19.04.2017

Surgery for breast reconstruction after mastectomy

The company DNIPRO PREMIUM CLINIC is pleased to announce the possibility of a unique surgery for breast reconstruction after mastectomy, which is conducted by leading Ukrainian doctors only in Dnipropetrovsk city. More detailed information can be found by contacting our company.

For breast reconstruction after mastectomy (breast removal full or partial) use many techniques. For example, the modeling of scar and tissue remnants to recreate the similarity of the breast, the installation of silicone implants, the movement of "muscle-skin" complexes from the abdomen and so on. However, they all have drawbacks. Let us examine them one by one, depending on the applied techniques of breast reconstruction

1. The most obvious method is to place a silicone implant instead of removed gland. It might seem simple: the tumor is removed, the volume recovered - everyone is happy. However, there are many hidden pitfalls. First of all is aesthetically unacceptable appearance. Indeed, the main for oncologist is to remove the tumor as fully as possible.  In most cases, the nipple-areolar complex is also removed, according to the requirements of ablastics and antiloblastics. (This is the main principle in the surgical treatment of tumors, which implies the removal of the tumor within healthy tissues). And after such removal it may not be enough skin to recreate the same breast as it was before the operation.  Second, one-stage techniques (when in one operation removed the glands with a tumor, and reconstructed it) have a lot of technical limitations, primarily due to the peculiarities of the implants, that is, what replace the lost volume. For example, silicone implants should not be placed directly under the skin and under the scar on the skin. Through the scar they will sooner or later superbly drop out, under skin it will be noticeable. The use of various technical tricks (the installation of special spacers between the skin and implant, preliminary stretching of the skin with the help of an endoexpander) significantly increases the cost of the operation and extends the terms of treatment. In addition, we must not forget that even the most modern and expensive implants need to be changed at least once every 10 years.

2. Restoration of the lost volume of the breast with a flap from the back. So-called thoracodorsal flap. Excellent technique, however, has some limitations. The first is the appearance of another scar on the back. Given the nature of the operation, the scar will in most cases be ugly. Second is the need to use an expander, as on the back fat thickness is small, therefore the volume restore is problematic.

3. Restore the breast with a flap removed from the abdomen. Or so-called TRAM-flap. It involves cutting out an oval shape flap in the lower abdomen and moving it to the breast on the muscle. This method kills two hares. First restored the breast, and secondly there is a single-stage abdominoplasty. That is, a lift of the abdomen. However, there is one "BUT", which crosses out all the pluses. A woman loses a straight abdominal muscle. Yes, there are duplicate muscles that partially take over the function of lost muscle, but a full recovery never takes place.

4. Microvascular flaps. The word “microvascular” implies the fact that the vessels are sewed together under a microscope, because the size of the vessels does not exceed 1.5 millimeters. There are many of them. The most common and popular is the DIEP-flap, which is very similar to TRAM-flap, but devoid of its flaws. The technique involves taking a flap in the lower third of the abdomen (we remember that at the same time abdominoplasty is performed, that is, the abdomen becomes more aesthetically pleasing) isolation of blood vessels, which provide its nutrition, and the stitching of them [vessels] with vessels on the chest, followed by the formation of the breast and the nipple-areolar complex. In the end, it turns out:

a) Restored breast. If necessary, tightening or enlarging of the healthy breast on the other side is performed).

b) Flat abdomen, as after a separate aesthetic operation of abdominoplasty.

c) If there are scars on the abdomen from previous surgical interventions, they also disappear.

d) The seam line on the abdomen is positioned so that it easily hides under the laundry. On the chest, respectively, the seam line is also hidden.

e) No other anatomical structures are affected. All muscles remain in their place, there is no threat of formation of postoperative hernias and violation of posture.

f) There is no need for subsequent inspections and replacements of the implants, and therefore there is not a large number of negative sides that occur when using silicone implants.

A few words about other variants of microvascular flaps. They are mainly used in cases when a woman is thin, and there is no stomach fat to reconstruct the breast.

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