Breast Reconstruction

Breast Reconstruction - 33 years of experience in surgery · 28 years of experience in plastic surgery · Extensive experience and comprehensive training and continuing education · Course instructor for colleagues · Own practice for 22 years · Practice clinic for 5 years

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The most common cancer in women—which often requires breast reconstruction after treatment, for example at Dr. Münzberg's specialist clinic—is mammary carcinoma, also known as breast cancer. Ideally, it is advisable to have your breasts examined regularly by a gynecologist for lumps or unusual features such as unevenness. Doctors recommend that you examine your breasts yourself at least once a month. In addition, numerous courses on self-examination and detection of changes in the breast are offered by gynecologists and health insurance companies. If a tumor has been diagnosed, it is essential to discuss the next steps after determining the type of tumor. It should be noted that complete breast removal (mastectomy) with subsequent breast reconstruction is not always necessary. Breast-conserving surgery/therapy followed by radiation and chemotherapy can often be performed. Breast-conserving therapy does not usually require a second surgical procedure on the breast. If breast-conserving surgery is not possible, aesthetic breast reconstruction can restore the appearance of the breast after the medically necessary surgery.

Breast reconstruction after mastectomy: There are various procedures and indications for breast reconstruction, but it should be noted that due to their complexity, not all of them are performed at Dr. Münzberg's specialist clinic.

Reconstruction using a breast implant is only possible if there is sufficient muscle and skin (tissue) available. If the chest muscle (pectoralis major/minor muscle) was removed during the operation, it is not possible to work with or insert an implant immediately.

If breast reconstruction is indicated, you can choose between different sizes and shapes of implants, as well as between silicone and saline solutions.

Breast reconstruction using expanders is recommended if the opposite breast is significantly larger or if the skin is very tight after amputation. The requirements are the same as those described in section 1. The expander is placed under the chest muscle and regularly filled with air using a valve until the desired size is achieved. The expander is then replaced with a permanent breast implant. In addition, it may be necessary to tighten and/or reduce the size of the healthy breast during breast reconstruction.

The third method of breast reconstruction involves using a pedicled skin-muscle flap from the back. It is important to note that if the chest muscle (pectoralis major/minor muscle) has been removed, muscle tissue must be moved to cover the soft tissue. A large skin-muscle flap is often transferred to the breast region to reconstruct the breast. A distinction is made between pedicled and free flaps. In pedicled flaps, the vessels and, in some cases, the nerves are still attached to their origin, and the skin-muscle flap is moved as a pedicle. A commonly used example of a pedicled flap is the latissimus flap, which is taken from the back muscle.

The fourth method of breast reconstruction involves using a pedicled skin-muscle flap from the lower abdomen. This technique is known as a transverse rectus abdominis muscle flap (TRAM flap). A skin-muscle flap is removed from the abdomen, more precisely from the lower abdomen, and then used as soft tissue coverage for the new breast. The supplying vessels are not reconnected. The muscle used is part of the rectus abdominis muscle, whereby the pedicled skin-muscle flap is moved to the breast region. The remaining scar from this breast reconstruction in the lower abdomen is located above the pubic bone, as after an abdominoplasty (tummy tuck), and then runs towards the lateral iliac crests.

Breast reconstruction using a skin-muscle flap from the abdomen can also be performed as a free TRAM flap. This means that the blood vessel bundle (artery and vein) supplying the flap is separated from its original location (lower abdomen) and then connected (anastomosed) to vessels in the breast area using microsurgical techniques. This surgical technique is much more complex and carries an increased risk of disrupting or completely interrupting the blood supply to the new muscle-skin flap. It is essential that such an operation is performed in centers that specialize in this type of breast reconstruction and have the relevant experience.

The reconstruction method is determined based on various factors, such as the proportion of fatty tissue and the use of an implant. For this reason, a detailed consultation with a thorough examination by Dr. Münzberg is necessary.

Following breast reconstruction at Dr. Münzberg’s clinic in Dortmund, the question arises as to whether there is sufficient volume. If necessary, a skin and soft tissue expander may be required to increase the volume. In addition, a lift and/or reduction of the healthy side may be necessary to achieve symmetry.

Finally, the areola and nipple are reconstructed.

The reconstructive procedures can be performed in various ways:

• Tattooing
• Skin graft from the patient’s own tissue in the labial region (labia)
• Skin graft from the opposite side, if sufficiently large

The surgeon ensures the result looks particularly natural. With all methods, the scars are as inconspicuous as possible.

Aftercare

Bruising and swelling may occur after the operation, but these usually subside within a few weeks. A drain will be inserted to remove fluid from the wound. Dr. Münzberg will determine when to remove the drain during regular follow-up examinations and dressing changes.

As with any surgical procedure, a period of rest and recovery is required, during which you should avoid baths, sports, saunas, and sunbathing. You should resume physical activity only after consulting with your treating physician. Proper scar care can help improve the appearance of the scar. Dr. Münzberg is available to consult with you on this matter.

We would like to politely inform you that Dr. Münzberg, a specialist in plastic and aesthetic surgery, performs only procedures involving expanders and implants, as well as local flap procedures (latissimus flaps), as part of breast reconstruction. In the context of breast reconstruction, Dr. Münzberg, a specialist in plastic and aesthetic surgery, performs only procedures involving expanders and implants, as well as local flap procedures (latissimus flaps). Given the wide range of surgical techniques and options available, he can provide you with comprehensive advice and subsequently refer you to specialized clinics and breast centers.

It is important to note that even with regular and routine procedures, there may be a certain risk of wound healing complications and other complications, even when performed by experienced surgeons. In general, surgical procedures carry risks of wound infection, bleeding, and complications related to anesthesia. The use of breast implants carries a risk of capsular contracture. In this condition, the tissue surrounding the implant hardens, forming a capsule.

For more detailed information on this topic, please contact Mr. Münzberg.

In the vast majority of cases, the costs of breast reconstruction following breast cancer treatment involving a mastectomy are covered by health insurance. To qualify, it is generally necessary to submit a treatment plan for plastic and cosmetic surgery to the health insurance provider.

Are you interested in breast reconstruction using implants, tissue expanders, or flap procedures performed by Dr. Münzberg, or would you like more information about breast reconstruction methods? If so, we would be happy to hear from you. Simply give us a call or send us an email. We would be happy to send you free informational materials in advance.