All Cancer surgery that are performed over face or
over the head & neck lead to defects that make appearance grotesque,
Immediate reconstruction by plastic Surgery can restore the appearance and
help provide a socially presentable appearance. Reconstruction of facial
defects following Cancer surgery has been a challenge to plastic surgeons
since the beginning of this century. Old-fashioned reconstructions were done
in multiple stages and use to take several months to complete. Till recently
Reconstructions were done using skin and muscle (most commonly Pectoralis,
the chest muscle) from the fore head or from the chest wall. These are
called pedicled flap reconstruction. Such reconstructions are staged and are
far from acceptable, as they appear very bulky.
Microvascular surgery and use of Free Flaps for reconstruction of defects
is the recent advance in cancer reconstruction of face and other parts of
the body. These are single stage reconstructions can be combined with
surgery for cancer and are called primary reconstructions. These can be
performed any time from 6 weeks to several years after cancer surgery and
are called Secondary Reconstructions.
The basic concept is to reconstruct a defect in all the three dimensions
and all the tissues. If bone is missing bone is transferred along with skin
fat muscle etc. The total material required for reconstruction is taken from
the body of the same person, Most commonly from the forearm or from the legs
or trunk and then it is transferred to the face, to make it survive and
function the blood supply has to be restarted and this requires the skills
of microvascular surgery.
Breast reconstruction after removal of breast
following cancer surgery for breast cancer is one of the most commonly
performed reconstruction after reconstruction of face all over the world
Reconstruction of the breast is usually needed after the breast has been
removed due to :
- Breast cancer
- Following deep burns of chest
- Rarely due to injury or infection
- Severe fibrocystic disease( a type of benign tumor)
It is now possible with the new surgical techniques to create a breast that
can closely look and feel like the natural breast. With the rising awareness
of the possibility to reconstruct the breast immediately after cancer
surgery, more patients are now requesting breast reconstruction immediately
following their breast removal. This option should be discussed with every
patient undergoing breast removal or surgery for breast cancer.
Breast reconstruction has no known effect on the recurrence of cancer in
the breast. It should not interfere with either the chemotherapy or
radiation treatment if you have cancer recurrence. If you have an implant
with your reconstruction, some interference with the reading of your
mammogram may require that you take special views mammogram and/or extra
radiological procedures like ultrasound, to examine your breasts.
Breast reconstruction is usually performed in a hospital. General
anesthesia is usually used for this procedure. Like any surgical procedure,
there is some risk and possible complications involved. Discuss these risks
and complications in details with your Plastic & Cosmetic Surgeon. There
are many options for reconstruction that your surgeon will discuss with you.
- Skin Expansion: Skin expansion and insertion of an implant.
- Flap reconstruction: This procedure involves creation of a skin flap
using your own tissue taken from the back, abdomen, or buttocks...etc.
In some of these cases you will not need an implant as the bulk of the
muscle or fat, taken in your flap, will give you the fullness you need
for the newly constructed breast.
- Follow-up procedures: These will be needed to reconstruct the nipple
and the areola, modify the shape or size of the other breast, or replace
a tissue expander with an implant. Your surgeon will explain to you the
details of these follow up procedures
Your hospital stay will vary but could be one to five days. You may need
about six weeks of recovery before going back to work.