الفهرس 
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Abstract
Breast cancer is unfortunately a common disease affecting millions of women, often at a relatively young age.
Reconstruction following mastectomy offers women an opportunity to mollify some of the emotional and aesthetic effects of this devastating disease. Although varying techniques of alloplastic and autologous techniques are available, all strive to achieve the same goal: the satisfactory reformation of a breast mound that appears as natural as possible without clothing and at the very least is normal in appearance under clothing.
Implant-based breast reconstruction has evolved through advances in mastectomy and reconstruction techniques to offer excellent outcomes with both prepectoral and subpectoral implant placement. Proper patient selection and surgical technique are key for optimizing outcomes and minimizing complications regardless of implant location.
Following broad introduction of immediate implant-based breast reconstruction (IBBR) in clinical practice in the late 1970s, the implants were originally positioned above the pectoralis major muscle after NSM and SSM to reconstruct the breast in its natural pocket (prepectoral positioning). Initially, however, this technique was associated with unacceptably high rates of complications, including implant loss due to skin necrosis or infection, implant exposure and capsular contracture.
To decrease the risk of complications, the procedure has been modified to position the implant below the pectoralis major muscle. While two-staged IBBR (initial tissue expander placement later exchanged to implant) has been the traditional approach, one-stage direct implant placement has recently become standard care in many European countries.
Compared with the subpectoral technique, the prepectoral positioning has been suggested to reduce discomfort with no differences in overall complication rates.
The aim of this study was evaluation of immediate breast reconstruction using silicone implant regarding: advantage, disadvantage, complications and aesthetic outcomes.
This study was conducted on 19 patients at General Surgery Department, Menoufia University and Patients randomly selected.
The main results of the study revealed that: The study included 19 patients; their age ranged between 34-67 years with mean value of 48.421 ± 9.465 years and their BMI ranged between 26-31 with mean value of 28.647 ± 1.431. Among our included patients 36.8% needed neoadjuvant chemotherapy. Average size of final implant ranged between 340 – 800 gram with average of 553.158 ± 130.599 gram. Among our studied patients none of them developed local recurrence after breast reconstruction while isolated regional lymph node metastasis and distant metastases were developed in 5.3% (1 Case). Among our studied patients breast volume decreased after reconstruction in 52.6% and increased in 47.4%. The mean value of alveolar size before reconstruction was 5.295 ± 0.321 cm and after construction it was 3.411 ± 0.328 cm.
Among our studied patients Seroma and Minor infection were developed in 31.6% for each followed by lack of symmetry in 26.3 than unacceptable scar, pain in 21.1% for each then areola Depigmentation, restricted arm movement, numbness or tingling in 15.8% for each then hematoma and delayed wound healing in 10.5% for each. Other complications included failure (loss of prosthesis), return to theatre for wound dehiscence, arm cellulitis, and hypertrophic scar were developed in 5.3% for each. There was a significant improvement of EORTC Quality of Life Questionnaire C30 (QLQ‐ C30) 6 month after operation than before operation in the studied population.
Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion.