Breast cancer is a disease that has increased markedly in recent years. Quadrantectomy (removing the area of the tumor) or mastectomy (removing the entire mammary gland plus the areola and nipple) is performed as part of the treatment.
Associated with this and depending on your condition, it will be pertinent or not, that you practice chemotherapy and / or radiotherapy. The breast is part of the female anatomy and hence the importance of reconstruction, which can be performed immediately or late. There are several possibilities:
Reconstruction Flap
Muscle flaps are a fragment of tissue that has muscle and carries its own artery to ensure its circulation. There are several flaps among which the most used are:
Tram flap
It is a reconstruction with tissue from the abdomen joined by an artery that is located in the rectus abdominis muscle and is taken to the area that was left empty by the mastectomy. The candidates for this flap should not be smokers because they run the risk that the flap does not have adequate circulation and suffers from necrosis, that is, the death of the cells that make it up. The procedure with flap TRAM, allows to reconstruct the breast with its characteristics, that is, the consistency and the fall
Indications
- Patients with excess abdominal tissue.
- Non-smoking patients.
Anesthesia
Procedure that is always done with general anesthesia.
Postoperative
- Requires a minimum of two days of hospitalization.
- Sometimes you have to transfuse blood.
- It requires the use of drains or devices that facilitate the exit of liquids in the abdomen for a period of 15 days.
- A girdle and a bra that help with pain should be worn.
- It must be accompanied by physical therapy to strengthen the oblique muscles in order to replace the function of the rectus abdominis.
- Requires antibiotic, analgesic and muscle relaxants.
- 30-day disability.
Wide Dorsal flap
This flap uses a back muscle that, because it is thin, requires a prosthesis to be incorporated to increase the volume. The design of new sinus-shaped implants (anatomical or Bidimensional implants) has allowed to improve the results.
Indications
- It is a very useful procedure in young patients who have not had children and when there is a contraindication to the TRAM, as for example, the antecedent that you have been a smoker.
- Patients with small, firm breasts.
Anesthesia
It should always be done under general anesthesia.
Postoperatorio
- Requires a day of hospitalization.
- Generally does not require blood transfusion.
- Two drains are left, one in the breast, which is removed on average on the tenth day; and another in the back, which is removed after 15 days.
- Most of the time it requires puncturing the back several times to eliminate fluid that can accumulate.
- Capsular contracture can occur when radiation therapy is done.
- 30-day disability
- Management with antibiotic, analgesic and muscle relaxant.
