What is breast reconstruction and when is it recommended?

Breast reconstruction is a procedure that restores a relatively normal appearance to the breasts. It is a surgery that is performed in different ways, depending on the conditions of each woman and the underlying pathology.

It is usually necessary after a mastectomy for cancer. Mastectomy is an operation that consists of removing one or both breasts in order to treat or prevent breast cancer pathology.

Unfortunately, breast cancer is one of the most common in women. In addition, breasts have a remarkable importance in a person's confidence and self-esteem. Therefore, in this article we explain everything you need to know about breast reconstruction and how it is performed.

Why is a breast reconstruction performed?

Breast reconstruction, as we have explained in the introduction, It is a procedure that is usually performed after a mastectomy. Mastectomy is an operation performed to treat or prevent breast cancer.

Reconstruction, according to the Spanish Society of Aesthetic and Reconstructive Plastic Surgery, improves the image and facilitates the emotional stability of women who have had to face a mastectomy. In addition, it allows the attitude towards the disease to be more positive and to have a less impact on daily life.

Breast reconstruction is intended to give the breast a natural appearance again. The idea is to fill in the gap or deformity that has been left after the mastectomy. It is also tried that both breasts are as similar as possible. In most cases, a nipple and areola are recreated to improve the result.

It is often thought that breast reconstruction can only be done with implants. However, thanks to advances in medicine, there are more and more ways to do it. In fact, concern and awareness about the importance of this issue has increased.

In many countries, such as Spain, reconstruction is part of the treatment of breast cancer. As soon as the diagnosis is made, the strategy is usually planned. Both oncologists and plastic surgeons collaborate to find the best solution and the safest and most aesthetic result.

When can breast reconstruction be performed?

Breast reconstruction can be done in almost all women who have undergone a mastectomy. However, this depends on the health conditions of said patient. Above all, the state of the cancer.

In some cases it is carried out during the same mastectomy operation. It is called immediate reconstruction. It has the benefit of requiring less income and interventions. In addition, it supposes less psychological impact for the patient.

However, it cannot always be done that way. As an article by the National Cancer Institute explains, it is essential to consider whether or not the woman will require radiotherapy.

The problem is that radiation therapy causes complications in the wound, such as difficulty in healing. However, there are cases where this is not considered a contraindication.

The type of cancer is also decisive. If the breast cancer is inflammatory, it is usually necessary to remove a lot of skin during the mastectomy. That is why it can be complex to rebuild at that time.

Breast cancer is a common pathology among women and the consequences are not only physical, but also psychological.

Importance of medical advice

Medical advice is of fundamental value in breast reconstruction. As we have seen in the previous sections, the strategy is usually agreed between different medical specialties.

The patient must understand what the treatment options are and assess them. There are many factors that influence the type of technique chosen for reconstruction. For example, age, breast size, and shape. Of course, everything must be valued individually.

In addition, the woman may prefer to choose the time of breast reconstruction. Some wish not to do it immediately.

On the other hand, it is important to note that plastic surgeons are very familiar with this type of intervention. Because, their criteria are usually objective and very indicative about the result.

Breast reconstruction options

Breast reconstruction can be performed using different techniques. As we have explained before, we try to find which one is the most suitable for each patient. In the following sections we explain the main options.

1. Reconstruction with implants

One of the most used options to reconstruct the breasts is to use breast implants. As explained by specialists from the Mayo Clinic, they are devices that help reshape the breast, giving it volume. They are usually filled with saline or silicone gel.

Implant placement is often done immediately, in the mastectomy itself. However, several subsequent interventions are often necessary. In some cases an expander is placed in that first operation.

The expander is a device that allows the skin of the chest to be stretched. In addition, it helps to make hole to place the prosthesis in a second moment. This instrument progressively increases the creation of this space.

When the desired expansion has been achieved, the implants are placed. Subsequently, surgery is usually performed to reconstruct the nipple and areola, which we will explain later.

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2. Reconstruction using own tissues

Breast reconstruction can be done using tissues from another part of the body. They are called grafts or flaps. As explained in an article by Breast Cancer, the tissue is obtained from areas such as the thighs, the belly or the buttocks. Once achieved, it is used to reshape the breasts.

As it is a fatty tissue from another part, it can gain or lose weight depending on how the woman's weight varies. The main benefit is that the result is usually more natural than implants.

The problem is that it leaves more scars. One in the place where the tissue was obtained and another in the chest itself. In addition, several interventions are usually necessary.

On the other hand, it is not recommended to perform this technique in women who have blood circulation problems. Nor if they are smokers, diabetics or they have some type of connective tissue pathology.

3. Posterior reconstruction of the nipple and areola

The nipple and areola are the most visible part of the breast. Breast reconstruction usually requires an intervention to repair these tissues. This makes the breasts look more like each other. An attempt is made to match them in position, shape and size.

The areola is usually tattooed by a specialist. The nipple, for its part, can come from the skin of another part of the body. If the other nipple is large and preserved, a small part may be removed and placed on the reconstructed breast.

There are even techniques to project a new nipple with the skin of that same breast. In general, this intervention is performed about 3 or 4 months after surgery.

Breast cancer treatment is long and includes different stages that must be respected.

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Limitations and complications of breast reconstruction

It is important to keep in mind that, with breast reconstruction, the desired results are not always achieved. It is a technique that can be complex. It depends on the situation you start from and what your chest was like before.

Also, like any other surgery, there can be complications. For example, infections, bruising, and delayed healing. In some cases seromas appear, rupture of the implants or even extrusion of the same.

Rebuilding requires recovery time

Breast reconstruction is a very useful surgery to try to make the breasts look natural, symmetrical and attractive again. In this way, it is achieved that the woman who has had to undergo a mastectomy has greater self-esteem and self-confidence.

Nevertheless, still a surgical procedure that can be complex. Like any other surgery, it requires a recovery time and many considerations before being performed. Therefore, it is essential to always follow the advice of the specialist.