Immediate breast reconstruction during mastectomy

The breast can be reconstructed already in the primary operation (during mastectomy,) if the cancer is limited to the breast (not metastasised). An immediate breast reconstruction with mastectomy is done for the breast cancer gene carriers prophylactically (as a preventive method).

In many cases it is possible to spare the skin of the breast area and then in most cases also the nipple.

The reconstruction can be performed with implants or own tissue transplants. The implant will be placed under the pectoral muscle. The muscle will not cover the lower, outer part of the breast, and that’s why extra support (acellular matrix) is needed.

The own tissue transplants can be taken from below umbilicus (free abdominal flap) or from back (LD-flap), from femur area or with a perforant flap with skin and fat around the breast. The transplant is placed under the normal breast skin, and it gives the best aesthetic result.

Photo: Immediate breast reconstruction with free abdominal flap from below umbilicus (left breast), also a nipple has been removed and reconstructed later with local flap and tattooing the areola.