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The term "breast reconstruction" describes the plastic restoration of an amputated female breast. With the help of the body's own tissue or an artificial implant, the original breast shape, including the nipple, is modeled.
Breast cancer and the removal of the diseased breast are the main reasons for a breast reconstruction. But also congenital malformations or the precautionary removal of the mammary gland at a genetically increased breast cancer risk may be reason for a breast reconstruction.
DIEP, TRAM, S-GAP, I-GAP, implant - the list of methods for breast reconstruction is long and often confusing for laymen. Every procedure has its advantages and unfortunately also disadvantages.
In principle, a breast reconstruction can be performed at any time - either in combination with mastectomy (primary reconstruction, one-step procedure) or as a separate procedure at a later time (secondary reconstruction, two-stage procedure). Primary reconstruction (immediately after amputation) is less of a mental burden for some women.
Other patients, on the other hand, first want to recover from mastectomy and calmly deal with the various options of plastic surgery before undergoing breast augmentation. An additional influence on the optimal time for breast augmentation also plays a role in further treatment planning, ie whether, for example, radiation is planned after the amputation.
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If the shape and size of the breast changes as a result of a breast cancer therapy, a breast reconstruction can help the affected women to regain their self-esteem. Even after a breast-conserving surgery (BET), the volume of the breasts may decrease, so breast reconstruction may be useful.
Often, surgery for breast cancer patients is an important step towards full recovery. For example, women may often be better able to manage the necessary breast loss if they are educated about the possibilities of reconstructive surgery before breast removal. In addition, surgical surgeries with own tissue provide significantly better results than with prostheses or implants. The female breast is a body part that decisively influences the self-image of women. After a breast cancer therapy in which one or both breasts had to be removed, but also after a so-called breast-conserving surgery (BET), it can be useful in many cases to perform a breast reconstruction. Thus, the former shape and volume of the breast can be largely restored.
A breast that looks as natural as possible is desired by women who opt for a breast reconstruction. With modern treatment methods, plastic surgeons can come very close to this ideal today. However, it is important to know that despite the best results, the breast can never resemble a natural breast after reconstruction.
The surgical technique, which is used in an individual breast reconstruction, should always be consistent with the respective findings. The treating physician decides together with the patient on the choice of the method: gold standard is today the so-called DIEP procedure. In this case, abdominal fat is used as a replacement for the breast tissue, in the SGAP flap tissue from the buttocks area is used. The latissimus Dorsi plastic is another method in which the body's own fat and muscle tissue from the back area is placed in the chest area.
When deciding on a breast reconstruction, the health risks also play a major role for most women - after all, a recurrence of the dangerous cancer should be avoided. For a functioning breast cancer prophylaxis, regular check-ups are necessary. These should, so the desire of women who are suffering from breast cancer, be easily possible even after a breast reconstruction. In addition, the breast cancer risk due to breast reconstruction should not be increased.
With modern surgical methods and the use of high-quality implants or endogenous tissue, it can be ensured that breast reconstruction does not have a negative impact on health. Thus, even after breast augmentation, breast cancer screening continues to take place, and there is no increased relapse rate even after breast augmentation. If silicone implants are used, modern silicone cohesive gel and rough implant covers ensure a high degree of patient safety.
"Breast cancer is the most common cancer in women, it is about 70,000 per year diagnosed in Germany," says Prof. Dr. med. Riccardo Giunta, President of the German Society of Plastic, Reconstructive and Aesthetic Surgeons (DGPRÄC). Although surgery is increasingly operated on to maintain the breast, the reconstruction in parts or as a whole still has a high priority, especially as the prophylactic amputations increase with genetic predisposition, the plastic surgeon explains. Correspondingly, the reconstruction will once again be a topic at this year's congress of the German Society for Senology from 14 to 16 June in Stuttgart: "An important event to exchange current knowledge and to cooperate in the interest of our patients in direct dialogue with all participating disciplines strengthen," says Giunta.
From a plastic-surgical point of view, according to Giunta, it is of particular importance that the patients are already informed of all possibilities of reconstruction at the beginning of their treatment. All the more gratifying is that the certification conditions of the German Cancer Society were extended so that all patients were handed out a brochure at the beginning, the advantages and disadvantages of different reconstruction options with self-tissue as well as the reconstruction with implants.
"In some locations, in our view, the actual involvement of plastic surgeons is expandable," Giunta says, making it clear that optimal results would best be achieved if the breast reconstructor is included before the primary procedure, ie the removal of the tumor. "So already first cuts can be selected according to a future reconstruction. Even if survival is first and foremost, patients should think about the possibility of reconstruction at an early stage, including with the body's own tissue and request appropriate advice from a plastic surgeon, "the plastic surgeon clarifies and is delighted that the cooperation regarding breast reconstructions Once again, the German Cancer Society clearly outlined the procedure for dealing with oncoplastic and reconstructive operations and made it clear that all available procedures had to be offered to the patients. "The consistent integration of plastic surgery in an interdisciplinary breast center is an important landmark and sharpens the profile of a center for all involved, so that real added value for all results - patients, colleagues and hospital" sums up Giunta.
DGPRÄC-certified focus for plastic-surgical breast reconstruction. "The importance of breast reconstruction in caring for women with breast cancer has been increased again and the cooperation strengthened," emphasizes Giunta, pointing out that patients can find out about facilities with a high level of expertise in reconstructing their own tissue via our web page. "With this portal, we want to provide patients with transparency as well as in exchange with our gynecological partners, where the tissue regeneration with great expertise is provided by whom," concludes Giunta.