[Recent advances in breast reconstruction].

In ten years, breast reconstruction has become a routine procedure. It is now well established that it does not influence breast cancer. Techniques have been refined, and even use the excess of skin and fat of the lower abdomen to reconstruct a breast without a prosthesis. The indications of reconstruction remain mainly psychological, and it is difficult to predict which patients will be candidates for a reconstructive procedure after their mastectomy. Immediate reconstruction is more often proposed since expansion prostheses are used. It should however be reserved to highly selected cases. An unusual type of reconstruction is now becoming more common, after conservative treatment of breast cancer. It is asked by patients who are disappointed by the aspect of their breast after partial mastectomy and irradiation. Reconstructive surgery is specially difficult in these cases, and may induce more complications than usual reconstruction. It is therefore important that surgeons keep such procedures for cases in which they have good chances to leave a breast with satisfactory volume, consistency and aspect.