Dr Corinne Becker – Lymphoedema Center

Breast reconstruction afetr oncologic treatment

Reconstructive breast surgery

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 combinationn of implant and/or fat filling can be the easier alternative 

If 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.

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. We can also use a skin paddle from the interior or post part of the thigh (TUG or PAP).

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

All those flaps can be combined with a free lymphnodes transplantation , to replace the nodes in the axillair region and treat the lymphoedema.

reconstruction of the breast after total mastectomy by filling (in 2cessions), the skin must be expanded , and always some fat resorption.

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

Reconstruction of the breast by Prothesis after mastectomy and radiotherapy

The realization of all these interventions: 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

(DIEP with nodes for breast reconstruction and lymphoedema treatment)

Surgery for breast malformations

To treat the breast malformations,the combinations of breast mastopexy and breast reductions will be combined.To increase the breast volume, it is better to insert fat coming from lipoaspiration of fatty regions.

Breast reduction and mastopexy

Those surgeries are performed with minimal scars, and can be combined with fat fillings, mini implants if hypoplasy post feeding babies.Each case must be consideed and the adapted surgery can be proposed

Capsulectomy after explantation of the prothesis, and filling

Sometimes, after introduction of prothesis, some patients do develop intolerance to them with antibodies. The symptoms are asthenia, arthritis, headaches, thyroiditis. The prothesis can brake and the silicone spread in the nodes and then in the body. It is important to remove them as soon as possible. The caspula around the prothesis witch can be very thick, adherent to the muscle. Their removal can be a challenge because the fibrosis, the chronic inflammation can provoque bleedings, but it is mandatory.

The replacement with fat can be performed directly during this cession, of after some months. The volume can be correct , and the symptoms will decrease within the months.