Breast Reconstruction

Breast Reconstruction Surgery with Patient's Own Tissues After Mastectomy

Breast repair can be done in two periods in terms of timing. One of them is a period of simultaneous or immediate repair. In this case, in patients diagnosed with breast cancer, breast reconstruction is required in the session in which breast surgery was performed. Thus, the patient comes out of the surgery with a new breast, not without a breast. Early-stage breast cancer patients are suitable candidates for simultaneous repair. It is advised for patients who are diagnosed at an advanced stage or to whom radiation therapy will be applied, to apply repair after a few years without disease .This is called the period of late repair.

One method that can be used to reconstruct the breast is breast reconstruction with the patient's own tissues. The first preferred area for breast repair performed with the patient's own tissue is the abdominal tissue in the lower part of the navel. The abdomen is a soft area which is very similar to a normal breast and provides adequate tissue. The scar formed in the area where the tissue is taken is symmetrical and can be hidden beneath the underwear. This method is advantageous for many women as it also gets rid of the fat in the lower abdomen. The complication rate is low when the right patient selection is made and the right techniques are used. Aesthetic results are quite good. Abdominal skin and fat tissue can be transferred to the new breast area using the underlying abdominal muscle, or it can be transferred by microsurgery. The reason for using muscle is that it creates a blood supply to the tissue that will be brought to form the chest, providing blood circulation.

One of the treatment methods is to completely separate the abdominal muscle by bringing the abdominal tissue to the chest wall and to connect the veins inside it with microsurgery to some veins on the chest wall. After the breast repair is performed, the opening formed in the abdomen is closed. This also provides a tummy tuck effect. Sometimes, despite all these practices, it may be desirable to provide a little more resemblance of breast tissue with a breast implant.

In the use of abdominal tissue for breast repair; it is desirable that the abdominal tissue is in sufficient condition for such an application, which is slightly saggy and has fat tissue. Some obstacles to using implant-related options may also lead us to do breast repair with abdominal tissue (such as radiation therapy, unsuccessful silicone treatment interventions).

Other tissues that can be used in patients for whom abdominal tissue is not suitable are found in the back, hip and waist regions. Among these, the latissimus dorsi muscle, which we can also call the back muscle, is used together with the skin, and sometimes silicone implants are used to enlarge and support the new breast. If a breast implant is used with this method, then it is placed under the muscle in order to obtain a better breast shape. If it is not possible to enlarge the breast with a direct implant or enlargement with tissue expander methods, if the patient has been treated with radiation and bad results have been obtained from previous breast repairs, muscle tissue methods can be chosen. The surgical procedure may need to be postponed in patients with poor general health, overweight, high blood pressure and smokers. The patient’s medical or psychological unsuitability for repair or a previous accidental injury to the latissimus dorsi muscle are conditions that may prevent breast repair using the latissimus dorsi muscle tissue. In this case, the surgical scar on the back is hidden under the bra, the use of the muscle does not cause any harm to the body and it is a relatively easy operation.

Another method is the free transfer of excess skin and subcutaneous tissue from the hip and waist area to the breast with microsurgery.

The patients' own tissues are more similar to breast tissue in terms of content. Thanks to these features, the physical behavior of the breast made with the patient's own tissue is more similar to the natural breast, and the sense of sensation is better formed. In the postoperative period, fading of the scars and softening of the tissues used increase the feeling of satisfaction over time. The patients' own tissues especially respond to weight gain and loss like normal breasts. As a result, there is no asymmetry between the two breasts in case of excessive weight gain or loss after repair.

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