At all times, female breast was considered the main sign of sexuality and femininity. Unfortunately, many women are faced with the need to completely remove one or both breasts.
This operation is called Mastectomy and is usually done when:
complex inflammatory and purulent processes;
serious post-traumatic consequences;
gynecomastia (for cosmetic purposes);
prevention of the development of breast cancer with a genetic predisposition.
The last point remains very ambiguous, since not every woman is able to decide on such a serious step as preventive mastectomy. However, such an intervention can reduce the risk of cancer by up to 90%.
Regardless of the indications for the breast amputation, the loss of this part of the body can lead any woman to severe psycho-emotional disorders. Decreased self-esteem and inner discomfort can reduce the quality of both personal and social life. If psychological problems are detected against the background of mastectomy, it is recommended consulting specialists in the field of aesthetic surgery.
Reconstruction of the mammary glands can be performed both during mastectomy and some time after it. In the case of reconstructive surgery, in parallel with amputation, number of surgical interventions is reduced and a larger amount of patient's skin and tissues is preserved, which is necessary for reconstruction work.
However, in practice, breast reconstruction is often performed some time after mastectomy. This is due to the fact that in the struggle for health and life, appearance fades into background. In some cases, patients do not make decisions about plastic surgery until histological examination of the removed material is carried out.
How is the operation done?
For patient's calmness, description of general algorithm for its implementation is provided. At the first stage of the surgical intervention, it is necessary to stretch the tissues using a special expander, which is a kind of silicone ball. This expander is placed under the skin or pectoral muscles and gradually forms a pocket for the future implant. A small amount of saline or silicone gel enters the expander through the minimum valve, with the help of which the expander gradually enlarges and simultaneously stretches the skin.
After the skin pocket reaches the required size, the expander is removed, and the implant is implanted into the formed cavity. Some developments perform the function of both expander and endoprostheses-implants and accordingly, cannot be eliminated.
The postoperative recovery period lasts from one to two weeks. An important condition for rehabilitation is abstinence from intimate life, physical training, and lifting weights.
Six months after the reconstruction of the new breast, plastic surgeons proceed to the next important stage - the restoration of the nipple and areola. By this time, the scars from the first surgery will be less noticeable.
Breast reconstruction is considered a rather complex operation requiring careful consideration of each individual case, but nevertheless, it can provide excellent aesthetic results. This is experienced by patients, who were initially interested simply in replenishing the lost part of the body, and after achieving this goal, insisting on improving the reconstructed body parts.
Types of Mastectomy
Surgery to remove only part of the breast - tissue that contains a tumor. It is performed for women with stage I cancer, in some cases with stage II.
One of the methods is lumpectomy. With this intervention, the malignant neoplasm and a small amount of healthy local tissues are removed. Another type of partial mastectomy is to remove tumor and larger area of healthy surrounding tissue.
It is a complete removal of the breast: skin, muscles under the mammary gland, lymph nodes, tissue - subscapularis, axillary (three levels) and subclavian. This operation is very large-scale, but not more effective than other types.
Breast Reconstruction After Operation
Reconstruction can be carried out immediately or delayed. In the first case, the load on the body is big, and surgeon's capabilities are limited. Therefore, preference is often given to delayed types of plastics.
Mastectomy with Simultaneous Reconstruction
The mammary gland can be restored immediately after removal, in one operation. This is possible if the tumor is not aggressive, the risk of disease recurrence is minimal. Surgeon can place a silicone implant or expander for stretching the skin and subsequent endoprosthetics. Also, patient's own tissues can be used for modeling or combination of these techniques is used.
Severe cardiovascular failure
Severe metabolic disorders - decompensation of diabetes mellitus, severe renal, liver failure
Severe cerebrovascular problems
Analysis of urine
Mammography or ultrasound studies, a conclusion from a mammologist
Rh factor and blood group information
Test results for hepatitis B and C, syphilis and HIV
Mastectomy is indicated for various types of breast cancer. Also, the operation can be performed for other pathologies, for example, with gangrene of the mammary gland.
There are a number of medical contraindications for a mastectomy:
severe diseases of internal organs;
severe swelling of the breast skin;
numerous metastases in the lymph nodes.
At the time of the operation, patient must be as stable as possible, for this special therapy can be prescribed.
Before the intervention, patient will have to undergo a complete examination of the body in order to exclude possible contraindications. Based on the picture of the disease, doctor will select the most gentle mastectomy technique.
The operation is performed under general anesthesia, therefore the results of the examination will also be examined by anesthesiologist. The type and dosage of anesthesia is selected taking into account the individual characteristics of patient's body.
During the procedure, surgeon will make an incision in the skin and excise the affected tissue in accordance with the chosen technique.
At the end of the mastectomy, drains are placed and wounds are sutured.
Gymnastics is an essential part of rehabilitation. Exercise will eliminate stoop and curvature of the spine, restore hand mobility, relax the shoulder and neck muscles, and reduce pain. With their help, patient "learns" anew to perform daily activities: combing her hair, raising her hand, etc. If there are no complications, exercise therapy is started already 7 days after the operation. The set of exercises is selected individually. Trainings on simulators and in pool are also effective. Physiotherapy may be prescribed, although the issue of its use for cancer patients is controversial. Physiotherapy methods include electrophoresis, photodynamic therapy, etc.
After the operation, patient is transferred to inpatient department. Length of stay in hospital depends on the type of surgery performed and general health of patient. Usually it is no more than a week.
During the rehabilitation period, patient must wear special compression underwear, take care of drainage system, and regularly come to attending physician for preventive examinations.
Many women are intimidated by very possibility of mastectomy. However, it should be noted that with breast cancer, this is the only way to struggle with serious illness. If mastectomy is indicated for you, we recommend not to postpone the operation. The sooner the surgical procedure is performed, the higher the chances of cure.