Reconstructive surgery in which breast shape is restored after mastectomy for breast cancer, using either implants or the patient's own tissue (DIEP flap).
Indication
- Breast reconstruction in patients who have undergone mastectomy for breast cancer
- Breast reconstruction after prophylactic (preventive) mastectomy
- Asymmetry and contour deformity after partial breast removal (lumpectomy)
- Congenital absence of the breast or developmental disorders (e.g., Poland syndrome)
- Revision of a prior breast reconstruction
Preparation
- Joint evaluation by the breast surgery and oncology teams
- Decision regarding immediate (at the time of mastectomy) or delayed reconstruction
- Detailed imaging and vascular mapping (if a DIEP flap is planned)
- Smoking cessation at least 4 weeks before the procedure
- Blood tests, ECG, and cardiac evaluation if needed
How it's performed
- Surgery is performed under general anesthesia using the planned technique
- In implant reconstruction, a tissue expander is placed first, then a permanent implant is inserted
- In the DIEP flap method, skin and fat tissue from the abdomen is transferred to the breast area, with its vessels reconnected via microsurgery
- Nipple and areola reconstruction may be planned in a subsequent session
- Drains are placed and tissue layers are closed
- The abdominal or back donor site is repaired appropriately
Post-procedure
- Hospital stay of 1-3 days for implant reconstruction; 4-7 days for major surgeries such as DIEP flap
- Drain removal (1-2 weeks)
- Weekly dressing and suture checks
- Heavy lifting and exercise restrictions for 4-6 weeks
- Long-term follow-up alongside oncologic monitoring
Risks
- Infection, bleeding, hematoma
- Circulatory disturbance at the tissue site, flap loss (in microsurgical reconstruction)
- Implant displacement, capsular contracture
- Weakness or hernia at the donor site (low rate with DIEP flap)
- Asymmetry and need for revision
FAQ
Should it be performed at the time of mastectomy or later?
It can be performed simultaneously (immediate) or later (delayed) depending on the patient's medical condition. The oncologic treatment plan is the determining factor.
Is implant or autologous tissue reconstruction better?
Both methods have advantages. Body type, accompanying treatments (such as radiotherapy), and patient preference are evaluated together.
Is the nipple also reconstructed?
Yes. Once the breast shape settles, nipple reconstruction and tattoo coloring can be performed in a later session.
Is it covered by insurance and SGK (Turkish social security)?
Breast reconstruction after mastectomy is considered therapeutic; current SUT/SGK conditions should be checked for reimbursement.
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