What is breast reconstruction?

Physical appearance and body integrity are the most important features of women, and the breast is one of the most important organs that constitute this integrity. Breasts form the basis of feminine appearance of women’s bodies and women’s self-confidence, and they are also one of the indispensable organs for women because of breastfeeding, in terms of motherhood. Breast cancer has ranked first among the diseases that women are most worried about and affected by in recent years. Breast removal procedures performed for various reasons, cancer in particular, affects every woman mentally, physically and psychologically, and it causes them to feel negative in their both daily and sexual lives.

Today, the innovations and developments in medicine and technology make it possible to create natural looking and healthy breasts for the reconstruction of removed organs, especially for breast reconstruction. With this procedure, the difficult process that is traumatic for women is replaced by a new beginning. It provides physical and mental healing in women.

Breast reconstruction is a surgical procedure intended to reconstruct breasts removed completely or partially due to any disease or other reason, by placing permanent breast implants or placing a balloon (tissue expander) for a certain period of time in order to stretch and expand the patient’s own tissue for the purpose of making the area suitable for implant placement, depending on the patient’s age, her general health status, the proportion of the breasts, and whether the she is on chemotherapy or radiotherapy.

 
 

 

 

In what cases is breast reconstruction performed?

  • In case of complete or partial removal of breast tissue due to any disease, cancer in particular
  • In case of symmastia
woman having a Breast Reconstruction

What is symmastia?

It is a condition characterized by the confluence of the breasts in the midline (presternal region). As a result of this condition, the elevation of the skin in the midline decreases or completely eliminates the depth of the sulcus between the breasts. In some cases, breasts can be completely merged in the midline. Simmasti that rarely develops as a congenital condition usually appear due to displacement of breast implants (silicon) towards the middle.

Who are suitable candidates for breast reconstruction?

Almost patients of all ages who have had mastectomy can be a suitable candidate for breast reconstruction. Breast reconstruction can be performed in conjunction with mastectomy (breast removal) in some patients, while surgeons may advise some patients to wait for a certain period of time for reconstruction surgery.

In both cases, the preoperative evaluation of the patient is performed by a team of physicians in the fields of medical and radiation oncology, general surgery and plastic and reconstructive surgery, and then the surgery is planned based on the general health status of the patient at the time of or after mastectomy.

Planning may vary depending on the stage of the disease, the patient’s anatomical structure, and a great variety of features. In conclusion, breast reconstruction can be performed in conjunction (simultaneously) with mastectomy (surgical removal breast tissue in the treatment of breast cancer) or later (lately), depending on the patient’s body structure and general health status.

What are the treatment procedures in breast reconstruction?

In patients who have had a mastectomy, breast reconstruction can be performed in two ways.

One of the options is the creation of breast tissue with breast implants or grafts taken from the person’s own tissue (autogenous tissues). The other is breast reconstruction surgery performed with flap reconstruction (the person’s own tissue).

In both techniques, the preoperative evaluation of the patient is performed by a team of physicians in the fields of medical and radiation oncology, general surgery and plastic and reconstructive surgery, and then the most suitable treatment and surgical technique is determined and the surgical process is planned accordingly. Breast reconstruction performed after removal of breasts due to breast cancer or another disease is one of the most successful plastic and aesthetic surgery procedures.

Breast reconstruction with breast implants

Silicone implants are made of materials compatible with the body. Silicones used in mammoplasty procedures are materials that can be used not only for breast augmentation, but also for a great variety of procedures in medicine and have no proven harm to the body. Silicone does not interact with any tissue or organ in the body after its placement, and it does not cause any condition that will endanger the health of the patient. If an experienced specialist physician and a hygienic, sterile clinic are preferred and a high quality implant material is used, no negative condition will be experienced due to silicone.

After mastectomy, a tissue expander balloon is placed under the breast skin or chest wall muscle, depending on the anatomical structure of the patient, and after the skin has reached an adequate and sufficient width, the tissue expander is removed and an implant is placed in its place. The areola (brown area that surrounds the nipple) and the nipple are then reconstructed. Body structures of some patients do not require the use of expanders, and in such a case, it is possible to place a permanent implant immediately after a mastectomy operation in the same session.

Breast implants are structures prepared in the form of a breast. Round-shaped versions and more natural looking teardrop shaped versions are available. Teardrop shaped silicone, also known as water drop silicone, is a type silicone implant that is most similar to the natural breast structure. Teardrop-shaped implants are more commonly preferred because when they are placed correctly by the plastic surgeon, they look like a breast, providing an emptier appearance at the top and gradually increasingly fuller appearance towards the bottom, in such a way as to create a more natural looking breast.

The physician performs a detailed examination and interviews with the patient to determine the most ideal implant type, and then places implants with the most appropriate volume, taking into account the anatomical structure of the patient and her chest width.

Breast reconstruction performed with  Flaps (Person’s Own Tissue)

It is a surgical procedure performed by transferring the skin and subcutaneous fat tissue in the lower part of the abdomen together with one of the muscles in the anterior abdominal tissue (TRAM: Transverse Rectus Abdominis Muscle) to the breast area.

Tummy tuck surgery can also be performed in conjunction with this surgical procedure. In this procedure, the skin, subcutaneous fat layer and muscle tissue remain connected to their original sites through a vascular stem, and they are transferred to the area where the breast will be constructed, through a tunnel-like line created under the skin.

Depending on the patient’s condition, the transferred tissue alone can form the breast, or an implant can be placed under that tissue. In the second type tissue flap procedure, the tissue is completely separated from the back, abdomen or hip area, and then the blood vessels are placed and connected to the blood vessels in the recipient site, in order to ensure tissue vitality.  

Risks: Both of these tissue flap reconstruction procedures are more difficult and complex than the surgical procedures performed with silicone implants. In consequence of the surgery, scars may develop in both the donor and recipient sites. In addition, their healing process is longer than that of the breast implant placement procedures. However, despite these risks, flap breast reconstruction performed with the patient’s own tissue (autogenous) gives more natural results and it doesn’t carry the risks that exist with the silicone placement procedures.

Fat Injection in Breast Reconstruction Surgery

In some cases that differ from patient to patient, breast reconstruction operations may also involve fat injection into the breast. In a breast implant placement operation, fat injection can be done in the same session. Alternatively, a breast implant has been placed before, and then fat is injected into the breast to achieve a more aesthetic result.

Since patients with anatomically weak body structure or those who have lost weight due to treatment have thinned skin, the implant is positioned very close to their skin, and this may make the implant more prominent than normal. For the elimination of collapses, pits and protrusion in silicone implants, fat taken from the abdomen or back are injected into the areas where required. The fat injection procedure can also be performed on patients who have had breast reconstruction with their own tissues (autogenous).

What is the submuscular pocket technique used in breast reconstruction?

The complications that may develop after a breast implant placement operation, which may be caused by various reasons, include deformations due to thickening and compression of the membrane surrounding the silicone, displacement of the breast implant due to various reasons, and wrong placement of the breast implant in a position lower or higher than the required level. In such cases, wrong positions of breast implants are corrected with the “submuscular pocket technique” intended to eliminate implant displacement problems.

In this technique with an approach involving the creation a new submuscular pocket, an implant pocket is created for the placement of the new implant, by opening a completely new space in front of the previous space and behind the pectoral muscle. The new pocket is positioned directly in front of the previous implant space, so that the implant can be placed in the same position. In order to prevent the breast implant from re-entering the previous implant space, the previous one is partially removed and then it is completely closed with sutures.

This new submuscular pocket is reinforced with the Acellular Dermal Matrix (ADM) layer, or the breast reconstruction procedure can be added as a protective shield to help the newly created submuscular pocket to keep the breast implant in its place.

What are the risks that may arise in breast reconstruction?

Risks of complications such as bleeding, edema/fluid retention, delayed wound closure or infection, which are generally arise after all surgical operations, can also arise after breast reconstruction operation (although it differs from person to person). There is no effect of breast reconstruction on the recurrence of breast cancer. In addition, it does not cause any condition that can prevent chemotherapy or radiotherapy.

How is the postoperative period of breast reconstruction surgery?

After the patient is diagnosed with cancer, the breast reconstruction surgery can be planned together with general surgery and plastic and aesthetic surgery. After the evaluation of the general health status of the patient, the surgeons determine the surgical technique to be used and the date of the surgery (in conjunction with or after mastectomy), taking into account the patient’s age, anatomical structure, tissues and wishes, and then the preliminary preparations are made accordingly

How is the postoperative period of breast reconstruction surgery?

Thanks to the medications prescribed by the physician, the postoperative pain is considerably prevented. After the operation, it may be necessary to stay in the hospital for a period that differs from patient but which is usually between 2 and 5 days. Drains placed in the breast area in order to prevent fluid accumulation are removed within a few days after surgery. Returning to daily life after a breast reconstruction operation may vary depending on the scope of the operation and the general health status of the patient. It usually takes 2 to 4 weeks.

This period may be shorter after breast reconstruction operations performed with silicone implants, compared to breast reconstruction operations performed with autogenous tissues. Surgical scars that develop during the surgical process do not completely disappear.

Breast reconstruction prices

The prices of breast reconstruction operations vary depending on the experience of the surgeon who will perform the procedure, the clinical environment where the operation will be done, and the quality of the materials that will be used in the operation. You can call our clinic to get detailed information and  make an appointment.