BREAST PROSTHESIS RECONSTRUCTION IN PARIS

Mastectomy is a non-conservative breast surgery.

This surgical operation corresponds to the removal of the gland breastof the areola and nipple, associated with a variable amount of skin.

There are no "absolute" contraindications.

On the other hand, it is not advisable to undergo cosmetic reconstruction surgery with internal prosthesis if you have :

• A history of radiotherapy;
• Poor skin quality;
• Failed implant reconstruction.

In such cases, a autologous reconstruction using a DIEP flap, for example.

Complications related to reconstruction can be :

• Mastectomy skin suffering;
• Suffering or even necrosis of the areola/nipple in the case of immediate breast reconstruction;
• The formation of a hematoma, which requires a second operation in the operating room;
• Healing problems in the first month after surgery. Nursing care may suffice, but if the prosthesis is discovered, implant removal should be discussed.

The most frequent long-term complication of reconstruction with breast implant is the formation of a periprosthetic shell.

A membrane forms around the implant, which may harden. The aesthetic appearance of the breast changes. Sometimes the shell can cause pain.

Depending on the stage (degrees) of this shell, we will need to discuss changing or removing the implant.

Several precautions can be taken to ensure that aesthetic results and your health.

• When you leave the hospital and for the next 48 hours, get help;
• Wear a bra without hoops with staples attaching at the front. If you have undergone DIEP or free TRAM breast reconstruction, wear a girdle for the breast. abdominal wall. You must wear this underwear 24 hours a day for 3 weeks, then daytime only for the following 3 weeks;
• Do not take nicotine (cigarettes, electronic cigarettes, patches, gum) for 6 weeks;
• Do not drink coffee, tea, herbal tea, Coca-Cola, Pepsi, energy drinks or chocolate for 2 weeks after the operation.

The lipofilling is a technique that involves liposuction (fat removal) and reinjection of this fat into the breast.

This technique can only be used to reconstruct small breasts.

In general, several sessions (>5) are needed to achieve sufficient volume. You also need good fat reserves to achieve this.

Silicone gel implants are the most widely used to reproduce the natural consistency of the breast.

Anatomical "macro-textured" implants have been withdrawn from the market since 2019. It was found that they were more often associated with anaplastic large-cell lymphoma. This means that this technique increases the cancer risk.

Since then, reconstruction using micro- or nano-textured round implants has been the best solution for implant-based reconstruction.

A distinction must also be made between secondary and immediate reconstruction.

In the case of secondary reconstruction, the surgeon tries to use the same scar as the one used to remove the breast.

In case of immediate reconstructionthere are several possible solutions:

• Submammary scar (in the submammary fold) ;
• External hemi-radial scar at areola level.

Yes,

After all, breast reconstruction after cancer is a very important cancer surgery. It is therefore 100 % reimbursed by the French health insurance system.