SEBASTIEN GARSON M.D
This fact sheet was developed under the aegis of the French Society of Plastic Reconstructive and Aesthetic Surgery (SOF.CPRE) as an addition to your initial consultation, to try to answer all the questions you can ask yourself if you plan to use surgery baldness. The purpose of this document is to provide you with all the necessary and essential elements of information to help you make your decision with full knowledge of the facts. Also you is it advisable to read with the greatest attention.
• DEFINITION OBJECTIVES AND PRINCIPLES
Mastectomy or mastectomy (the terms are synonymous) is the removal of the mammary gland, a section of skin and areola. It is unfortunately necessary in some forms of breast cancer.
A request for breast reconstruction is quite legitimate after mastectomy.
After rebuilding the volume and shape of the breast, it is desirable to provide a reconstruction of the nipple-areola (nipple areola +) to completely restore this symbol of femininity that is the breast.
This reconstruction is supported by health insurance.
The rebuilding of a colored areola and nipple as a central relief surgery aims.
The areolar reconstruction is never mandatory and some women are satisfied with the reconstruction of a volume. The reconstruction of the nipple and areola is a personal choice.
However, this simple reconstruction to better integrate the reconstructed breast in his personal psychological pattern.
The operation can be performed when the volume of the reconstructed breast is considered stabilized.
* There are several techniques for reconstruction of the areola:
- The total skin graft skin is ideally taken at the genito-femoral (groin) because at this level it is naturally pigmented and appears brown when the graft at the breast area. The pigmentation is not always sufficient to reproduce the color of the contralateral areola but the result appears sustainable and often natural. It can be secondarily tattooed if necessary.
You can also use the peripheral half of the areola of the other breast.
The tattoo-This is the simplest technique is to introduce into the dermis, a sterile pigment. These tattoos often tend to fade.
* There are also several techniques to reconstruct the nipple including:
- The contralateral graft
This is the technique of choice if the nipple is sufficiently planned and generous: it takes part in the graft to the other side. This gesture hardly leave a trace and does not alter the areal sensitivity.
- The local flaps
A local skin flap is removed and wrapped himself in a central restaurant raised nipple. Scar removal is hidden beneath a skin graft or a tattoo that rebuilt the areola.
• BEFORE THE OPERATION
It is not necessary to make a new assessment procedure unless an invasive procedure is associated. A new anesthesia consultation, at least 48 hours before the procedure is only required if we consider mild sedation or are associated with the reconstruction areal more invasive procedure requiring general anesthesia.
No medication containing aspirin should not be taken within 10 days before surgery.
• TYPE OF ANESTHESIA AND CONDITIONS OF INTERVENTION
Type of anesthesia
It is a local anesthetic, unless the associated procedure is performed. Sedation may be offered to the most anxious patients.
Terms of hospitalization
This gesture is performed most often on an outpatient basis. Hospitalization is considered only if it involves the reconstruction areal more invasive procedure requiring general anesthesia.
The procedure usually lasts 1/2 hour. After surgery, a light dressing is crafted.
AFTER THE INTERVENTION: THE OPERATING SUITES
The operating suites are simple and do not require a work stoppage. The pain is usually mild and easily relieved by conventional analgesics.
If a bolster is made (small ball of fat compresses applied firmly on the transplant), it will be removed by the surgeon after five to seven days.
Other dressings can be made by the patient herself, dressing fat compresses applied to the skin graft every day.
At the first dressing, transplants sometimes have a very white appearance (bloodless) this color is moving rapidly toward a slightly purplish saignotant. Crusts are possible. A more favorable appearance (graft dew) appears in the following weeks.
The son of suture will be removed on day 21. It is advisable to wait for healing before anchoring the graft (conservative showers).
• THE RESULT
After healing dew and well relaxed areola makes in its natural and complete look, chest reverting symbol of femininity.
• FAULTS OF THE RESULT
Unfortunately, it is impossible to reconstruct a perfect areola.
The areola reconstructed lost all possibility of contraction (size difference) and erogenous sensitivity.
There is often a difference in color between the two areolas. In addition, tattoos often tend to fade but renewal is still possible.
• POSSIBLE COMPLICATIONS
Complications of areolar reconstruction are actually rare.
The failure of engraftment is still possible. In this case, a new skin graft can be attempted again..
In total there should not overstate the risks, but just be aware that surgery, even seemingly simple, still a small share of hazards. The use of a qualified Plastic Surgeon ensures that it has the training and knowledge required to avoid these complications, or effectively treat if jurisdiction.
These are the pieces of information that we wanted to bring you in addition to the consultation. We recommend that you keep this document, read it again after the consultation and reflect "a clear head." This reflection may raise new questions for which you wait for additional information. We are available to talk during the next consultation, or by phone, or even on the day of surgery when we meet in any way before anesthesia.
Phone : + 33344282959
7 impasse de la Passerelle 60300 SENLIS
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