Breast reconstruction refers to the use of autologous tissue transplantation or breast implants to reconstruct chest wall deformities and breast defects caused by post-mastectomy, also seen in burns, trauma, infections, congenital dysplasia, sex reassignment surgery, etc .
I. Historical Development
In 1907, Willian Halsted of Hopkins University first pioneered radical mastectomy for breast cancer. For more than half a century, it became the standard procedure for the treatment of breast cancer.
Halsted considered a lump less than 6 cm as an early stage tumor at that time. Halsted was adamantly opposed to any form of breast reconstruction due to the lack of adjuvant treatment and the high rate of local recurrence.
For the few brave women who requested reconstruction at that time, there was also a lack of effective reconstructive methods and the morphological results were not very satisfactory.
Reversal of the healthy side of the breast
In 1932 Keinhard split the healthy breast in half and transferred it to the affected side to reconstruct the breast.
Dermatome
In 1942, Gillies et al. reported abdominal skin tube transfer for breast reconstruction, and in 1977, Cronin applied a longer combined thoracoabdominal skin tube for breast reconstruction.
Although the skin tube transfer is safe and feasible, it requires multiple surgeries to complete the reconstruction, which increases a lot of surgical scars, and lacks good shaping methods and poor morphological results, and its results have become one of the reasons against breast reconstruction.
Prosthesis
The use of breast implants for breast reconstruction began in the early 1970’s. In 1971, Snvderman and Guthrie reported a case of breast reconstruction by implanting a breast implant under the skin of the breast. This method became the main method of breast reconstruction in the mid-1970s.
Advantages and disadvantages of breast reconstruction with implants
1. Advantages
Simple operation.
No new surgical scars are added.
Making full use of the local skin, the texture and color of the skin is similar to that of the healthy side.
No destruction of the donor area, etc.
2.Disadvantages
Thin skin flap in radical breast cancer surgery, poor quality of skin covering the prosthesis, difficulty in placing larger prosthesis.
Cannot express moderately sagging breast form.
Cannot be corrected.