Zusammenfassung
Weltweit gehören die Methoden der alloplastischen Brustrekonstruktion zu den häufigsten operativen Prozeduren zur Wiederherstellung der weiblichen Brust nach Mastektomie. Die Verfügbarkeit einer breiten Vielfalt anatomisch geformter Expander-Implantat-Systeme gestattet dem Operateur die möglichst optimale Rekonstruktion der Brust in Größe, Form und Symmetrie. Das Konzept der sekundären Expander-Implantat-Rekonstruktion zeichnet sich durch zahlreiche Vorteile gegenüber anderen Rekonstruktionstechniken aus. Es handelt sich um eine relativ einfache chirurgische Technik mit Verwendung des Hautweichteilmantels gleicher Farbe, Textur und Sensitivität, ohne Hebedefektmorbidität, ohne zusätzliche Narben und verbunden mit günstiger Operationszeit und postoperativer Rekonvaleszenz. Die Komplikationsrate ist bei richtiger Indikationsstellung äußerst gering. Die adjuvante Strahlentherapie ist die bedeutendste relative Kontraindikation zur Expander-Implantat-Rekonstruktion. Wichtig ist die Aufklärung der Patientin über die eventuell erforderliche kontralaterale Mastopexie oder Reduktionsmastopexie zur Erzielung eines symmetrischen Rekonstruktionsergebnisses.
Abstract
Alloplastic breast reconstruction methods are the most commonly used worldwide to reconstruct the female breast after mastectomy. The tissue expander-implant system gives very consistent results in the vast majority of patients. The availability of a wide variety of textured, anatomically shaped implants enables the surgeon to perform the best possible reconstruction in terms of size, shape and symmetry. The concept of delayed two-stage expander-implant reconstruction is extremely sound, offering several potential advantages over other available techniques: It is a relatively simple surgical procedure, using donor tissue of similar color, texture, and sensation, eliminating distant donor site morbidity, ensuring minimal incisional scarring and reducing operative time and postoperative recovery. When correctly indicated, the complication rate is very low. Radiation therapy is the strongest contraindication to alloplastic breast reconstruction. Patients should be informed preoperatively about the necessity of contralateral mastopexy or reduction mammoplasty to achieve symmetric results.
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Friedrich, M., Krämer, S. Alloplastische Brustrekonstruktion nach Mastektomie. J. f. Ästhet. Chirurgie 3, 142–148 (2010). https://doi.org/10.1007/s12631-010-0083-2
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DOI: https://doi.org/10.1007/s12631-010-0083-2