Reconstruction of a mammary gland (breast) after mastectomy — before and after photos, prices, reviews
Usually to be restored:
- the volume of the skin and subcutaneous fat in a remote region of the breast;
- the volume of tissue around the reconstructed breast in that case, if during the operation, the mastectomy removed nearby tissue and the pectoralis major muscle;
- the nipple-areola complex;
- can be adjusted to the shape and size of the second breast to improve appearance of the bust and the elimination of asymmetries.
Of all known methods of plastic surgery can be used almost any:
- use espandersi breast implants;
- the movement of the skin, subcutaneous fat and muscles in the area are restoring breast;
- laser polishing of scars;
- tattooing of the areola area;
- in some cases it is possible to use vacuum devices to stretch the skin in that area is breast reconstruction after mastectomy.
As you can see, to reconstruct the breast from the plastic surgeon needs a lot of skills because such jobs do not need to trust unproven people.
What does it do
Absence of breast is not only a psychological problem. Although in most cases it is psychological discomfort is the motivator of the majority of patients who decided on plastic surgery.
In addition to the problems associated with the unaesthetic appearance of the bust after mastectomy can be:
- the load imbalance in the thoracic spine from two sides: where the breast is preserved, the load will be more;
- secondary changes of the osteoarticular system associated with the load imbalance on the spine, which is expressed by posture, with drooping shoulders, curvature of the spine;
- the effects of the curvature of the spine: a malfunction of the organs of the thorax – heart and lungs.
Because after a mastectomy is not the only way to regain confidence, but also an excellent preventive tool against a number of chronic diseases of the cardiovascular and respiratory systems.
Video: Life after mastectomy
What determines the volume of plastic surgery for breast reconstruction
Not all patients of a plastic surgeon the operation to restore the breast are the same. Depends on the volume of a number of criteria.
- The volume removed during surgery for cancer of the tissues.
Depending on the extent of the cancer can be removed different amounts of tissue.
The simplest situation is the removal of the local entities with the preservation of the healthy part of the breast. In this case, the formed inverted scars and areas of collapse in areas removed nodes and tumors.
Can be removed all breast tissue with preservation of skin and subcutaneous tissue covering the mammary gland. Relatively easy to reconstruct option. Currently, this option is surgeries cancer is rare. In most cases it is used to prevent breast cancer in individuals with a genetic predisposition to the development of disease.
This operation has made him Angelina Jolie, whose mother at the time died of cancer. On a remote place of the glandular tissue of the installed implants. Complete removal of the breast is the most common way to remove breast cancer in women.
In cases where there is a risk of spread of metastases, removes the whole breast, pectoralis major muscle, subcutaneous fat half of the breast in order to remove the lymphatic vessels and lymph nodes to which lymph flowing from the patient breast. This option is the most complex for subsequent recovery of the bust and requires special skills of the plastic surgeon.
- The health status of the patient.
The patient should be able to go through another surgery and anesthesia without complications. Keep in mind that contraindications for the plastic surgery will be much more stringent than for operations performed for health reasons (cancer, for example). And that is not prevented in the past the surgical treatment of cancer can be a serious contraindication for carrying out of reconstructive breast surgery.
- The appearance of the second breast and the wishes of the client regarding the future size and shape of the bust.
It is only at first it seems that after a mastectomy there is no life. Over time, during reflection and discussion with a plastic surgeon details of the upcoming reconstructive breast surgery, often there is a desire to «tidy up» and healthy mammary gland, if there has been its omission, there is a desire to reduce or increase the bust size.
One of the reasons why many agree on this, is the reluctance of subsequent transfer to another anaesthetic, when you need to perform a surgical breast lift, reduction or augmentation.
How may be performed to remove
Until recently it was thought that the best is to first remove the breast, and conduct reconstructive surgery only a year after the mastectomy.
Some surgeons still believe that it is the best way to prevent the development of metastases and cancer recurrence. But not all patients are psychologically just have to wait for so long. For some physical defect is so significant that even the fact of getting rid of cancer is not happy.
Worsen relations in the family. According to several reports, the European authors of opinion polls and surveys in the first two years after mastectomy splits 70% of marriages. In the end of the disease there, but the quality of life allows little to be desired.
Because in most cases the reconstruction is now performed simultaneously with the removal of the breast, if there are no serious health problems and contraindications to advanced surgical intervention.
How recover soft tissue in the area of remote breast
Options for the restoration of tissue volume in the area of mastectomy several.
Can be used expander
Expander is a special device that is installed in the field of breast reconstruction for a period of 3 to 6 months. It stretches the skin and forms a hollow sufficient for subsequent placement of the implant. Expanders are in the list of products of most companies that manufacture breast implants. Algorithm two-stage use and the breast implant shown in the video.
Video: breast Reconstruction (expander + implant)
It is installed under the skin and over time fills up with liquid. Put liquid with the syringe. The procedure is performed on an outpatient basis.
The advantages of using the expander:
- much megatransect operations compared to transplantation of skin-muscular flap;
- the final volume of the skin required for breast reconstruction is achieved two times faster than using the vacuum system.
The disadvantages of using the expander:
- The need for frequent visits to the doctor to perform the injections;
- Unnatural breast appearance and to the touch;
- There is a risk of necrosis (necrosis) of the tissues over the expander, if the skin stretching is done too quickly;
- The implant is placed directly under the skin, because there is a risk of rapid development of ptosis, there are restrictions on the use of several implants at the density of the gel, so that the end result is as close to natural.
Can be used vacuum device for the formation of excess skin in the area where the planned restoration of the breast. For such cases, developed a system of Brava. It should be worn for a long time. Daily to obtain the desired result it should be used for 10-12 hours.
The method that the breast is put a special bowl in the shape of a dome. Under the bowl creates a vacuum, due to which the skin is always taut and gradually stretched.
The advantages of the method is that:
- is performed simultaneously with liposuction;
- the method can be used to restore volume breast implants in the transplanted of own fat;
- if you are using transplantation of adipose tissue, no scars.
The disadvantages of the method is that:
- need for many months to wear on the breast a special device;
- it is difficult to achieve significant stretching of the breast and the implant;
- there is a risk of appearance of stretch marks and spider veins.
The whole procedure consists of three stages:
Stage 1 — preparatory. He is wearing the vacuum system within a certain period of time every day for 10-12 hours. Wearing the system in both day and night.
Stage 2 — transplantation of adipose tissue. There is a collection of fat with the places where it is usually the excess by liposuction method. Fat tissue moved to the breast area with injections.
Stage 3 – the final. System Brava must be worn for 3-4 weeks in order to increase the degree of survival of displaced fatty tissue.
Transplantation of skin-muscular flap
The flap can be transplanted from the back (latissimus dorsi), or the front abdominal wall (rectus abdominis).
- natural form and feel breast;
- no problems associated with the use of implants, such as displacement of the implant, the need for replacement.
- prolonged anesthesia (4-5 hours);
- very vysokoaromatichnyj operation;
- long period of rehabilitation;
- there is a risk of necrosis of transplanted skin-muscle flap and its subsequent rejection;
- significant postoperative scars.
A mixed methodology
For breast reconstruction uses a flap of skin from the buttocks, stomach or back and the implant.
The recovery of the soft tissues around the remote of the breast.
If you expanded the operation to remove not only the breast but also the surrounding soft tissues of the breast, then during the reconstruction is necessary to restore their missing volume from the surgery.
Usually the recovery is performed by the method of transplantation of adipose tissue that you take away from those places where its surplus.
Methods of recovery of nipple-areola complex
Without the restoration of the nipple and areola breast reconstruction will be considered unfinished, as a woman it is important to look good in clothes and without it.
The main ways of recreating the nipple and areola are three:
- the areola is reconstructed from the tissue of the areola with a healthy side;
- transplanted skin small labia, if it is pigmented;
- the nipple is formed from the tissues of recovered breast and areola pigmentada with tattooing.
Correction of the second breast
In order to correct the asymmetry, improve the shape of a healthy breast, used a large number of ways:
- mastopexy with breast augmentation with implants;
- mastopexy with breast reduction.
Less such methods, breast lift threads, the use of fillers.
- the presence of infectious diseases;
- the presence of tumor of any stage and location;
- serious diseases of internal organs, which affect their function;
- diabetes mellitus;
- violation of blood coagulability;
- the age of 18;
- less than a year after the end of lactation;
- the General severe condition of the patient;
- doubts about the necessity and expediency of reconstructive operations on the part of the patient.
Preparing for surgery
- laboratory and instrumental examination to identify possible contraindications for surgery;
- it is forbidden to drink alcohol two weeks before surgery, as this may cause problems with anesthesia and exit;
- it is recommended to stop Smoking at least two months before surgery, especially if you plan to change musculo-cutaneous flaps, to prevent problems with delayed healing and necrosis.
- necrosis of skin flap or skin over the expander;
- slow healing;
- complications associated with the wearing of the implants (capsular contracture, rotation and displacement of the implant, etc.).
The time required for the body to fully recover after the surgery depends on the size of the operation. If we talk about the method Brava, it is the least traumatic method, which requires a hospital to a maximum of three days at the time of the liposuction and transplantation of adipose tissue.
Full recovery occurs after 2-3 weeks after surgery and does not require any restrictions except for a ban on thermal treatments. The use of expanders and implants is basically two transactions. During the first install the expander, while the second is extracted and replaced with an implant.
After each operation there is a need to limit the load, to take painkillers, to observe a ban on heat treatments and sunbathing. After the implant recommended wearing compression underwear.
The rehabilitation period is about 4 weeks. If we are talking about the formation of the breast metol move the skin-muscle flap, then the period of rehabilitation is often long and difficult.
After such an operation:
- period of stay at the clinic is about 10-14 days;
- the sutures are removed on day 14;
- possible intense pain, which gradually subsided towards the end of the rehabilitation period;
- a ban on weight lifting and intense exercise for at least 6 months;
- wearing a bandage or a gauze dressings at least six months after surgery;
- avoidance of sexual activity within 3 to 6 weeks after breast reconstruction.
The recovery period in this case, it may be 6 weeks.
|the actual surgery for breast reconstruction||from 150-180 thousand rubles depending on the amount of the alleged intervention|
|survey||from 1.5 to 7 thousand rubles depending on the list|
|anesthesia||from 3000 rubles (Sometimes can enter the cost of the operation)|
|the implant||depending on the brand|
|drugs||often included in the cost of the operation|
|a day in the hospital with food records||from 2000 rubles|
The before and after photos