Is plastic surgery necessary after breast cancer treatment?
Plastic and Aesthetic Surgery Specialist Prof. said that in some cases, aesthetic intervention to the breast can be very important after breast cancer treatment. Dr. Necmettin Kulu, breast cancer He gave comprehensive information about post-surgery plastic surgeries. The breast, as the source from which we get our first nourishment as soon as we are born, becomes a leading element of lifelong dependence on the female, according to Freud’s philosophy. As a matter of fact, it has been used as a symbol of fertility in history.. In psycho-social terms, this organ, which is the mediator of the first contact with the child’s mother, has gained value as a jewel and ornament on the woman’s body as a distinct and important sign of femininity.
Medicine has started a determined struggle against such a cruel disease as cancer, which threatens such an important organ and women’s life, and important developments have been made, especially in recent years. For example, while the principle of “take as much tissue as you can” was advocated in the past, the principle of “keep as much as you can” has now become valid. Beyond preservation, the effort to “replace the lost” has also led to the development of reconstruction methods and options.
If lumpectomy (removal of part of the breast tissue) is performed, it is possible to form aesthetic-looking breasts by shaping the remaining breast tissue and reducing the other healthy breast.
However, after larger mass removals, skin-sparing or full mastectomies (removal of the breast completely), either implants (breast prostheses) are used or other tissues obtained from other parts of their own body are used. When using implants, either the breast implant is placed directly, either the existing skin is expanded using tissue expanders, and then a permanent breast prosthesis is placed under it, or two-component breast prostheses containing both tissue expander and silicone gel are used. In recent years, there have been significant developments in breast implants and the options have increased.
In the methods that we call autologous reconstruction, which utilizes own body tissues, either the tissues obtained are shaped and the breast is formed, for example; The skin of the lower abdomen, together with the fat layer and muscle under the skin of the upper hip or lower hip, is lifted into a breast shape, or it is lifted with the muscle under the skin of the back or thigh, transferred to the breast area with its vein, and a breast prosthesis is placed under them and brought into a breast shape.
In a method that has been gradually introduced recently, the remaining skin after mastectomy is first enlarged by means of a special bra that applies negative pressure, and then by applying liposuction, the fat tissue obtained from other regions is injected under the enlarged breast skin through a special process, and the breast mass and shape are thus created. It is possible.
Whichever technique is chosen, the important thing is to “do no harm first”. What is meant here is that the primary focus of the disease is not prevented from being followed.
What are the risks?
The risk increases in cases of diseases of small vessels, diabetes, obesity, chronic lung diseases, previous surgery or injury scars in the places where tissue will be taken, heart diseases, psychological problems, smokers, and radiation therapy.
What are the complications?
Bleeding, infection, seroma (collection of tissue fluid), partial or complete tissue retention, asymmetry, delay in wound healing and poor scarring can be counted.
When should it be done?
Reconstruction can be done in the same session after breast cancer surgery or delayed and done at a later time. Waiting time is variable. In this decision, the type of cancer, its spread, the use of radiotherapy or chemotherapy, the condition of the skin and, to a certain extent, the patient’s preferences are taken into account.
Can it be done after radiation?
Depending on the quality of the skin and how much it has been affected by radiation, the use of breast prostheses may be limited. However, many options can be suitable using its own texture.
It varies according to the reconstruction method. While it takes a few days when a breast prosthesis is used, it may take several weeks when, for example, abdominal skin and muscle are applied.
The possibility of breast repair after cancer increased with early diagnosis
Post-reconstruction follow-up tests ?
Monitoring is very important. The patient’s life is at stake here and should be taken seriously. In the first place, when performing monthly examinations. At wider intervals, mammography, ultrasonography and MRI may be performed.