What is a breast mastectomy? Radical mastectomy as a major operation to remove the breast

Research and development in the field of breast oncology is gradually leading to the fact that previously thought effective means the fight against breast cancer fades into the background, giving way to more advanced techniques. Despite this, radical mastectomy is still one of the most common ways to combat breast cancer.

The essence of the operation is the complete removal of the mammary gland along with adjacent lymph nodes and pectoral muscles. Axillary and subscapular region, as well as lymph nodes located under the sternum. And although other diseases of the mammary glands (advanced mastitis, mastopathy) can be treated with mastectomy, a similar method is used much more often for breast cancer.

Types of radical mastectomy

Since the inception of this operation, doctors and scientists have not ceased to develop more advanced techniques. Today there are several types of radical mastectomy:

• Halstead mastectomy;
• mastectomy according to Urban;
• Peyti mastectomy;
• Madden mastectomy;
• subcutaneous mastectomy.

The first option (Halstead mastectomy), in addition to amputation of the gland itself, involves the removal of both pectoral muscles, axillary tissue, and also affects the subscapular region.

This operation has been the standard for a century surgical treatment. Now, due to the occurrence of severe side effects(decreased motor activity of the hands, deformation chest, weakening of muscles) the Halstead operation is used extremely rarely. The indication for radical mastectomy according to Halstead is the growth of tumor cells into the pectoral muscles.

Urban's operation is similar to the previous type of surgical treatment. The only difference is that during an Urban mastectomy, the parasternal (located near the sternum) lymph nodes are also removed. It is used for severe forms of cancer with the formation of dangerous metastases.

Patey's radical mastectomy is a more advanced version of the operation. At this time, the gland itself, the pectoralis minor muscle and axillary tissue are removed. Now this method is the most common.

Radical breast mastectomy according to Madden also involves complete removal of the affected gland along with axillary and subscapular tissue at two levels. But unlike the previous two methods, the pectoral muscles are not removed during the Madden operation. This helps maintain motor function of the hand. Similar treatments are increasingly used in the fight against breast cancer.

Subcutaneous mastectomy is relatively modern look surgery and is used for small tumors located away from the skin and nipple. The tumor is removed through a small incision, followed by plastic surgery. After such treatment, radiation therapy is necessary.

Why is radical mastectomy performed?

The purpose of the operation is to remove tissue into which cancer cells could have spread. And since most often tumor cells affect nearby The lymph nodes, then they are removed first.

In this case, only one or two nodes are removed, which are then sent for histological examination to identify cancer cells in them. And if none were found, then there is no need for further excision of lymph nodes.

The type of operation is selected by the doctor depending on the stage of the disease. Thus, for cancer of the first and second stages, the Madden operation is performed, for cancer of the third stage, the Patey operation is performed.

As for breast reconstruction after radical mastectomy, in the first and second stages the breast can be restored during the operation itself. In the third degree, reconstruction is carried out only after the end of the main treatment.

Contraindications for surgery

Contraindications to radical mastectomy include tumor tissue growing into the sternum, swelling of the gland and limbs, and the presence of ulcers on the skin. Also, surgery is not performed for cardiovascular dystonia, diabetes mellitus, in case of circulatory disorders, as well as if the patient reaches very old age.

Complications

Among the complications that most often occur after surgery are bleeding, fluid accumulation and infection in the wound.

To stop bleeding, doctors use special hemostatic devices and solutions. Bandaging is also used: the patient’s body is wrapped in an elastic bandage. If blood accumulates in the wound, the operation is repeated.

The accumulation of fluid is the result of excision of lymph nodes. The drainage of lymph from the wound is carried out using drainage, and then by puncture - punctures through which the fluid is removed.

A week after surgery, the wound may become infected. It penetrates through the skin and to reduce the risk of infection, doctors try to minimize incisions during surgery. The patient is also given antibiotics before surgery to prevent infection.

Postoperative complications also include swelling of the arm, impairment of activity shoulder joint and weakening of the arm muscles from the operation.

As you can see, removal of the mammary gland is in every sense a rather traumatic operation. Therefore, you should not delay its implementation. After all, the sooner it is carried out, the less complications it will cause and the sooner the patient can return to normal life.

Subcutaneous mastectomy‏‎ is a surgical operation to remove fatty and glandular tissue of the mammary gland. In this case, only 90% of the tissue is removed while preserving the nipple-areolar complex. This feature distinguishes the procedure from subcutaneous dissection, an operation in which only up to 5% of the glandular tissue remains.

Subcutaneous mastectomy is performed for therapeutic purposes to prevent the development of cancer.

Indications for surgery

The following medical indications exist for the operation:

• the tumor should be localized at a distance of no more than two centimeters from the nipple-areolar zone;
• the size of the tumor should not exceed two centimeters;
• the tumor is located far from the surface;
• the oncological formation is located deep in the mammary gland.

Features of the operation

Subcutaneous mastectomy can be performed by several different ways, differing in the type of cut. The surgeon must choose the optimal method based on physiological characteristics patient. The incision should be of such a size as to make it possible to remove the oncological formation along with the surrounding layer of fatty tissue and lymph nodes.

When performing a subcutaneous mastectomy, a woman can simultaneously undergo breast correction through high-quality healing of the surgical incision. It should be noted that during the procedure, complete excision of glandular tissues located in the axillary, subclavian and subscapular areas occurs. The nipple and areola remain intact. This eliminates the possibility of cancer recurrence.
Another important feature of this operation is the mandatory course radiotherapy. This course allows you to completely remove cancer cells that may have remained after the operation. Radiation therapy begins immediately after the incision heals and continues for one and a half months, several sessions per week.
To return the breast to its previous volume, the surrounding muscles are used, which can be moved without fear of circulatory problems. In cases where muscle volume is insufficient, silicone prostheses can be used. As you can see, surgery can solve two problems at once: therapeutic and cosmetic.

Contraindications to subcutaneous mastectomy

Efficiency of the procedure

The effect of the operation was studied in 1999. Based on the results of the studies, it was found that the risk of tumor formation decreases depending on the number of glandular tissues removed. Patients at high risk of developing cancer reduce their likelihood of developing cancer by ninety percent after undergoing a mastectomy.

Operation methodology

Subcutaneous mastectomy is usually performed in two traditional ways:

1. making a long transverse incision for a complete anatomical view of the subcutaneous structures;
2. resection in the areas of the nipple and areola.

It is impossible to say for sure which of these methods is more effective.

The standard operation is performed by making an incision around the areola to create an internal view of the tissue and inclusions being removed. At a certain breast size, the incision may increase in a literal direction. For more effective excision, glandular tissue is treated with a tumescent solution. This reduces the risk of bleeding during surgery. After treatment with saline, the breast tissue is removed while maintaining the blood supply. During the operation, precautions are taken to prevent necrosis in the nipple area. To prevent bleeding, large veins are recommended to be ligated rather than coagulated.

What is a mastectomy? This is an operation to remove the mammary gland. The main indication is breast cancer. Sometimes this surgical intervention is used for intractable inflammatory process or breast injury.

The purpose of this operation is to prevent the spread of the cancer process. Breast removal in women is achieved by completely removing the tissue of the gland itself, the surrounding subcutaneous fat and lymph nodes. Therefore, mastectomy is considered a radical operation.

Types of mastectomy

There are many ways to remove the mammary gland, but the main techniques are:

• according to Halsted-Meyer;
• by Patey;
• according to Madden.

Important! The type of mastectomy surgery for breast cancer is selected by the doctor in accordance with the stage of the cancer process.

Stages of breast cancer: 1st - the oncological process is localized within the breast tissue; 2nd - tumor cells spread to the thoracic lymph nodes; 3rd - axillary lymph nodes are affected; 4th - metastases in other organs.

Madden mastectomy

This modification of the operation is considered the most gentle, because when it is performed, only the gland itself is removed with subcutaneous fat and lymph nodes. However, its implementation is possible only at stages 1-2 of the oncological process.

After the incision, the wound expands, the glandular tissue is separated from the surrounding and removed. The next step is excised subcutaneous fat, thoracic, subclavian and supraclavicular lymph nodes. The pectoral muscles are preserved.

When the wound is sutured, drainage is performed, which lasts for about 4-5 days. With a favorable course of the postoperative period, the woman is discharged home on the 4th day. The stitches are removed after 10 days.

Thanks to the preservation of muscles, this operation does not impair the mobility of the shoulder joint.

Important! After Madden breast removal, chemotherapy and radiation therapy are necessary, because... There is a risk of preserving single tumor cells, which can relapse.

Peyti mastectomy

The indication for surgery to remove breast cancer with this modification is the presence of tumor cells in the axillary nodes (stage 3).

The difference between this operation and the Madden modification is the removal of the axillary lymph nodes and pectoralis minor muscle.

After breast removal muscle intersects, which allows you to get deeper and more complete access to the subcutaneous fat and lymph nodes with metastases.

Important. This type of mastectomy is more traumatic than the previous one, because There is a partial disruption of movement in the shoulder joint due to the removal of the pectoralis minor muscle. Cicatricial changes may occur in the area of ​​the subclavian vein. Subsequent breast formation with an artificial implant is also difficult.

Halstead-Meyer mastectomy

This operation is the most traumatic and disabling. Used in stage 3 breast cancer. Recently its use has been limited.

1. A circumferential incision is made around the gland and it is removed.
2. The wound expands to the axillary region.
3. Subcutaneous fat and lymph nodes are removed there.
4. The pectoralis major and minor muscles are excised.
5. The chest wall is cleared of remaining fiber.
6. Drainage is installed and the wound is sutured.

This type of mastectomy leads to impaired mobility of the arm. The postoperative period and rehabilitation last for a long time.

Important! The only indication for performing a Halstead mastectomy is modern world is a tumor lesion of the pectoralis major muscle.

Complications

Mastectomy, like any operation, has a number of complications that can lead to negative consequences up to the death of the patient:

• Bleeding. During the removal of the breast, the integrity of tissues and blood vessels is violated, which leads to a certain blood loss. In order to minimize it, a special device is used in surgery - an electrocoagulator. In the postoperative period, tight bandaging and aminocaproic acid are used to stop bleeding.

• Infection. Suppuration of the wound occurs most often by the end of the first week of the postoperative period. To prevent this complication during the operation, the rules of asepsis and antisepsis are strictly observed, and a course of antibiotic therapy is prescribed.
• Exudate. The intersection of the lymphatic vessels during the operation leads to the accumulation of copious amounts of fluid in the area of ​​the postoperative wound. In the absence of adequate drainage routes, it can fester. To prevent lymph stagnation, drainage is used.

These complications are observed in the early postoperative period.

Late complications include:

• dysfunction of the shoulder joint;
• lymphostasis in the hand;
• muscle weakness on the affected side.

Early onset of rehabilitation (massage, gymnastics) reduces the likelihood of upper limb dysfunction.

What to do after breast removal?

Breast augmentation after mastectomy is possible! The timing of this operation varies. For tumors of small sizes of stage 1-2, removed by Madden's modification, reconstruction is possible simultaneously with mastectomy.

If oncological disease was operated on at stage 3; between the removal of the mammary gland and the installation of the implant, an average of six months to several years passes. This time will be required to carry out full chemotherapy and radiation therapy.

Reconstructive operations are divided into two large groups:

• breast reconstruction using artificial implants;
• plastic with your own tissues.

The use of artificial implants is possible only if a sufficient amount of tissue is preserved at the site of the removed mammary gland. Most often they are used after Madden surgery.

Plastic surgery using one’s own tissues is used after more traumatic operations to remove a breast tumor (according to Patey and Halstead).

Important! The choice of one or another technique is made by the attending physician, because It is he who decides which of them will achieve the best cosmetic result. During the reconstruction process, some surgical correction of the healthy gland is possible. This will achieve maximum symmetry.

They achieve reconstruction of the nipple by using their own tissues, and the areola is recreated using dermopigmentation, or simply permanent makeup

In order for the result of plastic surgery to be permanent, and postoperative period passed easily and without complications, it is necessary to comply with some requirements:

• exclusion of any physical activity within six months;
• strict control of your own weight (with rapid weight gain, asymmetry may occur due to increased fat deposition in the healthy breast);
• avoiding smoking and alcohol;
• nutritious nutrition with a normal content of meat and vegetables in the diet;
• refusal of drugs that affect the blood coagulation and anticoagulation system;
• mandatory wearing of support bandages or underwear for six months.

Breasts are a woman's adornment! However, it is not worth risking your life because of it. When the first symptoms of concern about breast cancer appear, you should immediately consult a doctor. A mastectomy can save your life. And subsequent plastic surgery will return its former beauty.

This option of radical intervention is possible at any stage of the disease, except for metastatic or primarily inoperable infiltrative-edematous process that extends beyond the gland into the tissue of the chest wall. As a rule, for all operable tumors, RME is performed at the first stage of treatment.

Dr. Shapovalov D.A. A radical resection of the left breast with reconstructive plastic elements was performed for cancer of the left breast T1N1M0, stage IIA. Regional lymph nodes of levels I-III according to Berg were removed. Photo on the left - dressing the next day after surgery; on the right - view after 25 days:

A year ago, RME was performed on the right side with preservation of the pectoral muscles for cancer of the right breast T3N1M0. The next photo is the second stage of reconstruction (replacement of the expander on the right with an endoprosthesis and reduction mammoplasty on the left). The photo on the left is before surgery; on the right - a week after surgery (sutures removed). Next, it is planned to perform nipple formation on the right side of this patient with tattooing of the areola.

In the case of primary spread of the tumor beyond the gland, the so-called infiltrative-edematous form of the tumor, chemotherapy is performed at the first stage and, after reducing the carcinomatous lesion, radical surgery is performed with complete removal of the gland and axillary lymph nodes.

The difference between mastectomy and radical resection

Mastectomy is performed at any stage of cancer and any size of the cancer node, in contrast to radical resection - removal of part of the gland with a small tumor.

At small breasts performing resection is problematic even with a node size of 3 cm, since it is necessary to retreat several centimeters in all directions in order to minimize the possibility of relapse.

The immediate aesthetic result after resection is undoubtedly better than after RME, but subsequent mandatory irradiation compacts the tissue, and over time the scarring process worsens, which significantly changes the shape of the breast and its size. Subsequently, the deformation will require the use of special pads in the bra; it is extremely problematic to smooth out the lack of tissue in other ways.

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Is radiation therapy given after surgery?

Clinical studies have demonstrated equal life expectancy for patients after mastectomy and radical resection, but the rate of recurrence in the remaining breast tissue after resection is much higher, so in all 100% of cases, resection is necessarily supplemented with postoperative radiation therapy.

Complete removal of a breast with a tumor up to 7 cm does not require postoperative radiation. The question of additional radiation therapy is raised only for initially unresectable cancer, when preoperative chemotherapy has reduced the size of the tumor to an operable size.

Content

Breast cancer is a terrible pathology that is widespread in the modern world. Advances in medicine with this diagnosis help save patients’ lives. Mastectomy – surgical method solving the problem. What indications do the operations have, what is the difference between the techniques used, how does postoperative recovery occur - information, useful for women any age.

What is a mastectomy

A tumor found in the breast becomes a physiological and psychological problem for women. To resolve it, mastectomy is used - an operation to remove the mammary gland, which has options for execution. Surgeons, trying to preserve a woman’s breasts, choose the least traumatic method in all respects. Doctors' tasks:

• eliminate a dangerous disease;
• create conditions for subsequent breast reconstruction;
• improve a woman's quality of life.

During surgery, depending on the type of technique, the mammary gland, pectoralis major and minor muscles, and fatty tissue containing lymph nodes are removed. A cancerous tumor is dangerous due to the rapid growth of metastases. Surgical intervention has features depending on the stage of development of the pathology and the age of the woman. Indications for breast removal are:

• cancer risk more than 51%;
• sarcoma;
• purulent inflammation;
• genetic predisposition to cancer;
• gynecomastia.

There are restrictions for removing mammary glands. Contraindications for performance:

• cerebrovascular accident;
• hepatic, renal failure;
• decompensated diabetes mellitus;
• swelling in the gland, spreading to the chest;
• severe form of cardiovascular failure;
• multiple metastases to the lymph nodes with swelling of the arms;
• tumor growth in the chest tissue.

Types of mastectomy

The earlier a woman is diagnosed with breast cancer, the less traumatic surgery will be. Subsequent measures for breast reconstruction also depend on this. Several techniques for performing mastectomy have been developed. In addition to removing the mammary gland, they mean:

The most minimally traumatic method with the possibility of subsequent breast reconstruction is subcutaneous mastectomy. The affected glandular tissue is scraped out through a small incision. Modified types of radical intervention are used together with removal of the mammary gland:

Indications

Before performing a mastectomy, doctors evaluate the woman’s condition, the degree of tumor development, and the structure of the cancer. This is taken into account when choosing the method of surgical intervention. Everyone has their own testimony:

Oncologists choose a modification of mastectomy in accordance with the indications for the procedure and the severity of the process:

The choice of the method of surgical intervention is a crucial moment for surgical oncologists. The need for chemotherapy is determined by the doctor. Commonly used types of mastectomy:

Tumor in last stage with metastases is treated with the help of a surgical operation performed according to the following methods:

Preparing for the operation

Before proceeding with the mastectomy, the doctor conducts an initial examination of the woman, collects an anamnesis. An examination is scheduled, and the method of the operation is selected based on the results. Preoperative measures include:

• general, biochemical analysis blood;
• breast mammography;
• urine test;
• tissue biopsy;
• computed tomography;
• blood clotting test;
• research on tumor markers;
• prescribing a light diet;
• admission restriction medicines, promoting blood thinning;
• prohibition on drinking and eating on the operating day.

Operation

When choosing a surgical procedure, it is taken into account whether one breast is removed according to plan (unilateral mastectomy) or whether both are removed. The operation is performed under general anesthesia. Duration ranges from one to three hours, depending on:

• the patient's condition;
• stages of cancer;
• tumor localization;
• presence of metastases.

There is a general algorithm of actions when removing mammary glands in women:

• anesthesia is administered;
• Marking of the rifling is applied with a special marker;
• skin is incised;
• subcutaneous tissue is separated from it, breast;
• tissue is removed, including lymph nodes if necessary;
• in accordance with the surgical technique, fatty tissue and pectoral muscles are excised;
• vascular links and nerve endings can be traced;
• drainage is installed to drain fluid;
• Stitches are placed and removed after 12 days.

According to Halstead

This type of mastectomy is considered a classic option, used for stages 1-3 of cancer. The method bears the names of the doctors who developed it - Halsted-Mayer. For the patient, this is the most traumatic method of intervention, which is used in the case of extensive metastasis of the lymph nodes and chest muscles. During the operation, the following is simultaneously removed:

• mammary gland;
• pectoralis major and minor muscles;
• subcutaneous fatty tissue - subscapular, axillary, subclavian;
• lymph nodes;
• nipple;
• skin.

Holder-Meyer mastectomy is used when other methods are powerless. Contraindications for surgery must be taken into account. The technique causes a serious complication - limited mobility of the shoulder joint due to muscle removal and nerve damage. As a result of the elimination of a large number of tissues, problems arise during the plastic reconstruction of the breast:

• restoring the symmetry of the glands;
• correction of volume, shape;
• reconstruction of the nipple-areolar complex.

Radical mastectomy according to Madden

The type of surgery developed by Madden is considered more gentle and less traumatic. Mastectomy is used to treat women with nodular forms of cancer. During the event:

• the mammary gland, axillary, subscapular, subclavian lymph nodes with subcutaneous tissue are removed;
• all muscle groups are preserved;
• there is no heavy bleeding;
• vascular and nerve endings are preserved.

As a result of the Madden mastectomy behavior due to the reduction in the volume of surgical intervention, the reduction in trauma, complications rarely occur. After operation:

• going on fast healing wounds;
• the mobility of the shoulder joint is not impaired or restoration is carried out using special gymnastics and massage;
• Plastic reconstruction of the mammary glands is successful;
• there is a possibility of recovery in a short time.

Breast amputation

When choosing a method of performing an operation, oncologists take into account the stage of the disease, the degree of cancer activity, the rate of tumor growth, and hormonal state. female body. Amputation of the mammary gland is a simple mastectomy. It does not apply to radical interventions. It is planned to remove the mammary gland and fascia of the pectoralis major muscle, nipple and areola. Indications for this are:

• stage 4 cancer;
• decaying malignant neoplasms;
• pathologies of 2-3 degrees when it is impossible to perform radical surgical intervention.

This type of surgery is used for preventive purposes in the presence of a genetic predisposition to the development of breast cancer. Large size of the tumor is also an indication. Features of surgical intervention:

• A biopsy of nearby lymph nodes is required;
• if the cancer tumor is up to two centimeters in size, the areola and nipple are not removed;
• subsequent radiation and chemical therapy is prescribed.

By Patey

During the operation using this doctor’s method, the pectoralis major muscle is not removed. Peyti's method helps preserve the functions and cosmetic appearance of the remaining tissues. During surgery:

• the mammary gland and fascia of the pectoralis major muscle are removed;
• the small one is excised, providing access to the axillary lymph nodes;
• they are removed;
• subcutaneous tissue and skin around the malignant neoplasm are excised;
• drainage is installed;
• stitches are placed.

Patty's technique, a modified radical mastectomy, is considered low-traumatic and is widely used in oncology. After the operation, a minimal number of complications are observed. The disadvantages include:

• the appearance of scars in the area of ​​the subclavian vein;
• difficulties in breast formation using artificial implants;
• slight but quickly recoverable limitation of mobility of the shoulder joint.

Postoperative period

In order for a woman to quickly regain her shape after surgery, it is necessary to carry out rehabilitation measures prescribed by the doctor. This will help remove pain syndromes, increase the mobility of the shoulder joint, restore lymph flow, and eliminate complications. In the postoperative period it is necessary:

• refuse to visit the solarium, bathhouse;
• avoid lifting heavy objects;
• use an elastic bandage;
• wear special soft clothing;
• drink more fluids;
• avoid injury;
• be regularly examined by a doctor.

The postoperative condition requires careful attention to health. It is recommended for a woman:

• limit working hours;
• reduce movements;
• perform a special complex of exercise therapy;
• visit the swimming pool;
• use a bandage;
• eliminate exposure to heat;
• wear specialized underwear - bra, swimsuit;
• do gymnastics;
• do not inject into the arm on the removal side;
• conduct a course of psychological recovery;
• See a doctor if you feel worse.

During rehabilitation after a mastectomy you will need:

• normalize nutrition - use a low-calorie diet;
• carry out physiotherapy;
• perform massage, hydromassage;
• use exercise machines to restore mobility of the shoulder joint;
• limit prolonged stay in an inclined position;
• use compression sleeves during air travel;
• use therapeutic wrap;
• take the drug Tamoxifen to prevent relapses;
• perform reconstructive plastic surgery measures.

Complications

Having a mastectomy can have serious consequences. Complications appear after surgery and in the subsequent, long-term period. After the operation, it is possible that problems may arise:

• suppuration of a postoperative wound;
• bleeding;
• breathing problems;
• appearance in lower limbs blood clots;
• lymphorrhea - prolonged leakage of lymph as a result of injury to the lymph nodes;
• allergies to medications;
• marginal tissue necrosis;
• damage nerve endings muscles of the back, arms, chest;
• infection of the abdominal organs.

During the recovery period after a mastectomy, long-term complications may appear:

• pain, stiffness in the hands;
• shoulder joint mobility problems;
• lymphostasis – swelling of the hands caused by impaired outflow of lymphatic fluid;
• rough postoperative sutures;
• proliferation of connective tissue;
• disorder of the outflow of venous blood due to blockage of the lumen of the axillary and subclavian vein during surgery.

The most serious problems for women are post-operative psychosexual problems. Removal of the breast causes:

• depression;
• feeling of one's own inferiority, inadequacy;
• difficulties in communicating with the opposite sex;
• limiting social contacts;
• fear of relapse of the disease;
• fictional and real difficulties of sexual life;
• difficulty making new acquaintances;
• problems in family relationships.

Breast reconstruction

Women go to plastic surgery for breast reconstruction due to psychological discomfort. In addition, problems arise at the physical level associated with an imbalance of loads on the spine. After mastectomy the following are observed:

• change in posture;
• drooping shoulder on one side;
• rachiocampsis;
• disruption of the lungs and heart.

Reconstruction is often performed in conjunction with a mastectomy, or six months after surgery. As a result of measures at the site of removal of the mammary gland, restoration is carried out:

• volume of subcutaneous fatty tissue, skin;
• excised tissue located nearby, chest muscles;
• nipple-areolar complex;
• in addition to the operated breast, a second breast to adjust the size and shape.

There are several reconstruction techniques that differ in implementation and results. One of the popular methods is the use of endoprostheses. Features of plastic surgery:

• performed after subcutaneous mastectomy;
• An expander, a special device, is inserted through the incision;
• the skin is stretched, a cavity is formed for subsequent installation of the implant;
• advantages - low trauma;
• Disadvantages - unnatural breasts to the touch and appearance, risks of tissue necrosis, restrictions on implant installation.

To create a breast that is natural in appearance and feel, a transplant of one’s own tissue is used, which is taken from the back and anterior abdominal wall. This technique, the TRAM flap method, is characterized by:

• complexity of the operation;
• high morbidity;
• the need for long-term anesthesia;
• the possibility of tissue rejection;
• long recovery period;
• no problems associated with implant displacement.

Another reconstructive method is the use of vacuum devices. When using them:

• a domed bowl is placed on the chest;
• a vacuum is created under it;
• skin stretches;
• its excess is formed;
• a site is formed for the subsequent installation of a silicone implant and fat tissue transplantation;
• The disadvantage of this method is that it requires wearing the device for a long time, the appearance of stretch marks is possible, it is difficult to stretch until big size implant.

A combined breast reconstruction technique is often used. Breast plastic surgery includes a combination of methods:

• replenishment of tissue deficiency by transplanting flaps of the patient’s own muscles, subcutaneous tissue, and skin;
• correction of shape, size, symmetry, restoration of volume, elimination of depressions is carried out using silicone implants.

Price

Mastectomy in Moscow is performed in specialized clinics and oncology centers. Surgery involves only breast removal or simultaneous plastic reconstruction. The cost depends on the stage of cancer, the characteristics of the implementation process, the qualifications of specialists, and the status of the clinic. Transaction price in rubles:

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