Clinical Application Of Immediate Breast Reconstruction With Prosthesis Or Tissue Expander After Modified Radical Mastectomy

Objective : To summarize the technical process of immediate breast reconstruction using prosthesis or tissue expander after modified radical mastectomy for breast cancer,analyze the causes of the common complications of this surgical method and the treatment measures and evaluate its clinical application effect.Methods:Data pertaining to all 49 patients who underwent modified radical mastectomy with immediate breast reconstruction using prosthesis or tissue expander between May 2013 and September 2016 in our hospital.Collect relevant clinical data,perform the operations according to the uniform procedure,record all details of every operation,summerize all the complications and summarize the corresponding control measures.The patient ’s satisfaction is investigated by a telephone follow-up,then we can evaluate its clinical application effect.Results:49 cases of reconstruction were successfully implemented in this study.37 patients had immediate prosthesis reconstruction,of which 3 cases used biofilm;12 patients had immediate tissue expander reconstruction.Of the 49 patients,37 retained nipple areola complex(NAC)and 12 not.Postoperative complications were as follows: one patient’s nipple skin delayed healing after the operation;one patient with tissue expander implantation required removal of the expander due to a poor local healing;one patient removed the prosthesis due to surgical flap necrosis;one patient removed the prosthesis due to a poor tissue coverage;thirteen patients with displacement of implants;one patient had a recurrence on the chest wall one year after the operation.After postoperative follow-up,34 patients(26.5%)were satisfied with the shape of the reconstructed breasts.Conclusions:As for patients who are not suitable for the breast conserving surgery or ones who didn’t have the desire to conserve breast,this method can be a better choice.For this method could achieve good aesthetic effect,as well as high subject satisfaction.Implant migration and poor local healing were common complications,we could reduce them through intraoperative fine operation and postoperative rational prevention and treatment.Moreover,the method had the advantages of simple operation,less complications and high satisfactions.So it was an ideal mean of breast reconstruction under the premise of strict regulation and was expected to be promoted in hospitals at all levels.