[Breast reconstruction].

Abstract

The changes in the rationale of surgical therapy of breast cancer led to increased importance of plastic and reconstructive surgery in this field. Besides the development of surgical procedures for breast-conserving surgery, plastic surgery was mainly responsible for the popularization of primary or secondary breast reconstruction, based on several scientific studies, showing no negative effect of breast reconstruction on the oncological course. Also, for defect reconstruction in advanced cases, flaps are indispensable for improvement of the local situation. Further, reduction mammaplasty can be of prophylactic value by significant gland tissue reduction. For breast reconstruction, autologous tissue is of increasing importance, since silicone breast implants have been discredited by a long-lasting media campaign. The best results are achieved with the transverse rectus abdominis myocutaneous flap. In patients with small breasts, the latissimus dorsi myocutaneous flap without prosthesis should be preferred.