Reconstructive surgery in Paris 16

Plastic surgery is not confined to aesthetics. A significant part of Dr Pulvermacker's practice consists in repairing: reconstructing a breast after cancer, correcting a congenital malformation, treating the sequelae of an accident or of a previous operation.

These procedures belong to the same specialty and use the same techniques as aesthetic surgery. It was in fact reconstructive surgery that gave rise to most of the procedures used today for aesthetic purposes.

Which procedures come under reconstructive surgery?

Breast reconstruction after mastectomy comes first. It may be immediate, during the same operation as the removal, or delayed, once treatment is complete. Several techniques exist: implant, a flap of tissue taken from the abdomen or the back, fat transfer — often in combination.

Poland syndrome, a congenital malformation combining the absence of a pectoral muscle with asymmetry of the chest and breast, is corrected by implant, flap or fat grafting depending on the form and the age.

To these are added the sequelae of injuries, unsightly or contracted scars, and corrections following a previous operation whose result was unsatisfactory.

Are these procedures reimbursed?

Breast reconstruction after cancer is covered by French health insurance, including symmetrisation of the opposite breast where this is necessary to the balance of the result. Poland syndrome and certain sequelae are also eligible for reimbursement, subject to conditions and prior authorisation.

The practice will help you put the application together. The distinction between what is reconstructive and what is aesthetic is set out from the first consultation, without ambiguity.

How does the process work?

The pathway is often longer than in aesthetic surgery, and is built in several stages. A complete breast reconstruction frequently extends over a year, with two or three successive operations: reconstruction of the volume, symmetrisation, then reconstruction of the nipple-areola complex.

Dr Pulvermacker works in liaison with the team following you — cancer surgeon, oncologist, radiotherapist — so that the operations fit around your treatment.

When should you consult?

It is never too early to ask the question. A consultation before a mastectomy makes it possible to consider immediate reconstruction, which avoids a period without a breast and often gives a more harmonious result.

Nor is it ever too late. Reconstruction remains possible several years after treatment, and many patients undertake it when they feel ready, not when it is offered to them.