By Emel Gerdaneri • Medical review by Guray Yesiladali, MD on February 04, 2021

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Average Cost 20000
Treatment Genel anestezi
Doctors & Clinics
Andac Aykan, MD
Plastic, Reconstructive and Aesthetic Surgery
Gulden Avci Cakmak, MD
Plastic, Reconstructive and Aesthetic Surgery
Guray Yesiladali, MD
Plastic, Reconstructive and Aesthetic Surgery
Tahsin Gorgulu, MD
Plastic, Reconstructive and Aesthetic Surgery
Mehmet Orhan Cizmeci, MD
Plastic, Reconstructive and Aesthetic Surgery
Suleyman Ozer, MD
Plastic, Reconstructive and Aesthetic Surgery
Ismail Murat Onyedi, MD
Plastic, Reconstructive and Aesthetic Surgery
Mithat Akan, MD
Plastic, Reconstructive and Aesthetic Surgery

What is Breast Reconstruction Surgery, Breast Reconstruction?
Breast reconstruction, also known as breast repair, breast cancer surgery - surgical procedure that aims to restore one or two breasts to near normal shape, appearance, symmetry and size, in order to correct post-mastectomy or congenital breast deformities. Reconstruction of the breast may involve multiple treatments and surgeries, usually performed in stages.

Everything You Need to Know About Breast Reconstruction Surgery

When choosing a plastic surgeon for breast reconstruction, keep in mind that the surgeon's experience and your confidence are as important as the cost of the surgery. Esthetic prices after mastectomy, which vary according to the technique to be applied, are between 12 thousand TL and 30 thousand TL on average.
Having breast reconstruction surgery is a personal decision, as with other plastic surgery treatments. He must do it only for himself, not to fulfill the desires of others or try to conform to the ideal image he has formed around him. If you do not have an additional medical condition or other illness that may impair healing; Post-mastectomy reconstruction surgery can be performed if you have a positive perspective and realistic goals to restore your breast and body image.
If you have a negative opinion about the items listed below and you think you cannot accept them, post-mastectomy surgery may not be suitable for you:
Although breast reconstruction can repair the breast, results will vary from person to person. The newly made breast may not have the same feeling or sensitivity as your old breast. Visible incision scars will always be present in the breast, regardless of whether it is caused by reconstruction or mastectomy. Some surgical techniques will also leave incision lines in the donor area.
If you have decided to have a post-mastectomy aesthetic, the first step will be to discuss with your doctor and decide which reconstruction surgery will be best for you. There are many different breast reconstruction techniques. Breast reconstruction options:

  • Silicone surgery after mastectomy

After mastectomy or radiation therapy, breast reconstruction can be performed with an implant in patients with sufficient tissue in the chest wall to cover and support breast silicone. For patients with sufficient tissue on the chest wall or those who do not want an implant, a new breast design can be made using the fat transfer technique to create a new breast shape. In silicone surgery after mastectomy, the implant can be placed under or over the muscle.

  • Over-muscular silicone placement and breast reconstruction

This treatment can be done with or after mastectomy surgery. After mastectomy is performed by the breast surgeon, the plastic surgeon places the breast implant on the muscle in the same operation. With this procedure, recovery is faster as the muscle in the chest does not rise. In addition, the breast implant is not affected by the contraction of the existing muscle.

  • Submuscular silicone placement and breast reconstruction

This procedure can be done in the same operation as a mastectomy. The incision is usually made from the mastectomy site. After the mastectomy is complete, the plastic surgeon lifts the pectoralis major muscle and creates a pocket in the lower part of the normal chest position. The breast implant is placed under the muscle.

  • Late breast reconstruction using a tissue expander

In this procedure, the breast surgeon performs a standard mastectomy surgery, then the plastic surgeon divides the lower pole of the chest wall muscle, taking the chest wall muscle and the lateral chest muscle together, lifting it up towards the collarbone. Once you have done this, the underlying muscle and tissue are lifted together, creating a pocket for the breast expander at the base of the breast or under the breast fold, and add the expander. Tissue expansion usually occurs weekly according to the patient's tolerance. The aim here is to expand the tissue and make room for silicone to be placed. The pocket is inflated by administering saline every 3-4 days 2 weeks after the operation to the expander placed for tissue expansion. When the targeted pocket size is formed, the breast implant is placed in the second operation.

  • Instant breast reconstruction using the latissimus dorsi muscle

This procedure can be performed immediately during mastectomy as a secondary operation or after radiation. The latissimus muscle is a very large vascular muscle located at the base of the arm, crossing the head of the shoulder and extending from the arm to the chest and close to the spinal cord. Latissimus flap is a technique used when the amount of soft tissue is limited, the pectoralis muscle is absent, partially removed or damaged due to radiation. This flap is taken into the anterior chest to fill the area emptied by mastectomy. The muscle is placed in the chest wall and sutured. An implant is then placed behind this wing and in front of the breast. A tissue expander may also be used. The latissimus flap is often recommended for patients who have already undergone mastectomy and radiation. The biggest advantage of this flap is that it makes new blood flow to the spreading area and healthy skin. It is also recommended for patients who are very thin and have limited options for flap reconstruction.

  • Flap reconstruction

Sometimes mastectomy or radiation therapy leaves insufficient tissue in the chest wall to cover and support the breast implant. In these cases, breast reconstruction is usually done with autologous reconstruction. In this technique, a donor area such as the patient's lower abdomen and the patient's own fat are used to create a breast shape. Likewise, silicone can be placed in the breast. When this donor tissue is used, there will be an incision scar where the tissue was taken. In addition, your surgeon may choose another area of your body as donor tissue.
In addition, breast reconstruction can be performed using TRAM flap, Pedicled TRAM flap, delay and supercharge flap, free TRAM flap, DIEP flap, gluteal-based flap techniques. The difference of these techniques from each other is that the locations of the donor tissue taken are different.
Before the post-mastectomy plastic surgery, your doctor may ask you for some laboratory tests and a medical evaluation of your cancer treatment. Stop using aspirin, anti-inflammatory drugs and herbal supplements as this may increase bleeding, and stop smoking at least 2 weeks before as this will affect wound healing. Breast reconstruction surgery is performed in a hospital setting and is performed under general anesthesia. For this reason, you should take the necessary clothes with you and stop eating and drinking 12 hours before. It is important to follow the instructions given by your doctor about what to do before post mastectomy plastic surgery.
The final results of breast reconstruction following or concurrent mastectomy will help reduce the physical and emotional trauma experienced. For this reason, although the pain to be experienced varies from person to person, it will make you forget all the pain and troubles due to the result. The pain, which is controlled by the medications given by your doctor, will decrease day by day, and the re-existence of the breast taken due to breast cancer will give great confidence and happiness.
Breast reconstruction surgery begins with general anesthesia. If flap techniques are to be applied to the breast, tissue is taken from the donor area to create or close the breast bump. If silicone surgery is to be performed after mastectomy, tissue expansion is made to make room for the breast implant. In order to complete the enlargement process, a second operation is often required for implant placement. If the patient is suitable, only breast implant can be placed by deciding on the sub-muscular or supramuscular model.
Your plastic surgeon will help you decide what is best for you. It is unlikely that reconstruction surgery can be performed with a single implant because the tissue expansion technique usually needs to be applied.
In the last step, if necessary, the nipple and areola are reshaped. The skin is folded to form a nipple shape to the patient, creating a nipple-like bump. For the creation of the breast areola, it is possible to benefit from a three-dimensional nipple tattoo. This tattoo procedure is often done after the surgical recovery period.

Click to get detailed information about this tattoo made for the creation of the breast areola.
Breast reconstruction surgery may take 1-2 hours on average when performed with a breast implant, and between 4 and 10 hours when performed using the flap technique.
In reconstructive surgery using breast silicone, 1 or 2 nights of hospitalization may be required depending on the condition of the patient, and an average of 2 or 3 nights of hospitalization may be required depending on the condition and weight of the patient in breast reconstructions using flap tissue.

After breast reconstruction surgery performed with flap techniques or other techniques, gauze or bandages are applied to the incisions. An elastic bandage or support bra will minimize swelling and support the repaired breast. These surgical garments, which are different from post-mastectomy bras, prevent edema formation. A small thin tube or drain can be placed under the skin temporarily to drain excess blood or fluid.
In the healing process, some sensation may return to the breast skin over time, and although it does not disappear completely, the scars heal and become pale. Careful monitoring of breast health through self-examination and other screening and diagnostic techniques is essential for your long-term health. If you experience shortness of breath or unusual heartbeats when you get home, you should call your doctor immediately. Following your doctor's instructions is the key to postoperative success. During the healing process, you should take care of the surgical incisions with your doctor's advice, take your medications without interruption, if any, and do not lift heavy for a while. If drains are placed, you can take a bath when removed. If flap surgery has been performed, it is very natural to feel sensitivity in the donor area, a large amount will pass within 1 week. It may take 1 month for you to fully recover.
Your plastic surgeon and or his staff will share with you in detail the risks associated with the surgery. Breast reconstruction is not a surgery that increases the risk of recurrence of breast cancer. Potential risks of breast reconstruction include bleeding from surgery, infection, difficult healing of incisions, and risks associated with anesthesia, all of which are temporary. In addition, there is a risk of loss of sensation in both the donor and the reconstruction area in flap surgery. In silicone surgery after mastectomy, there is a possibility of capsular contracture. Breast implants do not harm breast health. Scientific studies conducted by many independent research groups have not found a proven link between breast implants and autoimmune or other systemic diseases.

Written on 01/10/2020

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Last Update: 22/04/2021

Doctors & Clinics
Andac Aykan, MD
Plastic, Reconstructive and Aesthetic Surgery
Gulden Avci Cakmak, MD
Plastic, Reconstructive and Aesthetic Surgery
Guray Yesiladali, MD
Plastic, Reconstructive and Aesthetic Surgery
Tahsin Gorgulu, MD
Plastic, Reconstructive and Aesthetic Surgery
Mehmet Orhan Cizmeci, MD
Plastic, Reconstructive and Aesthetic Surgery
Suleyman Ozer, MD
Plastic, Reconstructive and Aesthetic Surgery
Ismail Murat Onyedi, MD
Plastic, Reconstructive and Aesthetic Surgery
Mithat Akan, MD
Plastic, Reconstructive and Aesthetic Surgery

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Doctors

68 Breast Reconstruction Surgery Doctor
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Andac Aykan, MD
Plastic, Reconstructive and Aesthetic Surgery
5 (2)
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Tahsin Gorgulu, MD
Plastic, Reconstructive and Aesthetic Surgery
5 (6)
İstanbul
Gulden Avci Cakmak, MD
Plastic, Reconstructive and Aesthetic Surgery
5 (2)
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Guray Yesiladali, MD
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5 (12)
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Mehmet Zeki Guzel, MD
Plastic, Reconstructive and Aesthetic Surgery
Ankara
Burak Kaya, MD
Plastic, Reconstructive and Aesthetic Surgery
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Erkan Yuce, MD
Plastic, Reconstructive and Aesthetic Surgery
İzmir
Mehmet Alper, MD
Plastic, Reconstructive and Aesthetic Surgery

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