Immediate breast reconstruction call to that which is performed at the same time as the mastectomy. It is the preferred reconstruction patients and the specialists in Plastic, Reconstructive and Aesthetic Surgery , it is the best aesthetic quality. But it is not always possible for oncological reasons. In cases where reconstruction is performed over the entire cancer treatment it is called delayed breast reconstruction. And usually you have to wait between 6 and 12 months after radiotherapy or chemotherapy to start it.
Reconstruction can be by prior passage through expander prosthesis or not, or the patient 's own tissues.
What is breast reconstruction with expander and prosthesis?
The main advantage is simplicity and little surgical and hospital stay time is needed.
When an expander is placed, it must be being filled regularly (weekly) in consultation over several months. When the target size is reached, it is expected around 6 months for replacement by the prosthesis. In the surgical time, it is performed, if symmetrization with the contralateral breast is required.
The main drawback of this technique is that the prosthesis does not change with time and therefore appear asymmetries between the reconstructed breast, which does not change and the contralateral, which varies with time.
In the case of receiving radiotherapy, there is a complication that is most common, which is the capsular contracture.
When capsular contracture occurs, the breast gets hard and begins with discomfort in the breast that may radiate to the shoulder.
As in all cases where a prosthesis, it must be monitored by ultrasound at 3 years, 5 years and then annually it is placed.
How is breast reconstruction own tissues?
For autogenous reconstruction they can be used several donor sites, but is the first choice abdominal. The breast is reconstructed with skin and abdominal fat. For tissue vascularization has a flap with the skin, fat and vessels that nourish is designed. These vessels are sutured using microsurgical techniques to vessels that are under the ribs in the area of the breast. Subsequently, the form is given to the new breast. The abdominal area is closed like an aesthetic abdominoplasty is involved.
This technique is a great advantage, which is the ultimate reconstruction of a breast shape and texture very similar to those of the contralateral breast and suffer the same changes as the breast heals over time.
The last step is reconstructive reconstruction of the areola and nipple. The nipple is reconstructed with a small local flap to give it the proper way.
The areola and nipple should be the new tattoo to get the same color as that of the contralateral breast.