Breast cancer is nowadays the most frequent type of tumor among women in our country. During their treatment, the patient amy be given chemotherapy and radiotherapy, in addition to the surgical treatment. This intervention can be partial (lumpectomy circumscribed) or complete (mastectomy, or removal of the breast).
By this, the reconstruction of the breast is just one more stage of the healing process: restore the body shape to women has direct impact on overcoming psychological process, and therefore its complete cure.
The reconstructive surgery of the breast gets:
- Restore the removed organ
- Recover one of the factors that affects the more the feeling of the own feminity
- Improve its personal image
- Promote the psychological balance during the treatment, and also after it
- Reduce the long term shock that supposed the process
DIEP – Microsurgical Reconstruction with tissue from the Abdomen
DIEP (Deep Inferior Epigastric Perforator) is a technique of microsurgery that was developed in 1994 and which has revolutionized surgery for breast reconstruction to let us get very natural results in color, touch and evolution in time of the breast. At this moment, it is the most advanced technique in this field.
At the time of making this intervention of plastic surgery, skin and fat from the abdomen are used. It is not necessary any muscle nor implant foreign materials (mammary prothesis). The objective of the surgeon when it develops this interventions is to shape in the patient a new chest as close as its natural breast.
This reconstructions does not interfere in the treatments given by the oncologist (either befor or after). Nor does it affect the subsequent controls after the overcoming of breast cancer. That is to say, in the case of tumor recurrence, reconstruction will not affect the early diagnosis if the exploratory mechanisms are properly carried out. Therefore, it is a breast reconstructions absolutely compatible and complementary to the oncological treatment, In fact, more oncologist recommend it because they recognize it only brings benefits to the patient.
The Microsurgical Reconstruction with Tissue from the Abdomen (DIEP) is, nowadays, the most used breast reconstruction technique in the hospital centers of prestige and can be applied to the majority of the patients with mastectomy.
Preparation of the patient for reconstruction with Microsurgery
After a preliminary analysis, the professional advises the patient about the DIEP technique and puts at your disposal the information about the steps to follow.
Here are indicated the previous common recommendationsto a surgical interventions, such as:
- Follow a healthy diet
- Information about medication
- Delete the smoking
- Keep the skin clear, and similars.
In the procedures, are also performed in a standardised way a series of tests to ensure that there is no health risk and that contribute to the file all the diagnostic information that the current techniques can offer.
It is very likely to make professional photographs that are use to raise and prepare the surgery, as well as to compare the results of before and after. They are images that are treated strictly under the “Law of Protection of Information”.
It will be delivered all the documentation that the patient may need: information provided during the visit, tests to perform before the intervention, needed medication when the discharge proceeds, as well as the contact data and communication channels varied and agile to be able to contact with the surgeon and the doctors team when needed.
Intervention of DIEP for breast reconstruction
at the time of making a breast reconstruction, the surgeon chooses one method or another depending on the characteristics of each patient. the DIEP technique is based on using tissues from the own patient to perform breast reconstruction. Therefore, in the same intervention it is removed the excess skin and fat in the abdominal area, and it is moved to the thorax area where it joins to an artery and a vein.
This is an intervention which lasts, approximately, six hours.
the reconstruction of the areola and the nipple of the breast (CAP) is performed after four months since the intervention, because the transplanted tissue must not be swollen to undertake this phase. But this is a minor intervention, that can be done with local anesthesia and without the need for hospital admission.
If we compare the DIEP technique of breast reconstruction with other methods, we can highlight 3 benefits:
- Conservation of the muscles, nerves and natural movements of the abdominal area. Therefore, the recovery will allow to the patient to continue with its daily activity without assistance.
- The breast adaps to the changes that the patient can experience with the course of time: changes of weight and physiological. Therefore, it is avoided the need of retouching.
- When performing an abdominoplasty to the patient, to obtain tissue (skin and fat), it is achieved a remodeler effect body contour.
Postoperative period of DIEP
The recovery period after the intervention for the Microsurgical Reconstruction with Tissue from the Abdomen extends over 3-4 weeks, following this deadlines as usual:
- After the intervention, the patient should just stay four days in hospital admission.
- Once the discharged is given in the clinic, it will be recommended a week of rest, in which there should be no activities with physical effort.
- After this time, the patient can reassume their activity in a progressive way, always maintaining certain precautions.
- During the first two or three weeks will be placed an specific bra. Once this term is over, can be used the ordinary bras, but always without hoops.
These recommendations and any doubts that may arise, will be cleared by the surgeon in the consultation.
An important remark is that due to the inflammation, the patient may notice a considerable increase in their breast and tension in the abdomen after the intervention. These symptoms disappear with the passage of days.
Exceeded the postoperative period, the patient must come to its habitual visits with the usual specialists (oncologist, gynecologist and surgeon).
As it is mentioned before, four moths after the DIEP intervention, which the tissues have lost the inflammation, it can be addressed the reconstruction of the areola-nipple.