Breast reconstruction after a mastectomy

• When is breast reconstruction after a mastectomy performed?

Usually, the breast lift is performed immediately after the mastectomy. In this way, the woman immediately experiences the encouraging results without her psychology being negatively affected by the removal of a breast. However, sometimes, when there is a risk of spreading the disease, it is recommended to perform the operation later, after the evaluation of the current situation.

• Who is it for?

Breast cancer usually occurs in women in their fourth or fifth decade of life and less commonly in women under the age of forty. Once a woman has been diagnosed with breast cancer and is about to have it removed, she may be aiming for a simultaneous reconstruction procedure. The candidate must always be informed of the choice she has to have her breast reshaped anew.

• The first visit to the doctor’s office

Before the interested party visits the Plastic Surgeon, it is necessary to have the meeting of the Surgeon with the Plastic Surgeon to evaluate the current condition and the degree of breast reconstruction. After that, the interested party can be fully informed about the methods, the type of anesthesia and the timing of the operation. It is also very important to analyze any complications that may occur, as well as the expected results.

• What complications may occur?

After breast cancer surgery, the patient needs to start some anti-cancer treatment such as chemotherapy and radiotherapy. Breast reconstruction does not prevent the effect of these treatments nor does it contribute to the aggravation of the disease.

Complications that may occur are hematoma, inflammation or capsular contracture, redness of the scars, which can be soothed by the application of antibiotic cream, the presence of asymmetry or deformity, fluid accumulation (seroma), necrosis of skin flaps, the displacement of the implant or the body’s allergic reaction due to non-acceptance of the implants. All of them are treatable and in every case the Plastic Surgeon must be informed timely so that they can be controlled.

• Analysis of breast reconstruction methods

Breast reconstruction is a personalized operation that can be performed with three different surgical methods. After consultation with the Plastic Surgeon, the most suitable one will be selected for each case separately. Specifically, the methods are the following:

Reconstruction with expanders – silicone implants

The procedure is done in two different phases. In the first one, the expander is placed, which is an empty silicone insert sized and shaped appropriately, in which saline is gradually injected to stretch the overlying tissues. In the second phase, after a few months, the dilatator will be replaced by a regular silicone insert with a final operation of lesser importance.

Most women seem to prefer this type of reconstruction, because usually the postoperative course is shorter and there is no need for another operation to remove and transfer fat from another part of the body. The only complication that may occur is capsular contracture, as a reaction by the body from the incorporation of a foreign object.

Reconstruction with autologous tissues

According to this method, the tissues (flaps) that exist either in the lower abdomen together with a part of the rectus abdominis or in the back area, in the latissimus dorsi, are utilized, in order for the new breast to be formed in a natural way. For the removal of the tissues that exist in the abdominal area, an additional operation is performed, the abdominoplasty, which also improves the aesthetic image of the abdomen. To remove tissue from the broad back muscle, it is sometimes recommended to use silicone implants, as the skin in the back area is not enough to form a breast.

Although autologous tissue repair involves the simultaneous reconstruction of the breast and abdomen, it has some disadvantages. It is not suitable for underweight women and the patient undergoes a set of surgeries that involve the extension of the postoperative period and therefore the slower recovery of the body.

Reconstruction with autologous fat grafting

It is a modern method of breast reconstruction by utilizing fat cells from various parts of the body. Specifically, areas of the body such as the abdomen and buttocks, contain excess fat, which after being processed, is gradually injected into the affected area of ​​the breast. Autologous fat grafting is becoming more and more popular among women, as it does not use external formulations for breast shaping. The patient, however, needs to undergo a series of surgeries that strain the body and prolong its recovery period.

It is worth noting that breast reconstruction is often combined with the augmentation, reduction and lift of the other breast, having as a central guide the existence of symmetry and harmony in the body.

• How long does breast reconstruction surgery take and what kind of anesthesia is required?

The duration varies depending on the method that will be chosen each time. Usually for the reconstruction with expanders it takes 2 to 3 hours while for the reconstruction with autologous tissues or fat grafting requires 4+ hours. All breast reconstruction surgeries are performed using general anesthesia for greater safety of the patient and so that the body does not suffer from the range of surgeries it undergoes.

• Restoration of the nipple and nipple areola

After the reconstruction of the breast, it is advisable to renew the appointment after 3 to 5 months, after the result of the shape and size of the breast has been finalized, to create a nipple and nipple areola at the very top of the breast tissue.

For the restoration of the nipple can be performed:

• the placement of a prosthetic plastic nipple
• the use of a skin flap or graft

For the regeneration of the nipple areola the following can be performed:

• tattooing
• the use of a skin graft

• Results

The woman no longer needs to feel inferior about her body and that she falls behind other women. Modernized breast reconstruction methods offer a stable result and many benefits for both the woman’s psychosynthesis and her body. A new breast is created, firm and symmetrical with the rest of the body, so that it flatters the woman’s appearance and offers her confidence and mental uplift. The main thing, though, is that it promises a better quality of life.