We have already commented on it on other occasions. Breast reconstruction is essential after a mastectomy, since the patient needs to regain the integrity as a woman that her breasts give her. It is extremely important for psychological purposes, as this step enables your full recovery.
Therefore, as we have emphasized in previous articles, it is essential that breast reconstruction, whenever possible, be carried out after the mastectomy, because it is a very important step in the process of emotional recovery of the woman herself.
Although there have been reconstruction trials since the end of the 19th century, it was in the 1940s that the father of plastic surgery, Harold Gilles, carried out the first reconstruction with tissue from the thorax and abdomen .
The surgical complications of this method determined that other doctors were inclined, in the sixties, to perform such reconstructions using silicone prostheses , discovered in those years. It will not be until the mid-1970s when the first latissimus dorsi muscle reconstructions occur . At the end of that decade, the use of abdominal tissue was another revolutionary system to alleviate the ravages caused by mastectomy in cases of breast cancer, with DIEP reconstruction, used since the 1990s, one of the best options for breast cancer. breast reconstruction today.
Therefore, breast reconstruction can be performed using three different methods: using breast implants, using a latissimus dorsi muscle-skin flap or with abdominal tissue. It is this last reconstruction method that we will talk about in this article.
Breast reconstruction using tissue from the abdomen
Breast reconstruction with DIEP involves the use of tissue (skin and subcutaneous fat) from the abdomen and that is vascularized by the deep inferior epigastric artery , which is extracted from the patient itself and inserted, through vascular microsurgery, into the the chest area. The intervention is closed with three types of sutures, namely: subcutaneous, subdermal and dermal.
This autotransplantation of abdominal tissue and the communicating vessels of the artery itself allows the abdominal tissue to be remodeled correctly, and in a completely natural way, in the thorax, with very satisfactory results for the patient.
In the abdomen area there will be a scar in the pubic area, similar to that which would be evident after a tummy tuck and which will be hidden by the female underwear itself.
The complexity of this operation requires the use of general anesthesia , since the intervention usually lasts approximately 8 hours. The patient will stay in the hospital for 4 or 5 days. After discharge, you will need to continue to be discharged until your full recovery and will need to wear a postsurgical bra until determined by the surgeon.
Regarding the risks, in addition to those of any surgical treatment, we must point out inflammation of the abdomen or breast, healing problems, infection .
For whom is breast reconstruction with abdominal tissue indicated?
Obviously, it is the surgeon himself who, evaluating the patient’s history, determines the best breast reconstruction procedure among the three mentioned above.
In the case at hand, breast reconstruction with tissue from the abdomen is usually the most successful option in cases of women who have received radiotherapy , patients with major physical sequelae after mastectomy, with damaged breast tissue or who lack pectoral muscle such as consequence of an abnormality, such as Poland syndrome . It is also recommended for people who, due to their condition, are not suitable for breast reconstruction with the other surgical systems.
On the contrary, those women who have undergone a tummy tuck cannot use this breast reconstruction method, since this system takes advantage of the patient’s excess fat, which, after a tummy tuck, is deficient.
It is also not recommended in cases where there are scars from previous cesarean sections when the scar is arranged vertically. Finally, those women with clotting, scarring or overweight problems should consult with the surgeon about the suitability of this technique.