Breast Reconstruction After Mastectomy
Breast cancer is one of the most common cancers in women worldwide, leading in mastectomy in certain cases.
It is absolutely normal that such an operation causes feelings of anxiety, loss of femininity, sexual rejection and, in general, an impact on self-esteem.
Breast reconstruction is a type of surgery that helps restore and even create a new breast. Women may choose to reconstruct their breasts on the same day of mastectomy surgery or in the near future. The advantage of simultaneous breast reconstruction with mastectomy is that women do not feel the loss of the breast.
There are many types of breast reconstruction processes, others more complicated and others simpler, which can be teamed in two basic surgical categories. It must also be noted that the reconstruction process might include more than one operation.
In the first category we use specialized tissue expanders and silicone implants, which are completely safe. The quality and variety of choices have improved a lot in recent years.
After a mastectomy, a special tissue expander is placed under the pectoralis major muscle and the rest of the muscles in the area that are under the breast. Then, through a tiny valve that is under the skin, the expander is filled with a salt-water solution at regular intervals in the doctor's office.
When the filler reaches the desired limit, the expander is replaced with an anatomical silicone implant. Some expanders remain permanently and in this case no second surgery is needed.
In the second category, we use the so-called myocutaneous flaps. That involves parts of the skin with abundant subcutaneous fat, which are transferred in a special way from another part of the body, e.g. back, abdomen and buttocks to the breasts. In this case, a silicone implant is usually not an option. Breast reconstruction is completed with the nipple reconstruction. Both the nipple and the areola reconstruction is carried out using special intradermal tattooing, using the same color as that of the opposite nipple so as to achieve more natural results.
Fat grafting techniques are now being applied with fat removed from other parts of the body. This can be enriched with stem cells and growth factors of the human body before it is transferred to the breasts.
The choice of the appropriate type of surgical method should be thoroughly discussed with the plastic surgeon before reaching any decision.
What to expect after surgery:
As breast reconstruction involves different stages and different techniques, your doctor will provide you with a detailed individual surgical plan and also offer guidance.
Risks and Side Effects
There is no evidence for breast cancer relapse after breast reconstruction while it also does not prevent postoperative chemotherapy or radiotherapy.
Possible postoperative complications are limited to the ones involving any surgery in the immediate postoperative period, such as hematoma, seroma, hypertrophic scar or wound dehiscence. In the case of breast reconstruction with implants, rejection of the implant usually occurs within the first weeks or capsular contraction during the healing process, but they are rare.
Benefits of reconstruction
Breast reconstruction cannot give a woman back her breast; however the benefits from the surgery are significant and obvious. The new breast that will be created will be much better and more natural than an external breast prosthesis attached to the bra.
The patient is greatly facilitated in her daily activities, as long as she does not risk losing her breast prosthesis, and she regains her self-confidence.
Therefore, breast reconstruction following mastectomy is considered to be part of the treatment for breast cancer.
Useful Information
- Returning to one’s everyday activities depends on the operation, the reconstruction surgical technique and other parameters, according to the individualized treatment plan that will be designed by the breast surgeon and the plastic surgeon.
- There is a broad range of surgical options that provide very satisfactory aesthetic and stable results for the majority of women.
- In many cases we need to intervene surgically to a healthy breast, in order to obtain the best possible symmetry between the two breasts. Thus, it is possible to proceed to a breast reduction in cases of large breasts; also, a reduction in healthy breasts may be required, whereas breast augmentation is performed in cases of saggy breasts. In cases of women with very small breasts, we achieve symmetry by inserting an implant.
- Most breast cancer patients are suitable for breast reconstruction performed together with a mastectomy as a one-stage operation. There are, however, cases where, for oncological reasons, breast reconstruction should be done at different times.
- However, it is advisable that a woman should be informed about the possibility of breast reconstruction when she is diagnosed with breast cancer and begins to discuss her treatment. At the same time, the breast surgeon may refer her to a plastic surgeon for more detailed information, in order to complete the entire pre-operative planning process.
