Breast Reconstruction following Mastectomy

	Duration	1 to 3 hours
	Anaesthesia	General Anaesthetic
	Hospital Stay	1 to 3 nights
	Downtime	2 weeks
	Final Result	6 months

Which technique is considered ideal?

There are several ways to restore the breast, but there is no doubt that microsurgical reconstruction using only tissues from our own body is the gold standard. However, there is no ideal technique. Each woman is a different case and she needs to decide with her doctor, after extensive discussion, what is the right reconstruction for her.

Immediate or delayed reconstruction?

More and more women are given the opportunity to initiate or begin recovery along with mastectomy. In these cases, the great advantage is the maintenance of the skin of the breast which gives us much better cosmetic results. Another important advantage is that women do not spend a moment without breast.

Almost always the first operation in reconstruction is very important, but it is often necessary to follow with other procedures. That’s why it’s important to have a complete plan from the beginning.

Delayed reconstruction means we start later to recreate breast. For some women, this may be the right choice for a variety of reasons, such as the need for radiotherapy, oncological reasons, or other health problems.

 Options and types of operations

There are 3 major categories / operation options:

1. Reconstruction with implants
2. Reconstruction with the patient’s tissues (autologous)
3. Reconstruction by combining its own tissues and implants

1) Use of implants and expanders. At the first operation, an expander is inserted under the chest muscles and gradually inflated (6-8 weeks) until a sufficient space for the placement of the silicone implants has developed after 3-4 months.

In some cases, the above procedure can be done in one stage / surgery together with mastectomy without the need for a 2^nd stage procedure.

In these cases we use specially adjustable implants / expanders or special matrices, biological or synthetic, which help us to create the new breast.

2) With autologous reconstruction, we use the patient’s own tissues from other parts of the body, such as back, abdomen, buttocks, in order to make the new breast in one stage.

3) In many cases where we use the tissue from the back, it is necessary to use a small implant because the tissue may not be enough to reconstruct the breast.

Choosing the right Reconstruction

The best method of reconstruction depends on many factors, such as the size and shape of the breast, if we reconstruct one or both the breasts, the available tissues from donor areas such as the abdomen, back, buttocks, thighs, and also if the woman is going to have or has undergone radiation therapy.

Final choice

Ultimately, the choice for reconstruction is a very personal decision. Studies show that there are psychological and physical benefits when reconstruction is done immediately (along with mastectomy), but if we are not sure and we have doubts, we can do it after completing cancer therapies.