Dr Corinne Becker – Lymphoedema Center

Breast reconstruction after breast cancer

The unit at the american hospital of paris , do propose all the techniques for the breast reconstruction, regarding the quality of the skin, and the extension of the defect.

If the remaining skin is large, and soft  enough, the combination of implant and/or fat filling can be the easier alternative Reconstruction of the breast  after total mastectomy by filling (in 2 cessions), the skin must be expanded , and always some  fat resorption.

 Reconstruction of the breast by Prothesis and filling after mastectomy and radiotherapy

The unit at the american hospital of paris , do propose all the techniques for the breast reconstruction, regarding the qIf the skin has no more elasticity and too tie, the only way to rebuilt a breast, is a flap. It can be a pediculated musculo-cutaneous flap (dorsalis flap) or just cutaneous flap based on the same vessels if it remains an extra fold in the axillair region (TDAP).The scar will be in the lateral and dorsal region under the bra.Thoses flap do require sometimes insertion of a prothesis to have enough volume.

Reconstruction of the breast with the dorsalis muscle when the skin is too tie and cannot be extended

The reconstructions without foreign body do require microsurgical techniques : The use of the skin and fat below the ombilicus combine the abdominoplasty and the breast reconstruction. This is a very elegant technique, but needs experimented hands.(DIEP)

DIEP with nodes for breast reconstruction and lymphoedema treatment

We can also use a skin paddle from the interior or post part of the thigh (TUG or PAP).All those flaps can be combined with a free lymphnodes transplantation , to replace the nodes in the axillair region and treat the lymphoedema.

Secondary corrections are performed to perform the symetrisation of the both breasts: reduction , mastoplasty of the other breast, fillings and reconstruction of the areola. The areola can be rebuilt or, by 3D tatoo, or with the upper lid skin (blepharoplasty), or with some skin of the contralateral areola in case of reduction and mastoplasty of the normal breast

The realisation of all these interventions needs: intensive care unit, microscope, laser, monitoring of flaps by tissue oximeters, state-of-the-art equipment for the realization of lipofilling, etc. This comprehensive offering allows patients to perform the most appropriate reconstruction method for their case.