Recent Knowledge of Breast Reconstruction

ABSTRACT

Breast is one of the most important organ which characterize the femininity and the maternity. As growing not only in numbers of breast cancer patients but also concerns about the quality of life, breast reconstruction after mastectomy turns into hot topics in the area of plastic surgery. Historically, numerous operation techniques have been introduced for breast reconstruction using prosthesis (tissue expander and breast implant) and autologous tissues (various pedicled flaps and free flaps). The most ideal method for breast reconstruction is to make a natural soft breast with less complications and morbidities, and no single technique can be universally accepted in every cases. However, in terms of making a natural, good-looking breast autologous tissue is more superior to tissue expander and breast implant in breast reconstruction. Usually a breast reconstruction is performed in 3 stages; 1st stage is breast mound reconstruction using autologous tissue or tissue expander and implant. 2nd stage is revision of the reconstructed breast and donor site such as abdomen (scar revision, volume adjustment using suction-assisted lipectomy and excision), nipple reconstruction, and surgery of the opposite normal breast (augmentation, mastopexy, or reduction) for maximizing cosmetic results. 3rd stage is a intradermal tattooing for nipple-areolar complex. In this article, various techniques are presented with their indications, methods, advantages and disadvantages. For the choice of best modality, many factors should be considered including an extent of mastectomy, the size and shape of opposite breast, the condition of possible donor sites, postoperative adjuvant therapy (radiation, chemotherapy), patient's age, and patient's preferance.