Reconstruction of the breast after mastectomy for carcinoma.

Over a period of five years 20 primary and 60 secondary reconstructions after mastectomy for cancer were performed. The breast mound was created by a silicone implant. In cases of Halsted mastectomy an additional silicone implant was used for the missing anterior axillary fold in a secondary procedure. The reconstruction of the nipple--areola complex was also delayed for several weeks after the implantation. The graft was taken either from the opposite areola or from labia minora in bilateral cases. The remaining breast was adapted for symmetry. Subcutaneous or prophylactic total mastectomy was performed in the high risk group. The main late complication remained the capsular contracture. Local recurrences or general metastasis developed in 5 cases and received appropriate treatment.