Breast reconstruction is a surgical procedure that rebuilds a breast that has been removed due to cancer or other conditions. Breast Reconstruction could be implant based or autologous breast Reconstruction. An implant based reconstruction is the most common form of breast reconstruction done in Greece. On the other hand, Breast reconstruction using a woman’s own abdominal skin and fatty tissue is an operation which can create natural-looking breasts that match the patient’s body shape and size.
Dr. Nena Deskoulidi has subspecialty training in breast reconstruction and performs all forms of breast reconstruction.
Implant based breast Reconstruction
In this procedure, an implant is inserted in the breast after a mastectomy is done. The implant may be placed under or above the chest muscle depending on the circumstances involved. This may be done at the time of mastectomy or at a later date depending on various factors. Mesh, or acellular dermis, sometimes is incorporated in the procedure for optimal results.
If the patient is having a mastectomy, She might be a candidate for this procedure. If She has had a mastectomy already, she will be likely need a two– stage reconstruction with tissue expander first followed by implant placement at a later date. Patients need to be healthy enough to undergo the procedure. Women who have small to medium breasts that do not have a significant degree of droopiness are excellent candidates. Otherwise, it can be difficult to obtain symmetry with the other breast. In this cases the patient’s might need a breast reduction or breast lift to the other breast for symmetrization or bilateral mastectomies is advised by Dr. Nena Deskoulidi.
Poor candidates for this surgery are women who have had prior radiation and mastectomy. The skin is very difficult to stretch in this condition and leads to an increased risk of skin breakdown and implant exposure, necessitating removal. Patients with previous radiation may require a more aggressive type of reconstruction involving tissue removal from other sites of the body such as the back (latissimus flap) or abdomen (DIEP flap).
A new nipple can be made and areolar tattooing can be done if the nipple was removed at the time of mastectomy.
Autologous Breast Reconstruction
Breast reconstruction using a woman’s own abdominal skin and fatty tissue is an operation that requires advanced microsurgical skills and vast reconstructive surgery experience.
DIEP flap reconstruction uses a patient’s own tissue (autologous) from their abdomen to reconstruct the breast (s). Using this tissue essentially gives the patient a flat stomach like an abdominoplasty (tummy tuck), and as such, is the favoured site for own tissue to be used. The DIEP (Deep Inferior Epigastric Perforator) breast reconstruction uses a section of tissue from your abdomen which is made of skin and fat. The tissue is transferred to your chest and the artery and veins are connected to blood vessels in your chest wall using microvascular surgery, which is a specialised plastic surgery technique. The tissue is then shaped into a breast. You will have a patch of skin from your abdomen visible on your breast which will be used to monitor the tissue and make sure that your new breast is healthy. In an uncomplicated DIEP flap, the operation should take between 5-6 hours. A bilateral breast reconstruction normally takes between 8-9 hours. Hospital stay is usually 4-7 days and most patients are completely recovered by 6 weeks. Dr. Nena Deskoulidi and nurses will continue to check your new breast regularly the first 2 days.. The physiotherapist will help you to mobilise and give you exercises at day 2 postoperatively.
Why autologous reconstruction has advantages?
- Is less affected by the effects of radiotherapy compared to implants
- Will evolve in shape and size (along with the rest of the body) as a person changes in body weight and ages
- Feels more natural than implants
- Avoids risks specific to implants (e.g. rupture, capsular contracture)
- Some patients are pleased with the tummy tuck they receive as a natural consequence of having the reconstruction
The disadvantages of autologous reconstruction with DIEP flap
- Potentially longer recovery time
- Flap failure especially women with BMI >35as this may lead to problems with abdominal hernias and/or poor blood flow to the abdominal tissue which can result in failure.
- Typically involves a longer surgery
- Not all patients have sufficient tissue for autologous reconstruction (thin patients)
- DIEP reconstruction is a much more complex procedure and may therefore be more costly than implant-based reconstruction in Private Practice.
Dr. Nena Deskoulidi doesn’t operate on smokers as their having a greater risk of complications due to poor blood flow.
Why Choose Dr. Nena Deskoulidi for your breast Reconstruction?
Dr Deskoulidi dedicates extended time and attention to detail to ensuring that you receive individualized care and the best possible outcomes. Dr. Nena Deskoulidi has subspecialty training in breast reconstruction in Australia and Zurich and performs all forms of breast reconstruction.
