Introduction

Every year cases of breast cancer worldwide increase. According to the Tandon Clinic cases of breast cancer increased by 30% between 2012 and 2018, registering 32,825 affected in the past year. This figure puts breast cancer in second in incidence in Spain over prostate cancer. 

For this reason , many women must undergo treatments such as mastectomy , leaving resulted in changes in physical appearance such as weight loss or gain, scars and even loss of the breast. The latter brings about various physical and psychological problems, so experts recommend undergoing breast reconstruction surgery for the patient to return to their quality of life and can feel comfortable with your body and appearance.

What is breast reconstruction?

The Tandon Clinic explains that breast reconstruction main objective is to restore the shape, symmetry and size of the breast after a mastectomy, lumpectomy or lumpectomy. 

After these surgeries may even be for removing benign tumors or infectious origin, the breast may remain as sequelae full natural breast removal, subsidence, scars and non-symmetrical shapes, or.

For this purpose, they can be used various surgical plastic surgery techniques among which are:

  1. Fat Grafting
  2. expanders and breast implants put added
  3. Tissue flaps by the patient’s own

In addition, Dr. Eduardo Simon mentions that a breast reconstruction surgery can be performed at the time of cancer surgery, which is known as immediate reconstruction or may be performed after completion of treatment and radiotherapy, which is known as delayed reconstruction.

Likewise, the specialist mentioned that techniques used in each case will depend on many factors as the type of incision, the weight, the size of the contralateral breast and expectations of the patient.

How do I know if I am a candidate for breast reconstruction surgery?

The breast reconstruction surgery is indicated for patients who have undergone the removal of the breast after mastectomy, lumpectomy or lumpectomy and thus the presence of physical effects such as absence of breast, sagging or scars in the chest area, among other aftermath.

It is also indicated for patients which were not developed one breast or has some genetic malformation.

On the other hand, experts recommend that this surgery patients should have a good general health. It is not recommended for patients with diabetes, hypertension, smoking or obesity, since the risks of this operation are increased during surgery or during the healing process.

How to choose my plastic surgeon?

Specialists leading organization of board- certified plastic surgeons in the world, ISAPS, explains that the most important thing is that the surgeon is qualified by some entity whether it is certified.

That will ensure the patient is an experienced plastic surgeon with the right technical skills, which will give the patient a safe treatment, using the latest technology, which will lead to satisfactory results, very in line with expectations.

On the other hand, experts recommend the patient information on the various centers and clinics where they perform surgery, reading comments and reviews about the experiences of other patients, which will provide a much clearer picture of where landscape and who made the operation.

Finally, Tandon clinic , Explains that a good formula to choose a plastic surgeon performs the surgery is to choose two or three doctors inspire confidence to the patient . After that, it is very important that the person is going to visit them and tell in detail what you need and what expectations you have with the intervention. As a second step it is important to listen to the surgeons, understand what techniques are used, the risks associated with surgery and postoperative care. Accordingly, you should choose who felt more comfortable, who will generated more confidence to who is in charge of the whole process.

How is the first visit to the plastic surgeon?

For the first appointment with the surgeon who have chosen to be in charge of our case of breast reconstruction.

In the first instance it is important that the patient take the full clinical history and as detailed as possible, together with the list of all medications (both natural and otherwise) that consumes daily, in order that the doctor can analyze in detail your situation medical.

On the other hand, the specialist advised to go together , because as it is a first consultation, there is much information to retain and memorize, so always help someone else, be quite useful. It is also very good to carry a notebook and take note of the techniques to be used or the key points of the conversation for later review.

In addition, and l surgeon will evaluate the patient and suggest the best treatment based diagnosis , medical history, among other factors such as weight, breast size, etc.

On the other hand, Tandon Clinic advised to be prepared with all you score freely expressing doubts . I wish to put on a first date, expectations we have with the operation and further on an issue that has not yet clear.

It is important to consider the reconstruction of the nipple and areola.

How breast reconstruction performed?

There are 4 types of techniques or procedures for breast reconstruction as each case, among which are:

  1. Breast reconstruction surgery by Flaps:  Specialists  Tandon Clinic Explain that this is one of the most complete procedures, since the body’s own tissues are used. This intervention can be performed while a mastectomy immediate reconstruction surgery or, you can do later, in a delayed reconstruction. In all techniques used general anesthesia. On the other hand, it is possible that this intervention more surgeries are needed for a reconstruction of the nipple or leave as natural and symmetrical breast as possible. With this technique, the surgeon performs a transfer of muscle, skin, blood vessels and fat from one area of ​​the body to the chest to reconstruct the breast. Usually, for this technique two methods are used; pedicle flap surgery,

Also,  there are various types of surgery with flaps.  Among them they are:

    • Abdomen (TRAM):  here the surgeon removes tissue, skin and muscle of the abdomen. It may be for pedicle flaps or free flaps. In the first, the surgeon removes the most important muscle of the abdomen, called straight. In the second the surgeon only shows part of the muscle, allowing the patientretain strength in that area.
    • Abdomen (DIEP):  With this procedure only skin and belly fat is removed and the patient retains most force capacity in that area, which means a great advantage.
    • Abdomen (SIEA):  this technique uses skin SIEA (SIEA). The same abdominal tissue is used, but with the advantage that this skin is not dependent on blood vessels so deep.
    • Back (latissimus dorsi flap):  in this technique, the surgeon takes skin and muscles of the upper back and is recommended for patients with small or medium breasts.
    • Buttocks (gluteus flap)  of the gluteal tissue is taken to reconstruct the breast and is recommended for women who do not have enough tissue in the back or abdomen.
    • Inner thigh (TUG):  fat and muscle of the lower buttocks area to the inner thigh is transferred. It is a fairly new technique and is recommended for patients with medium to small breasts.
  2. Breast Implants: By using this technique, the surgeon makes breast implants, that are silicone in order to mold the breasts and leave as natural as possible and asymmetric. This procedure can also be performed at the time of mastectomy is performed, but the surgeon will decide when the reconstruction can proceed. It is important to note that this technique several operations are required. On the other hand, if the patient requires radiation therapy after mastectomy, this procedure is not recommended.
  3. Breast implant reconstruction and expanders : after mastectomy, the surgeon inserts a temporary prosthesis called an expander and a saline solution under the skin and pectoral muscle. This, for several weeks to prepare the skin and leave enough space in which the surgeon will insert the final silicone prosthesis .
  4. Fat Grafting: This technique is the least common, but it is very simple. It is to improve breast shape and give volume through fat grafting, which visibly improves the elasticity and appearance of the breast. The patient should be about 4 interventions during 3 months to achieve optimal results.

When a patient a breast construction is usually also requires a nipple reconstruction, to make it as natural and harmonious as possible. Thus the surgeon reconstructs the nipple and may comprise a tattoo to define the dark area around the nipple.

How to prepare for breast reconstruction surgery?

Experts recommend not taking aspirin or any medication (acetylsalicylic acid) for two weeks before and after surgery. Remember not to smoke or drink alcohol, because it delays the healing process.

On the other hand, it is important to go with comfortable clothing and loose the day of surgery and for discharge clinic. Avoid shaving or shave the day before or the day of surgery because it is better to do at least 3 days before.

What are the main advantages of breast reconstruction surgery?

Among the main benefits we can highlight:

  •  The patient regains their quality of life
  • Increased self-esteem and confidence
  • natural and very satisfactory results
  • lasting results

 

What are the main complications and risks of breast reconstruction?

Like any surgery, breast reconstruction can have complications of various types such as:

  • Possible infection: If you notice you have pus drainage, fever or discoloration and redness in the area of the operation, you should immediately consult your surgeon will most likely prescribe you antibiotics.
  • Excessive blood loss: You should also consult your surgeon if you notice a big loss of blood in the area of the operation.
  • Problems in the implant: A common problem is capsular contracture is generated. This is when the scar is around the implant tightens. Usually in these cases the surgeon changes the implant new one.
  • Flaps problem : The main complication that can occur in these cases is the loss of strength in the area where the flap was removed. There is also a risk of clotting by various blood vessels involved and were transferred.
  • Tissue death (necrosis) due to interruption of blood supply.
  • Hernia or weakness in the abdominal wall, from which the flap was removed.

What are the results of breast reconstruction?

For specialists Tandon Clinic , the main expected results are: 

  • Improves visibly body image
  • Improved self-esteem
  • It provides a better symmetry of the breasts to look natural and look like
  • It helps to mitigate the physical memories of the disease
  • Most are long-term results

Frequent questions

  •  Is there any risk if I make me a second breast reconstruction after two years of disagreement on results? The Tandon Clinic , explains that depend on the particular case of each patient, so it is essential to attend the consultation of a specialist who will assess why the deformity. If the prosthesis is displaced in the case of an implant or the technique to be used must be modified. 
  •  If I performed a mastectomy, breast reconstruction is necessary? It is highly recommended for patients who have done a mastectomy breast reconstruction is performed because it will have a very positive effect on the physical and psychological level.
  •  How long should I wait after chemotherapy and / or radiation therapy to rebuild my breast? Experts Tandon Clinic mention that recommend waiting a period of 3 months after the end of chemotherapy, and 6 months after radiotherapy.
  •  Do all patients are a candidate for surgery? No. There are patients who for health reasons can not be operated or there are some who will not get the results they want, as explained in the Tandon Clinic.
  • When can I return to work? It depends on each case, but usually a week of discharge, as mentioned in the Tandon Clinic.