DEFINITION
Mastectomy is the removal of the mammary gland, a certain amount of skin and the areola.It is unfortunately necessary in some forms of breast cancer. The demand of breast reconstruction after mastectomy is completely legitimate.
The reconstruction by latissimus dorsi flap uses skin harvested from the back, the latissimus dorsi muscle (thin and extended muscle of the back) and often one prosthesis to recreate the breast volume.
AIMS :
This surgery aims to restore the volume and contour of the breast with skin and muscle taken from the back. An implant is often needed to complete the internal reconstruction whenever the transferred volume is insufficient.
This technique applies mainly to cases where the residual skin of the chest is insufficient or weakened by radiation and cannot, by itself, protect an internal prosthesis.
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PRINCIPLES :
The procedure is usually done remotely. Hence, it is called secondary reconstruction.
The intervention consists in placing in the thoracic region , skin and latissimus dorsi muscle taken from the back in the chest.This flap is slid under the skin of the lateral wall of the chest and inserted between the mastectomy scar and the inframammary fold as an insert.
The implantation of an internal prosthesis under the skin and muscle is usually used for the restoration of a sufficient volume.
The symmetrisation of the other breast and the reconstruction of the nipple-areola complex are most often realized subsequently, when the volume of the reconstructed breast has stabilized.
BEFORE THE OPERATION :
A pre-operative assessment is performed in accordance with the usual requirements.
The anaesthetist will be seen for consultation before surgery.
In all cases, the surgeon should check the breast imaging (mammography, ultrasound) of the other breast.
No medication containing aspirin should be taken within 10 days preceding the intervention.
Stop smoking is essential.
TYPE OF ANAESTHESIA AND HOSPITAL STAY
Type of anaesthesia
This is a classic general anaesthesia during which you sleep completely.
Hospital stay
Hospitalization for several days is usually required.
The operation can take 3 to 4 hours. At the end of surgery, a modelling bandage, shaped like a bra, is made
POSTOPERATIVE CARE AND FOLLOW-UP
The postoperative course is generally quite painful at the back for a few days and may require strong painkillers.
Swelling (edema), ecchymosis (bruising) of the reconstructed breast is possible in the postoperative period.
Wearing a bra (night and day) is necessary for several weeks.
It is advisable to wait one to two months to resume sport activities.
THE RESULT :
The appearance of the reconstructed breast will gradually evolve. it takes two to three months so that your surgeon can appreciate the result and in particular the symmetry.