Breast reconstruction following mastectomy; patient's satisfaction

Breast cancer remains one of the most common malignancies in women and is one of the leading causes of cancer-related mortality. Despite the current emphasis on breast conservation, mastectomy rates remain at 30%. Mastectomy is often associated with significant psychological sequelae including distorted body image and sexual dysfunction. Breast restoration is assumed to allow a full emotional and physical recovery from a breast cancer crisis. The methods of reconstructive surgery currently practised comprise flap reconstruction, implant reconstruction and a combination of these procedures. The most commonly used flaps are transverse rectus abdominis myocutaneous (TRAM), deep inferior epigastric perforator (DIEP), latissimus dorsi (LD), gluteal artery perforator (GAP). Autogenous tissue gives the best results, and currently the best technique in most women is probably the free DIEP flap. The lower abdominal tissue can mimic the breast to a high degree.