Breast Reconstruction following Mastectomy
There are many choices for breast reconstruction in women undergoing breast cancer surgery. Reconstruction can be done either at the same time as mastectomy (immediate reconstruction) or when the woman wishes it at a later stage (delayed reconstruction)
|Duration||1 to 3 hours|
|Hospital Stay||1 to 3 nights|
|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:
- Reconstruction with implants
- Reconstruction with the patient’s tissues (autologous)
- 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 2nd 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.
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.
What is the right time for surgery?
Reconstructive surgery can be done either immediately, with mastectomy or later, whenever the patient wishes.
Are there benefits in immediate recovery?
This choice is a very personal decision. Studies show that there are psychological and physical benefits when reconstruction is done immediately, but if you do not feel confident and you have doubts, we can do the reconstruction after completing cancer treatment.
What kind of anaesthesia is required?
The surgery is under general anaesthesia and you will need to stay in the hospital for up to 3 nights.
How safe and effective is the surgery?
Over the years, microsurgical techniques have been greatly improved, making it even possible to succeed even in 1-2 mm vessels! The great supremacy of these interventions in patients completing all preoperative criteria is evidenced by many scientific studies published in recent years in reputable journals.