Breast reconstruction with pith tissue

Reconstruction with a pith tissue or prosthesis each has its advantages and disadvantages. The important advantages of reconstruction with pith tissue are that the patient's tissue is used, and therefore naturalness is ensured by appearance and touch, aging with the patient, more resistance to the effects of radiation, a permanent reconstruction can be provided. Significant disadvantages include the complexity and length of the surgery, in addition well as the prolonged healing process. However, it has been shown by many clinical studies that there is no delay in treatment if the pith tissue reconstruction option is preferred. The abdominal region is the main region used for pith tissue breast reconstructions.

Since its definition, pedicled TRAM flap has been the most common breast reconstruction option; however, partial flap loss and fat necrosis are very common, especially in obese, smoking, diabetic, and hypertensive patients. In this case, debridement and additional surgical interventions may be required. For this reason, microsurgical techniques and free flaps used in the breast area have come to the fore. For these flaps, the DIEP (deep inferior epigastric artery perforator) flap, which is an advanced technique in which abdominal tissue is still used but muscle is preserved, is a reconstruction option with pith tissue that is still used and popular in important centers around the World. Alternatively, breast reconstruction is also performed with free flaps prepared from the hip and thigh area. Although breast reconstruction with back muscle has been performed very often in the past, it is mostly used as a recovery option to support the lower part and cover the tissue expander/implant in patients who have been reconstructed with prostheses today. The duration of these operations is longer compared to reconstruction with prosthetics, but the time is shortened with the increasing experience of the clinic, and when fat grafting applications are added after prosthetic operations, the total duration of surgery may be the same.