Breast Surgery. for Reconstructive. Center of Excellence. city center of Düsseldorf. You will find us in the

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1 You will find us in the city center of Düsseldorf Rathaus Rhein Steinstraße Berger Allee Poststraße Bastionstraße Kasernenstraße Breite Straße Königsallee Grünstraße Berliner Allee Königsallee 88 Graf-Adolf-Platz Haroldstraße Schwanenspiegel Graf-Adolf-Straße Adersstraße Kaiserteich Luisenstraße Center of Excellence in Reconstructive Breast Surgery:» aesthetic and reconstructive breast surgery» revisional surgery after complications» second opinion Center of Excellence for Reconstructive Breast Surgery after prophylactic or tumor associated mastectomies Königsallee Düsseldorf T info@breast-and-body.com

2 Reconstructive Breast Surgery Breast cancer is still the most common cancer in women and unfortunately it might result in ablation of the breast in about 30% of these patients. In addition to this, an increased number of women are being diagnosed with BRCA (Breast Cancer) 1-3 genetic mutation. This genetic mutation has a high risk of developing breast cancer. In order to reduce the lifetime risk of developing breast cancer, many patients will undergo a prophylactic subcutaneous mastectomy. These patients tend to be young women who need a definitive, long lasting solution for primary breast reconstruction. It is always a special moment for me, to see a patient with a relieved smile after waking up from the successful reconstruction of her breast, knowing that she has suffered from her breast cancer disease for a long time. These are the moments, when I get my motivation to work as a Plastic Surgeon.. Prof. Dr. med. Christoph Andree Further, in most cases of local recurrences after breast-conserving surgery, surgeons have to deal with irradiated tissue that is unsuitable for reconstruction with an implant. In view of this, there has been an increasing demand for an individualized breast reconstruction. Today skin sparing mastectomies could be performed, leaving the entire breast skin and the nipple areola complex intact without compromising the oncologic outcome. Today the women can decide between a primary or a secondary reconstruction with either implants or autologous tissue. Before surgery, women need to get all the information allowing them to choose for a personal, individualized treatment plan for reconstructive surgery. The Center of Excellence for reconstructive surgery in Düsseldorf will provide the women a secure and personalized treatment plan.

3 A good Reconstruction of the Breast will improve your Quality of Life. The decision what kind of reconstruction suits you in your special situation, you will need to get an appointment in our Center of Excellence for reconstructive surgery. We will inform you in a nice atmosphere about all the new reconstructive techniques, including free perforator flaps, knowing that a good result will improve your Quality of Life and your body integrity, making you feel secure about the future surgery. Immediate breast reconstruction with implants or autologous tissue after skin sparing mastectomies is for the most patients the first choice of reconstruction. Implant based surgery is most common, however if there will be a radiation of the breast or if the patient would like to have a natural, warm and long lasting result, she definitely should consider the new techniques of autologous breast reconstruction. Today there are many options to reconstruct the breast with autologous tissue harvesting the tissue either from the lower abdomen (DIEP flap), from the buttocks (S-GAP or I-GAP flap) or from the inner side of the upper limp (TMG flap). The tissue will be harvested without sacrificing the muscle, just taking the fat and the overlying skin. The tissue need to be connected with the vessels from the chest wall using a microscope and microsurgical instruments. This is a very tedious and skilled operation, which in our hands is safe and fast due to an enormous and specialized surgical experience. We teach many Plastic Surgeons from all over the world and publish our results in wellknown scientific journals and international meetings.

4 Well-known Techniques for Autologous Breast Reconstruction 1. DIEP flap Tissue from the lower abdomen 2. S-GAP or I-GAP flaps Tissue from the buttocks If there will be not enough tissue from the abdomen or the patient wish the harvest from the buttocks, this is good alternative leaving a hidden scar in the underwear. Reconstruction for one or two breasts can be performed and the operation time will be around 4 hours. The DIEP flap is the preferred choice for Autologous reconstruction. An oval skin and fat flap is harvested from the lower abdomen, leaving the rectus muscle intact. The tissue is then connected to the vessels from the chest wall with microsurgical instruments and either one or two breasts will be nicely reconstructed. The lower abdomen is closed like an aesthetic abdominoplasty with nice and tight skin. The operation time will be around 3-4 hours with a short recovering time. Discharge from the hospital will be after 6-8 days. 3. TMG flap Tissue from the inner side of the upper limb If the patient has tissue at the inner side of the upper limp and would like to have a tight upper leg, an ideal harvest of tissue is the TMG flap. One or two breast can be reconstructed and the operation time will be around 4 hours.

5 Breast Reconstruction with Implants Immediate breast reconstruction with implants is very common in Europe. It is a fast and safe procedure after skin sparing mastectomies with satisfied results. The position of the implant will be under the pectoralis muscle and supported with meshes. Implants are form stable with a high cohesive silicon gel and in either anatomic or round shaped appearance available. Today, Implants are very safe, however it will be always a foreign body for the women and requiring another procedure because of capsular contracture after years. If radiation therapy is necessary, an implant reconstruction should be reconsidered because of the high incidence of postoperative complications. Therefor an individualized personal treatment plan for each woman is necessary.

6 Center of Excellence for Reconstructive Breast Surgery Internationally well-known trained Plastic Surgeons for Microsurgical Reconstruction Our Center of Excellence for reconstructive breast surgery at the Sana Hospital in Düsseldorf is wellknown for microsurgical reconstruction of the breast in Europe. Patients from all over the world will travel to our department receiving a high standardized and aesthetically appealing breast reconstruction with the highest standards in medical treatment. Our performance has been published in scientific journals and in international meetings. Our aim is to personalize the treatment plan for each patient and to perform a safe and aesthetical excellent reconstruction of the breast to improve the Quality of Life after breast cancer.