Breast cancer is one of the most common types of invasive cancer worldwide. Approximately 1 out of 8 women develops invasive breast cancer at some point in her lifetime. The danger of developing breast cancer increases with age, which is the most important risk factor. Genetic, hereditary and environmental factors are among the causes of the disease. A number of doctors of different specialties, namely a general surgeon, an oncologist, a radiotherapist and a plastic surgeon, need to cooperate in order to diagnose the disease and administer the proper treatment.
A woman’s breasts are a symbol of femininity, sexuality and motherhood. Mastectomy is a disfiguring surgery that takes a high emotional toll on a woman. Breast cancer surgery is different from one patient to another and can be combined with adjunctive treatments, such as radiation therapy.
Breast reconstruction after a mastectomy aims at creating a new breast whose shape and appearance are close to the original one. The new breast should also be symmetrical to the other one. A breast reconstruction surgery can be performed immediately after the mastectomy or at a later time. Doctors of different specialties take into account all the factors and the patient’s wish, before deciding whether or not the breast reconstruction surgery will be performed immediately after the mastectomy or later.
Depending on the case, breast reconstruction is performed using implants or tissue expanders along with tissue from the patient’s own body. These two techniques can also be combined.
The advantages of using silicone implants or tissue expanders are that the new breast is created in less time with less scarring and without the need for microsurgery. The recovery period is shorter, as well. Using tissue from the patient’s own body is a very demanding type of surgery, as it requires specialized knowledge in the field of microsurgery. The advantages of this method are that the tissue used is more resistant to infections, the surgery can be performed following an adjunctive treatment (e.g. radiation therapy) and it also allows the plastic surgeon to reconstruct a large amount of tissue. The use of implants is also avoided through this method.
The abdomen area is the most common tissue donor site. The tissue used corresponds to the transverse rectus abdominis myocutaneous (TRAM) flap that is removed from the abdomen along with part of the rectus abdominis muscle. It is the same type of tissue with the one used in a tummy tuck. Microsurgery techniques have evolved in recent years, hence the same part of the TRAM flap tissue is removed without including the rectus abdominis muscle. Instead, the flap contains part of the deep inferior epigastric perforators (DIEP). Other types of flaps include the latissimus dorsi flap, which is removed from the back of the patient and can be used in conjunction with an implant, and the flaps of the superior and inferior gluteal artery perforators that are removed from the buttock area.
The final stage of breast reconstruction after a mastectomy is the reconstruction of the papilla-areola complex. This stage is conducive to the normal appearance of the new breast. The reconstruction is usually performed 3 to 6 months after the breast reconstruction surgery. The new papilla is created using local flaps or a composite graft extracted from the other papilla or the labia minora. As far as the areola is concerned, it is reconstructed through a medical tattoo or using skin grafts that are usually removed from the inguinofemoral area.
Breast reconstruction surgery after a mastectomy requires a certain level of familiarization and specialization in very demanding microsurgery techniques. Dr. Varnalidis uses specialized modern microsurgery techniques for breast reconstruction after a mastectomy. Creating a new breast that has a normal appearance and is symmetrical to other one is the desired goal of both the patient and the plastic surgeon.
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Dr. Varnalidis always discusses and explains each procedure step by step. He also offers extensive post-surgery advice and is here to answer any question you might have, so that a smooth recovery and the best functional and aesthetic outcome are achieved.