Breast Reconstruction: Post-Mastectomy Reintegration and Aesthetic Approaches
After mastectomy (removal of the breast), a surgical stage in the fight against breast cancer, a solution of vital importance for the physical and psychological well-being of patients comes into play: Breast Reconstruction (Breast repair ). This procedure aims to eliminate aesthetic loss by recreating the lost breast volume and shape. Thanks to advancing plastic and reconstructive surgery, these repairs can now offer symmetrical and natural results compatible with the patient's body structure.
The Importance of Immediate Reconstruction
With current approaches, breast reconstruction can usually be performed in the same session as the mastectomy. This immediate reconstruction, preferred especially in patients diagnosed early or undergoing preventive mastectomy, offers critical benefits for the patient's emotional process:
- Psychological Support: It helps the patient maintain body integrity by alleviating the trauma of breast loss.
- Well-being: Scientific studies show that immediate reconstruction significantly reduces the incidence of psychological problems such as depression and anxiety.
- Single Surgical Period: It eliminates the risk of two separate surgeries and anesthesia.
When is Delayed Reconstruction Necessary?
In some cases, immediate reconstruction may not be possible due to the patient's medical condition, co-existing diseases, or the requirements of cancer treatment. In such cases, delayed (secondary) breast reconstruction is performed after the patient's primary treatment is completed and general health status becomes suitable. This approach also provides aesthetic and psychological integrity to the patient in the long run.
Current Techniques Used in Reconstruction
The process of deciding how the new breast tissue will be created requires the expertise of the surgeon and a detailed evaluation of the patient's personal characteristics. The surgeon determines the most appropriate method by consulting with the general surgery team performing the patient's oncological follow-up.
The main reconstruction methods are grouped into two categories:
Autotransplantation (Use of Own Tissue - Flap Surgery): This involves using excess tissues (fat, skin, and/or muscle) from the patient's own body. This method offers the most natural and permanent result. The most commonly used donor areas are:
- Lower Abdomen: DIEP flap (the most popular free flap technique).
- Back Muscle: Latissimus Dorsi flap.
- Other Areas: Tissues taken from the hip, waist, or thigh regions.
Prosthesis-Based Reconstructions: Especially in cases where sufficient skin tissue is preserved or the patient does not want reconstruction with their own tissue, silicone breast implants or tissue expanders used to stretch the skin tissue beforehand are preferred.
Decisive Factors in Surgical Planning
Every patient is unique, and the ideal reconstruction method varies from person to person. Important factors affecting surgical planning include:
- Body Structure: Whether the patient has sufficient tissue reserves in the abdominal or back area.
- General Health Status: Metabolic conditions such as high blood pressure or excessive weight.
- Lifestyle: Smoking is a critical factor as it directly affects the success of flap surgery.
As emphasized by Prof. Dr. Osman Kelahmetoğlu, the decision for breast reconstruction should be made with a multidisciplinary approach that considers the patient's treatment process holistically.