History of breast reconstruction
Like many reconstructive procedures, some type of breast reconstruction has been performed for hundreds of years. Medical and surgical advances have brought about significant innovations in the field of breast reconstruction, leading to the development of breast reconstruction techniques that can completely recreate natural-looking breasts.
HISTORY OF BREAST CANCER
Documented cases of breast cancer date back to 6000 BC, but until the modern era the treatment has often been worse than the disease. If Cleopatra had had breast cancer, the ancient Egyptian doctors would’ve cauterized her breast in hopes of burning out the disease. As late as the 18th century a woman may have suffered through a mastectomy in which she was tied to a chair and her breast was removed without anesthesia. Often she survived the surgery only to die from the disease.
The situation improved in the 19th century with the development of anesthesia. Dr. William Halsted lead the way in making radical mastectomy the most effective treatment for breast cancer, but as other breast cancer surgeons started performing the procedure their lack of information, expertise and experience with breast cancer and breast reconstruction left numerous women disfigured.
The rise of feminism in the 1960s and 1970s gave way to significant changes in the treatment of breast cancer and methods of mastectomy. Modified radical mastectomy (total mastectomy with axillary lymph node dissection) was perfected. Breast conservation therapy consisting of lumpectomy, sentinel lymph node biopsy and radiation was developed. Breast cancer reconstruction was finally a viable choice.
HISTORY OF BREAST IMPLANTS
Breast reconstruction techniques saw rapid improvement in the mid-20th century, coinciding with the development of silicone breast implants.
In 1962, after the first silicone breast implant procedure for cosmetic breast enlargement was performed, a number of companies began designing implants to use in both breast enlargement and reconstruction procedures. By 1992, the popularity of silicone implants – said to be more natural in appearance and feel compared to their saline counterparts – bred complaints from some patients that the silicone had leaked out of the implant and caused painful scarring and disfigurement. As a consequence, the U.S. Food and Drug Administration pulled silicone breast implants from the market for further study. However, after a 14-year moratorium on silicone breast implants, the FDA approved them for use in 2006 after finding them to be safe and effective for breast enhancement procedures, as well as breast reconstruction procedures for patients of any age.
HISTORY OF FLAP RECONSTRUCTION TECHNIQUES
Over the years, a number of different breast reconstruction techniques have been tested, applied and performed, including tissue reconstruction, or flap surgery. This technique uses the woman’s own natural tissue and skin, rather than a breast implant, to form a new breast.
Early tissue reconstruction techniques such as the Latissimus Dorsi Flap reconstruction have been in use since the 1970s. In 1982, the first TRAM flap procedure was performed. It remains one of the most popular breast reconstruction techniques.