Breast reconstruction considers tissue compensation after the mastectomy (breast amputation) or in cases of undeveloped breast which can be done in several ways –using silicone implants, autologous tissue and by fat grafting.
The use of implants is the easiest way but as there is always a skin deficit problem, an expander augmentation is necessary during a certain period so it can create space for the implant, and the expander must constantly be filled with a solution in order to expand the skin and only then, in a second procedure, the implant can be inserted in the created pocket.
Contemporary medicine usually compensates breast with silicone implants immediately after the amputation, so nowadays augmentation in most cases means harmonizing both breasts and asymmetric corrections.
As the surgery is done in general anesthesia, all tests recommended by the physician and the anesthesiologist are required – mostly laboratory tests and internist examination and ECG, combined with all necessary oncology results in case of postmastectomy reconstruction.
In case the reconstruction is done with implants, in the first procedure expanders are augmented and filled regularly every week with a solution to create enough space for the implant.
In case of reconstruction with implants, only after using expanders for a certain period considered sufficient by the physician to create the necessary space, implants are placed in such created tissue pockets.
Reconstruction with autologous tissue provides the patient with a reconstructed breast created with her own tissues, obviating the potential complications associated with prosthesis. The disadvantage with this strategy is related to the creation of an additional donor site with scarring and potential morbidity.
By fat grafting, that is skin-muscle slices, the procedure itself is more complex and rarely used.
Reconstruction with fat grafting is much more patient-friendly, technically easier for surgeon, but often needs more than one session.
After the surgery, use of a special brassiere is obligatory for the first month, when hard physical activities and any type of heating, such as solarium and sauna, are strictly prohibited.
Results are immediately visible, but are considered final once the swelling disappears, that is, after a few months when the skin and the implants take their final position.
Swelling, bruises and pain during the recovery period are possible.
In cases of correction by fat grafting, asymmetric and uneven results may occur and sometimes the procedure must be repeated.
Mr sc. med. Vladimir B. Stojiljkovic is a pioneer in regenerative surgery in our country – with scientifically based approach he gained a lot of experience in fat transfer, stem cells and growth factors extracted from thrombocyte enriched plasma. Hi was first in our country to do a natural breast enhancement, using patients own fat tissue and BRAVA method for enlargement.
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