Breast reconstruction

Reconstructing a breast after mastectomy following breast cancer or lumpectomy. Plastic surgeons have a varied arsenal of treatments to offer their patients. These include new techniques such as fat transfer and classic breast reconstruction using prostheses, as well as heavier techniques such as a dorsalis major muscle flap or a DIEP (Deep Inferior Epigastric Perforator) flap.

Principle: 3-stage surgery

1) Breast volume reconstruction

There are a number of techniques available for this:

-Fat transfer:
The aim of this technique is to restore breast volume using the patient's own fat. Fat transfer requires several sessions to achieve adequate volume. Breast reconstruction can be performed using fat transfer alone for small breasts. However, this technique is a very interesting complement to breast reconstruction by prosthesis, as it enables the prosthesis to be better "camouflaged", giving a more natural result.

- Breast prosthesis (for volume) and abdominal advancement flap:
Breast reconstruction using prostheses remains a simple means of breast reconstruction, and combined with lipofilling, this technique gives very good results.

- Dorsalis major muscle flap:
The latissimus dorsi muscle is an adductor muscle of the arm that can be harvested and transferred for breast reconstruction. The advantage of this technique is that it enables autologous reconstruction (without foreign bodies).

- Pedicled rectus abdominis or free abdominal flap (Diep):
This involves taking skin from the abdomen and transferring it to the chest to reconstitute a breast. This is called a free flap, because the skin is removed along with the vessels, and the surgeon will need to perform anastomoses under a microscope to restore arterial and venous flow. The procedure takes between 5 and 8 hours.

 2) Symmetrization of contralateral breast

We can perform a symmetrization

- Breast prosthesis: If the contralateral breast is smaller, breast augmentation with a prosthesis can be performed.

- Breast lift: If the contralateral breast is more "drooping", a mastopexy may be performed.

- Breast reduction : If the contolateral breast is larger, a breast reduction may be performed.

 3) Areola reconstruction

The areola can be reconstructed either by skin grafting or tattooing.
The nipple can be reconstructed either by a plasty or by transferring half of the contralateral nipple.

Covered by Social Security :

Breast reconstruction surgery is covered by social security