The Capabilities of Reconstructive Plastic Surgery
Reconstructive plastic surgery restores the form and function of body parts following an accident, illness, or congenital defect, notes Plastic Surgeon Aris Damagas.
Scope:
- Burns
- Skin tumors
- Traumatic defects
- Congenital anomalies
- Breast reconstruction post-mastectomy
Breast Reconstruction Post-Mastectomy
Breast cancer is the second most common cancer after skin cancer and the second leading cause of cancer death after lung cancer.
Risk Factors:
- Genetic factors
- Age
- Family history
- First pregnancy after age 35
- Menstrual history
- Early onset
- Late cessation
- Benign breast tumors
- Personal history
- Exogenous factors
- Dietary factors
Reconstructive Plastic Surgery and Breast Reconstruction
Breast reconstruction after mastectomy does not affect survival rates. The goal is symmetry with the other breast. It can be done immediately after mastectomy or later. It has beneficial effects on patients’ psychology.
Techniques:
A. Using Implants:
First Stage:
A tissue expander is placed submuscularly to stretch the overlying skin to accommodate a permanent implant. Gradual filling with saline is done over 2-3 months.
Second Stage:
The permanent silicone implant is placed in the expander’s position. Breast reduction, augmentation, or mastopexy may be performed on the other breast simultaneously. The nipple-areola complex can be created at the same time or in a third stage.
Indications:
Thin individuals without sufficient autologous tissue (e.g., flat abdomen)
Technical infeasibility of other reconstruction methods (presence of scars)
Patient preference
Elderly individuals
Advantages:
Same color and texture
Fewer scars
Better sensation of the walls
Disadvantages:
Surgery in two or three stages
Multiple visits for progressive filling of the expander
Immediate postoperative complications (hematoma, infection, etc.)
Risk of necrosis of the overlying skin
B. Using Autologous Tissue:
Rectus Abdominis Muscle Flap (T.R.A.M Flap):
Pedicled T.R.A.M Flap
Free T.R.A.M Flap
Based on perforating vessels (D.I.E.P)
Latissimus Dorsi Muscle Flap
Gluteal Muscle Flap, etc.
Indications:
When implants are contraindicated, such as in irradiated areas
Healthy, non-obese individuals with excess dermal-fat tissue in the abdominal area (for abdominal flap)
Previous implant failure
Advantages:
Autologous tissue without the need for a foreign body
Simultaneous dermal-fat excision
Better long-term results
C. Breast Reconstruction with Stem Cells:
Initially, a device (brava) is applied to the breast area, exerting negative pressure externally to stretch the skin. After several weeks and achieving the desired skin relaxation, fat enriched with stem cells is injected into the breast area. This new promising method yields excellent results for creating small to medium-sized breasts.
Cost
The cost of breast reconstruction is partially covered (implant costs and hospitalization) by insurance funds. However, restoring the integrity of a woman’s body also restores her quality of life.
For more photos of reconstructive plastic surgery, click here.
