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Mikrochirurgische Brustrekonstruktion

Microsurgical techniques for breast reconstruction

Der Chirurg volume 82, Article number: 807 (2011) Cite this article

Zusammenfassung

Ergebnisse einer Umfrage zeigen, dass weniger als 10% der betroffenen Frauen von den unterschiedlichen Möglichkeiten der Wiederherstellung der Brust wissen. Dabei hat gerade in der modernen Medizin der Zusammenhang zwischen seelischem Wohlbefinden und körperlicher Gesundheit einen neuen Stellenwert erlangt.

Die erste erfolgreiche autologe Brustrekonstruktion erfolgte durch Czerny 1895. Nach Einführung der Silikonimplantate zur Brustaugmentation wurden diese auch häufiger zur Rekonstruktion eingesetzt. Weltweit wird die Mehrzahl der Rekonstruktionen noch immer mit Implantaten durchgeführt. Allerdings ist die Kapselfibroserate in dieser Patientengruppe deutlich höher als bei der ästhetischen Augmentation und wird mit über 30% angegeben. Ein Austausch der Implantate ist in der Regel nach spätestens 10 bis 15 Jahren notwendig. Nach einer Radiotherapie liegt die operationspflichtige Rate an Kapselfibrosen nach 4 Jahren bereits bei 38%.

Autologe Rekonstruktionsverfahren sind bez. der Gesamtkomplikationsrate deutlich überlegen. Im folgenden Artikel werden die modernen Möglichkeiten der mikrochirurgischen Mammarekonstruktion dargestellt und die Indikationen und Ergebnisse diskutiert.

Abstract

The results of a survey show that less then 10% of affected women are aware of the various options for breast reconstruction. However, in modern medicine the correlation between emotional well-being and physical health has been established as an important factor.

The first successful autologous breast reconstruction was performed by Czerny in 1895. After introduction of silicon implants for breast augmentation this method was also increasingly used for breast reconstruction. Worldwide most reconstructions are implant based, however the symptomatic rate of capsular contracture is up to 38% and the reoperation rate for implant-based reconstruction and radiotherapy up to 35%.

Autologous reconstruction procedures have a significantly lower complication rate. This article describes the modern microsurgical techniques for breast reconstruction and discusses the indications and achievable results.

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Affiliations

  1. ETHIANUM Betriebsgesellschaft mbH & Co. KG, Voßstr. 6, 69115, Heidelberg, Deutschland

    M. Pelzer, M.A. Reichenberger &  G. Germann

Authors
  1. M. Pelzer
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  2. M.A. Reichenberger
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  3. G. Germann
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Corresponding author

Correspondence to G. Germann.

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Pelzer, M., Reichenberger, M. & Germann, G. Mikrochirurgische Brustrekonstruktion. Chirurg 82, 807 (2011). https://doi.org/10.1007/s00104-011-2111-y

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  • DOI: https://doi.org/10.1007/s00104-011-2111-y

Schlüsselwörter

  • Autologe Brustrekonstruktion
  • Mikrochirurgie
  • Silikonimplantate
  • Kapselfibroserate
  • Komplikationsrate

Keywords

  • Autologous breast reconstruction
  • Microsurgery
  • Silicon implant
  • Capsular contracture
  • Complication rate