الفهرس | Only 14 pages are availabe for public view |
Abstract The female breast is one of the most important symbol of femininity, removal or deformity of this sexual organ can induce severe psychological effects. Therefore, breast reconstruction is an element of prime importance to mastectomized women. The goals of breast reconstruction are creating a breast that looks and feels like the normal breast, with achievement of symmetry by correction of the contralateral side, technically, simple methods should be used if possible. However, selection of the breast reconstruction procedure must be chosen individually depending on various conditions. Prosthetic breast reconstruction has the advantages of shorter procedure time, hospital stay and recovery as well as being lower cost and not having an additional donor site associated with an autologous reconstruction, Breast reconstruction either can be immediate at the time of mastectomy, delayed (secondary breast reconstruction) after months or late up to five years after mastectomy. Immediate breast reconstruction has many advantages. For the patient, it is easier, less expensive and psychologically more convenient. However, Patients with larger and/or ptotic breasts are not ideal candidates for IBR as they often need contralateral balancing procedures to achieve symmetry which can be difficult to judge at the time of immediate reconstruction, Disadvantages of immediate breast reconstruction are prolongation of duration of the surgery and a higher complication rate. Delayed breast reconstruction is considered months after mastectomy as by this time the soft tissue will have recovered from the operative trauma, also, adjuvant radiotherapy or chemotherapy is usually finished.In addition, the patient lived with the deformity for sometimes, which made her accept the concept of breast reconstruction, Delayed breast reconstruction is recommended in patients who require adjuvant radiotherapy as radiotherapy can adversely affect the aesthetic outcome, also tissue expanders allow effective and safe radiation delivery to the internal mammary and axillary lymph nodes. The most common complications associated with prosthetic reconstruction include capsular contracture, hematoma and infection , The complication rate are significantly lower if implants were inserted for cosmetic reasons compared to those who had implants inserted either following prophylactic mastectomy or mastectomy for cancer , Wound complications are usually associated with large breast volume . Significant risk factors for reconstructive failure include smoking, obesity, incomplete muscle coverage, implant volume >400 ml, type 2 diabetes mellitus, higher grade tumors and nodal involvement. Although not a statistically significant risk factors for complications, older age was associated with a borderline increased risk of complications in both IBR and DBR. In our study we have come to the conclusion that, statistically there was no difference between the incidence of post operative complications between immediate and delayed prosthetic breast reconstruction. |