For women who underwent a mastectomy due to a tumor, breast reconstruction is recommended. Breast reconstruction procedures can be done either during the mastectomy, in collaboration with the breast surgeon, or in a second year after some time.
Two surgical stages are required under general anesthesia.
In the first stage, a tissue expander (skin expander) made of silicone is placed under the chest muscles, which is periodically filled, every two weeks, with normal saline through a valve placed under the skin, until the new breast has the Desired outcome. The process takes 2-3 months.
In the second surgical stage, the permanent silicone implant is placed together with fat and at the same time we increase, reduce or straighten the other breast to achieve symmetry.
Commonly, we use the skin and muscles of the back (latissimus dorsi muscle) when the mastectomy area has blood supply disorders mainly due to radiation, as well as the skin of the abdomen when there is excess skin and laxity while doing abdominoplasty at the same time.
Mainly the latissimus dorsi muscle is used together with a silicone implant. After the completion of the breast reconstruction, the reconstruction of the nipple follows with the use of autologous tissues and with local anesthesia.
In order to choose the right technique, we should take into account the patient's physique and temperament, the condition of the other breast, the mastectomy's technique, the radiation history as well as the patient's preferences.
Nipple and areola reconstruction is best done after the completion of all stages of breast reconstruction, a few months later, with a separate procedure and with local anesthesia. Methods of restoration include the use of local skin flaps, the use of a graft from the other nipple, prosthetic nipples, the use of a tattoo or a skin graft from the femoral fold of our body.
The most recent data and developments in the field of mastectomy and reconstruction indicate that mastectomy is now performed with skin sparing mastectomy and reconstruction at the same time as the mastectomy, even if chemotherapy or radiation therapy will follow, without compromising the oncological safety of the patient.
As a result, the patient does not have to undergo a surgical stage, the cost of the procedure is reduced and the recovery time will be completed in 4-6 months instead of 2-3 years after mastectomy, which was in the past. This mastectomy and reconstruction technique is not only practiced in the most modern surgery centers in America and Northern Europe, but also in our country. An excellent cooperation between the patient and the breast surgeon, the plastic surgeon, the medical oncologist and the radiation oncologist is required.
In a large percentage of women, only tumor removal (lumpectomy) and postoperative radiation therapy are performed. This results in an asymmetry with the other breast. With the redistribution techniques of the mass gland, (rectification or reduction) we cover the deficit resulting from the lumpectomy and at the same time restore the shape of the other breast in order to achieve symmetry.
In public hospitals, the cost of rehabilitation is covered by public health insurance. In private hospitals, public health insurance covers part of the hospitalizations and part of the cost of implants. Private health insurance covers both the doctor's fee and the patient's hospitalization."