Advances In Autologous Breast Reconstruction -

Autologous reconstruction involves the surgeon using the patient’s own tissue to rebuild the breast. Usually taken from the buttocks, thigh, or abdomen, this procedure also includes removing fat, blood vessels, and, on occasion, muscle. Since it makes use of the patient’s own tissue, this form of breast reconstruction is frequently preferred over implants due to the latter’s artificial appearance and feel. Microsurgery precision is required for the extremely challenging technique. Surgeons painstakingly link the tiny blood arteries of the flap to those in the chest to restore blood flow to the transplanted tissue.

In order to ensure that the transplanted tissue receives sufficient blood flow and heals correctly, this link is crucial to its survival. After a mastectomy, the patient’s emotional and psychological well-being are both aided by the seamless integration of the transferred tissue into the breast area, which restores the breast’s look. Perforator flaps are one example of how surgical innovation has led to better results, less donor site morbidity, and happier patients.

In this post you will find information on Autologous Breast Reconstruction, Mastectomy among breast, Advances in autologous breast reconstruction before and after and so much more.

Autologous Breast Reconstruction

Autologous breast reconstruction involves transferring a flap of skin and fat from one site to the chest after mastectomy. This procedure is generally a lifetime procedure, as it is made entirely from the patient’s own natural tissue. It also reduces the risk of rejection or infection due to using donor tissue instead of a foreign body.

Autologous breast reconstruction is more likely to look natural and regain sensation in the breast than implant reconstruction. There are various techniques for performing autologous breast reconstruction, with Mount Sinai West having special expertise in the DIEP (deep inferior epigastric perforator) flap breast reconstruction technique.

Ancient Surgery

Surgery and dental operations have a long and storied history that begins in the pre-Classical and Neolithic periods. Trephining, or making a tiny incision in the skull, is the earliest visible sign of a surgical operation. From 3000 BC all the way into the Renaissance, this process was standard operating procedure. Some have speculated that trephining was done to exorcise ghosts from the body, although the original aim of the practice is unclear. All around the Americas, in Africa and Europe, people did this. Some patients may have survived the treatment, as there is evidence of mended skulls. Ancient Egyptians still used tripping to alleviate migraines. The ancient Mayans of South America were skilled dentists who filled cavities with a variety of precious stones, such as jadite, turquoise, quartz, and hematite. Rather than for aesthetic or health-related grounds, these operations were supposedly performed for ceremonial or religious ones.

Some surgical procedures were also performed by the ancient Greeks, such as setting fractured bones, bloodletting, draining the lungs of pneumonia sufferers, and amputations. Even with their new iron instruments, the Greeks still faced a significant risk of infection or death. The four humors theory proposed by Hippocrates had a lasting impact on medical practice for many centuries. According to him, the humors—earth, fire, water, and blood—exist in the body and can be balanced by several treatments, one of which is bloodletting, or draining of blood. To a large extent, the Greeks shaped the thinking of the ancient Roman physician Galen. He learned the ins and outs of surgery during his three years of service as a doctor to Roman gladiators and the surgeon to the Emperor. Amputations, trephining, and eye surgery persisted among the Roman medical practices. Notable Islamic surgeon Al-Zahrawi made significant contributions to the fields of orthopedics, military surgery, and otolaryngology (ear, nose, and throat) surgery starting in the ninth century AD with his writings on these topics.

Microvascular Breast Reconstruction with the DIEP Flap

Autologous breast reconstruction is a method used to reconstruct the breast after a mastectomy. Traditional approaches, like the TRAM flap, involve transferring muscle and skin and fat, which can cause recovery time and loss of movement. However, the DIEP flap microvascular reconstruction is a more advanced method that uses only skin and fat.

The surgeon removes a section of skin and fat from the lower abdominal roll and transfers it to the chest to rebuild the breast, preserving all abdominal muscles. This procedure also tightens the remaining abdominal skin, resulting in a “tummy tuck.” However, the DIEP flap procedure is not suitable for everyone, as it requires sufficient fat tissue in the lower abdomen to meet breast size and shape goals, and may not be suitable for women who have had certain types of abdominal surgery. The DIEP flap technique requires specialized skills from a microsurgeon.

Mastectomy among breast

In British Columbia, mastectomy is a crucial therapeutic tool. However, a woman’s self-esteem can take a hit, her feelings of mutilation can worsen, and her opinions of her femininity can be threatened when she undergoes a mastectomy (4). In a woman’s self-perception, her breasts have special symbolic value. The severity of the consequences of a mastectomy increases in proportion to her breast worth. Several issues, including a loss of femininity, fertility, charisma, and sexuality as well as fear of recurrence, have been linked to the amputation of one or both breasts in prior research (5, 6).

Changes to one’s breast size and hair loss have a devastating effect on one’s self-esteem. For women who place a high value on their physical appearance, the loss of symmetry and the resulting noticeable change in their appearance after having both breasts surgically removed can have a profoundly negative effect on their body image, femininity, sexuality, and sense of self (7, 8). Many people find that losing their hair is more emotionally devastating than losing a breast because hair is so intrinsic to who they are and because it serves as a constant reminder of their cancer diagnosis, making them feel like a “cancer patient” (9). Additional factors that lead to a negative self-image include skin changes brought on by radiation and weight gain, as well as sensory alterations brought on by systemic therapies like hormone or chemotherapy, such as discomfort or numbness. The literature reports that 15-30% of women with BC experience disturbances of body image (10-12). Nevertheless, alterations might differ from one individual to the next and are not confined to just these.

Having a negative perception of one’s body can have far-reaching effects on a woman’s mental health, her relationships with others, and her ability to function in society (13). Additionally, alterations in body image following cancer therapy may be linked to a number of issues that can significantly affect QoL, such as psychological discomfort, anxiety, decreased physical health, and sexual dysfunction (14). Hence, one’s self-perception of their physique may be a crucial factor in determining their quality of life. The effects of a mastectomy on a woman’s self-esteem and quality of life can linger for a long time after the procedure has healed (15, 16). As a result, a woman’s biopsychosocial functioning may be impacted by a variety of physical changes following a mastectomy. Those women, however, had never once brought up these worries with their doctors (17).