Aspects of Immediate and Delayed Alloplastic Breast Reconstruction After Mastectomy

Seventy percent of patients with early breast cancer can be treated by breast-conserving surgery, while the remaining 30% are forced to receive mastectomy. Nearly 30% of these patients choose breast reconstruction. In the last decade, new alternative techniques and improved surgical devices have significantly improved techniques for breast reconstruction that especially include immediate or delayed breast reconstruction with silicone implants as an excellent option. In general, implant reconstruction may be single- or two-stage procedures. Single-stage reconstruction is the preferred technique for patients with small breasts and minimal ptosis, while large breasts with ptosis require reduction mastopexy either combined with dermoglandular flap or with titane net for covering the caudal pole of the implant. Thus, excellent cosmetic results can be achieved. Recent studies showed a significant survival benefit for postmastectomy irradiation in nodal-positive patients, so that many candidates for breast reconstruction are irradiated with a higher probability of wound-healing complications after breast reconstruction and increased rates of other complications like capsular fibrosis