For the women who has lost a breast due to cancer; shunning from the society, worthlessness feeling and depression caused by the defection of body image may be seen very often. These women are applying to the breast construction surgeries.
After this operation the women can go back to their normal lives and activities, can wear all kinds of dresses and swimming suits, and van do all kinds of sports including swimming.
The breast reconstruction has several phases and will be affected from various factors;
First of all, the operation’s size is very important. The reconstructive procedures of partial breast tissue removal (Lumpectomy – breast protective surgery) and total breast tissue removal (total mastectomy) are totally different.
It is necessary to protect the veins during the removal of lymph glands on the armpit (axillary abortion). If the veins have been protected, the reconstruction options will be highly increased and it allows to transplanting tissues from back muscle-skin (latissimus dorsi muscle-skin phleb) or tissue transplantation by microsurgery from the other parts of the body.
In case the tummy muscle (rectus abdominis) used for the reconstruction, extra additions will be made to the veins and the success chance will be increased.
Previous chemotherapy (CT) or radiotherapy (RT) applications during the treatments are also affecting the results. In case of radiotherapy, the reconstruction with silicone breast implant will not be preferred. Because the tissues which should cover the implant have been weakened by the radiotherapy and become low-nourished tissues, in this case the silicone breast implant can come out. For the patients who have radiotherapy, the tissues far from the radiotherapy area will be used for the reconstruction.
The healthy breast’s situation is also important. The other breast, in other words the healthy and in comparison with the new one, the sagged breast will be reduced, lifted or augmented on the second session for equalizing.
-The situations of the tissues which will be used for reconstructions are also important in accordance with the reconstructive options; Silicone implant is the fastest option. However in case of RT (radiotherapy) the tissues which should cover the implant have been weakened and become low-nourished tissues. Because of that, preferably it will not be used for the patients who had radiotherapy.
Back muscle (latissimus dorsi): If the volume need is not much, the armpit veins have not been damaged and patient accepts the scar on the back, this method will be used.
Tummy muscle (rectus abdominis): If the patient has donor area on her tummy (if the sagged or meaty tummy form exists), fairly full breast tissue can be supplied. At the same time, the tummy lifting will also be performed. It can not be used for tummies with hernia problem or for the tight tummies.
Another option is to move the partial hip muscle to the breast area through microsurgery. The scar on the donor area/deformity and microsurgery need is its disadvantage.
Before the reconstruction:
The detailed notes about amputation surgery and the information about breast cancer’s phases,
The post-surgical treatments: Axillary abortion, chemotherapy (detailed), radiotherapy (if available details and doses),
Photos from the front, side and back till the border of genital area (for evaluating the opposite breast’s situation and donor tummy option)
will be given to the plastic and reconstructive surgeon who will perform the operation. Besides these, it is necessary to have a good general health conditions (internal examination) and possibility to go under anesthesia should be checked.
The operation will have generally two sessions. During the first session the tissues will be moved, and on the second session forming, creating the breast nipple and procedures for the opposite breast (for supplying the symmetry) will be performed. Can be additional session needs (retouches).