery. The duration of surgical intervention is up to 12 hours. If there is a significant damage to the blood vessel, the flap in the new place will be rejected.
How else can I restore my chest?
TDL stands for thoracodorsal flap. Its source is the chest of the woman on the side, from the back. No cosmetic or functional deficiencies after such a surgical intervention is observed, but the method is applicable only when working on breast reconstruction of a small size.
An alternative is to obtain donor tissue from the hip, from the inside. In many respects, this method is similar to the implantation of gluteal tissues, while also a flap that consists of skin layers, fat of fat and muscular areas.
The most innovative methods involve the use of synthetic protein matrices. These materials are similar in structure and appearance to human tissues. The accumulated experience in conducting such surgical interventions showed that the probability of an allergic reaction is minimized. You can also resort to donor tissues by implanting them.
Important point!
The above techniques can restore the chest, but in no way affect the presence of nipples. This stage of reconstruction requires a separate surgical intervention, as well as the formation of an areola. Usually, the skin areas obtained from the inside of the thigh are used. To the color was exactly what the client wants, the fabrics are additionally painted - in fact this is a tattoo.
Rehabilitation: what and how?
If breast restoration was chosen by installing a silicone implant, then the length of the rehabilitation period is 14 days. After this time interval, in the absence of complications, one can return to normal life. Doctors advise the first month after surgery to use a supportive sports top.
If the operation involves the transplantation of the patient's own tissues, then the 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 the level of the head. Prohibited more or less serious physical activity. If the operation was carried by the mother of young children, you need to seek help in caring for them - the woman herself is strictly not recommended to do this.
Complications: why prepare?
When breast reconstruction after a mastectomy, there is a possibility of puffiness, pain syndrome, provoked by excessive hemorrhage. Usually this happens when the implant is inserted. Also, near the implanted silicone site, an inflammatory process, triggered by an infection, may begin. The chest can become stiff, which is caused by the capsular effect. The term is commonly referred to as the "wrappers" created by the scars that surround the implant.
When choosing an operation with the use of own tissues, there is a possibility of healing with the formation of scars in those places from which they received the sites for transplantation. In some cases, the muscles of the abdominal cavity may loosen, when using dorsal tissues, liquid may accumulate in this region. Up to five percent of all operations result in an unsuccessful outcome. The probability of complications and a negative outcome of surgical intervention with constant smoking and diabetes in the anamnesis is increased.