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J.Jpn. Surg. Soc.. 122(3): 307-313, 2021


Feature topic

RECONSTRUCTIVE SURGERY FOR BREAST CANCER PATIENTS IN JAPAN

Department of Plastic Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan

Toshiharu Minabe

Surgical breast reconstruction restores the shape of breasts affected by cancer and always follows mastectomy. Together with breast-conserving therapy, it is the foundation of the concept of oncoplastic breast surgery. There are two methods of breast reconstruction:artificial breast implantation;and autologous surgical flap construction. Both are covered by National Health Insurance in Japan. They are applicable in immediate or delayed breast reconstruction. Immediate reconstruction is preferable in which a tissue expander(s) is inserted in the subpectoral envelope in the first stage, which is then replaced with a silicone breast implant(s) or surgical flap(s) in the second stage. Although an “allergan crisis” occurred in Japan in 2019, implant-based reconstruction is now being resumed. The operative techniques for breast reconstruction are described and discussed. Breast reconstruction in hereditary breast and ovarian cancer patients and autologous fat grafting are also mentioned.


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