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Overview of Breast Reconstruction

Breast Reconstruction Intervention Review

We realize that deciding whether or not patients will perform a breast reconstruction procedure is a difficult process, especially when it comes to diagnosing the illness and treating it. Although we can advise you and support you as much as possible with regard to choosing the best method, the final decision will remain yours and should be taken into account at the same time as the best for you and your health. Despite the fact that all women who have undergone a mastectomy procedure should also undergo a breast reconstruction procedure, there is no right or wrong to choose this in your case.

Breast reconstruction surgery can be performed at the same time as mastectomy (also known as first-time rehabilitation or as immediate rehabilitation) or later (second-time rehabilitation or post-rehabilitation). In cases of doubt or when there is a medical reason, it is equally acceptable to do some restoration in the second year. Generally, breast reconstruction can be done using either a silicone insert or a flap (a flap) from an area of ​​the patient’s body that is available – a “consumable” tissue (area of ​​the back , abdomen , buttocks or of thighs) and although in some cases a combination of both methods can be made, the method to be performed should be discussed during the session with Konstantinos Benetatos in order to decide on the best possible technique that suits the each patient.

More information about Breast Reconstruction is available below. Please do not hesitate to contact us if you have any questions or wish to know the details of the operation.

Why and When Should Breast Reconstruction Be Done?

Breast rehabilitation is not part of cancer treatment, but should always be offered to patients who undergo or have undergone a mastectomy procedure as an option.

It is important to understand that a breast reconstruction, from the simplest to the more complex, involves a further intervention with its possible complications. Of course it is true that today the techniques have evolved so much that the results are really impressive.

The decision as to when the patient is to undergo rehabilitation surgery will depend on the choice of each patient, accompanied by the guidance of Mr. Constantine Benetatos. If patients will need further treatments, especially radiation, it is advisable to perform the recovery surgery in a second year. Restoration of the Throat can be performed at the same time as Breast Reconstruction or usually later.

Primary Breast Reconstruction

This operation refers to breast reconstruction, which is performed at the same time as breast-mastectomy removal surgery. However, patients should always remember that a breast reconstruction procedure may also be performed at a later date following the completion of cancer treatment.

The intervention of immediate breast reconstruction has several advantages as well as possible disadvantages.

Benefits of Immediate Breast Rehabilitation

  • The biggest and most important benefit of immediate breast reconstruction is that the patient never experiences the traumatic experience of amputation of a mastectomy and that this further implies the psychosis of the female nature.
  • An immediate breast reconstruction using autografts (tissue from the patient's own body) means a single surgical procedure, and hence, a faster recovery of the patient.
  • Additionally, immediate restoration has a much better effect on the patient, especially when the mastectomy is carried out through the perimeter of the nipple by keeping the skin of the breast (subcutaneous mastectomy or mastectomy with retention of the skin) thus giving an insuperable aesthetic effect that can not another kind of rehabilitation to approach.
  • Mr. Constantinos Benetatos sometimes restores the nipple at the same time as the immediate restoration surgery when it is carried out with tissue from the back or abdomen, but not with a silicone insert.

Disadvantages of Immediate Rehabilitation

  • Understanding the surgical procedure of breast reconstruction and deciding patients for immediate rehabilitation that will prolong their stay in the hospital, it is inevitable to add further stress to an already difficult time.
  • There may also be postoperative complications from the recovery procedure, which will delay the treatment of complementary cancer therapies, such as chemotherapy and radiation. Of course, this will not affect the treatment and outcome of cancer anyway, but it will probably add an additional surgery to make sure that any complications occur will be addressed immediately.
  • If radiation is required as an adjunct to cancer treatment, the aesthetic effect of rehabilitation may be affected. In these cases after the mastectomy surgery, restoration is recommended in the second year. Of course, this problem is solved today with the most modern method of rehabilitation - Delayed Primary Reconstruction.

The rate of post-operative complications from a direct recovery is slightly higher than that of the post-rehabilitation breast and mainly concerns the survival of the breast skin after mastectomy.

Delayed Breast Reconstruction (Delayed Breast Reconstruction)

This surgery takes place after all treatment for cancer has been completed and may take place months or even years later. There is no specific time or specific age limit, and should only be done if the patient is physically and mentally ready to undertake an additional surgery.

Some patients opt for a recovery operation in the second year, in others merely suggested by the physician, and some who do not initially wish to undergo a breast reconstruction surgery, decide after some time you are ready to proceed with this surgery intervention.

Benefits of Extreme Breast Reform

  • Restoration is avoided by any possible delay in the onset of complementary therapies such as radiation or chemotherapy in the event of post-operative complications due to immediate rehabilitation.
  • Although the aesthetic effect of immediate restoration is superior to that of the ultimate, however, the addition of radiation to a direct restoration will have exactly the opposite effect. Of course, in the case of post-rehabilitation, the possible effects of radiation (sclerosis, shrinkage and breast distortion) are avoided.
  • The patient will not have to discuss surgery or take any decision related to breast reconstruction at the time of diagnosis and the duration of cancer treatment.
  • In addition, this method has a slightly lower complication rate compared to immediate recovery surgery.

Disadvantages of Ultimate Rehabilitation

  • Patients should live with the results of mastectomy until recovery is done, which may take several months to a year, depending on the case of each patient.
  • The aesthetic effect may not be as satisfying, as with immediate restoration, the skin of the breast is often retained and used to cover recovery, thus giving a more natural effect, as opposed to a post-rehabilitation procedure. In these cases, as skin is missing in the breast, it is transplanted from the back or abdomen, which will have a different shade initially and there will also be larger incisions in the breast area.
  • The difference in appearance in the skin of the breast will be less apparent in the silicone insert repair, as the skin initially displaces with a balloon dispenser.
  • In patients undergoing radiation, it is an absolute contraindication to place a silicone insert for recovery, as the possibility of complications is too high, and in this case it is necessary to carry tissue from the back or abdomen area to restore the breast.

Radiation and Breast Reconstruction

For some patients with breast cancer, radiation is a very important part of the treatment, especially for those who have undergone partial mastectomy (breast surgery), as it turns out to be a great contributor to reducing the chance of recurrence of cancer in the mass gland. It has been shown that a breast preservation surgery (ogenectomy – wide local excision – tetarthectomy) combined with radiation can have the same effects as a mastectomy procedure.

However, it has been observed that some patients who have undergone mastectomy will also benefit from a complementary radiation therapy. However, the necessity of radiotherapy is confirmed after mastectomy and histological examination of the breast preparation.

Supplemental radiation therapy, in addition to the destruction of cancer cells, also causes damage to the normal tissue of the area, leading to changes in the patient’s skin, such as discoloration, sclerosis and shrinkage, or even death of healthy breast tissue. It can also have the same effect on the tissues used to restore a breast (skin and fat from the abdomen or back). Particular attention should be paid to the use of a silicone insert with supplemental radiotherapy, where very high complication rates of up to 30% can occur, such as crevice capsitis, inflammation, discovery of the patch, severe deformity and pain but still and complete failure of recovery with forced removal of the insert.

The problems associated with radiation can be limited to breast reconstruction using the following methods:

  • In the majority of cases, if radiotherapy is planned or is already given, breast reconstruction surgery should be avoided with a silicone insert.
  • In the event that radiotherapy is considered necessary after mastectomy, it is advisable to rehabilitate until all required treatments have been completed. It is disappointing for both the patient and Mr Constantine Benetato to have a good breast reconstruction destroyed due to radiation.
  • If, on the other hand, radiotherapy is required, then it is preferable for the patient to choose an Extreme Recovery or Better a Delayed Direct Relief which is then analyzed in the section below.
  • It should be stressed, of course, that not all patients suffer the harmful effects of radiation and although it may make the final decision quite difficult, however, with Constantine Benetato the best treatment based on the individual case of the patient will be discussed.

Delayed Primary Breast Reconstruction

This is the best way to restore breast that combines the benefits of immediate recovery without putting the new breast on the risks and complications that can arise from radiation. This method initially involves placing a skin disorder under the major thoracic muscle in the same surgery as mastectomy. A prerequisite for the success of the technique is to undertake a subcutaneous mastectomy by maintaining the skin of the breast. After the histologically resected breast is removed, then the recovery plan is decided.

Two possible scenarios – first, no further treatment of the breast with radiation, so we can do the final phase of recovery either with a permanent silicone insert or with autologous tissue within the next two weeks – the second possible scenario is to need complementary radiation therapy and we expect this to be completed in order to avoid all the unpleasant consequences of radiation on the new breast, and then after a reasonable time (3-6 months) we continue with the state with autologous tissues (abdomen or back) only (not with silicone implant).

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