Combined techniques for breast reconstruction

There are other breast reconstruction techniques that combine implants with patients' autologous tissue.

Thoracodorsal flap with implant

How is it performed?

This breast reconstructive technique combines skin and excess fat from the side of the chest (under the armpit to the height that should correspond to submammary fold, that means the mammary sulcus).

This tissue turns up and moves to the chest, so that recreates a sort of bag or pocket to host a small prosthesis or implant. This surgery, which does not require microsurgery, usually lasts 2 hours and requires one or more days for recovering.

The operation leaves a small horizontal scar up to the bra line.

Advantages

Sometimes this type of flap could be recommended in conservative breast surgeries, for those patients who don't need a mastectomy to control breast cancer, but who need a breast conservative surgery or tumourectomy.

Although mastectomy is avoided, conservative surgery can generate asymmetry among both breasts, a trouble that can be solved with a partial reconstruction of the affected breast. In this partial reconstruction, thoracodorsal flap (although without implant) could become a a good option in order to restore symmetry in both breasts when the default affects breast quadrants.

Drawbacks

This reconstruction technique that was created in the eighties stands out for its simplicity and regularity, but brings moderate results. In fact, it has the same limitations as the reconstructions with implants. Although tissue has its own blood vessels does not always provide satisfactory outcomes in patients who had undergone radiotherapy previously.

Deadlines

  • Surgery: 2 hours
  • Hospitalization: 1-2 days
  • Daily activity: 3-4 days
  • Sports: 1 month
  • Nipple and areola: 4-6 months

Extended latissimus dorsi

How is it performed?

In the section of breast reconstruction with autologous tissue, we discussed the technique that employs expanded latissimus dorsi flap, a long and a flat muscle that lies under the shoulder.

The combined technique of latissimus dorsi flap not only uses skin and latissimus dorsi muscle from the back in order to create new breast, but also uses an implant or prosthesis to get the shape and volume needed in the new breast.

This technique could be an option for those patients who don't have enough fat and skin tissue to reconstruct the breast.

This operation needs to maintain drains on the back for at least 10 days so as to avoid the seromas to prevent accumulation of liquid fat, serum or lymph. For this reason, patient should leave the hospital and come back home with such drains. After 3 or 4 weeks, it is common to return to working life and social activity.

The surgery leaves a scar on the back. The final outcome is less natural aesthetic than other techniques because the skin of the bag is usually thicker and darker than the skin of the breast.

Deadlines

  • Surgery: 4-5 hours
  • Hospitalization: 5-6 days
  • Daily activity: 3-4 weeks
  • Sports: 1-2 months
  • Nipple and areola: 4-6 months

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