The mammary reconstruction pursues the obtainment by diverse surgical techniques of a breast with the shape (volume) and consistency similar to the normal breast. The biggest reward for the acceptance of mastectomy as a consequence of cancer or of other disease is the breast reconstruction. The mammary reconstruction can be achieved by using the own patient’s tissues (flaps) or by using mammary implants, or a combination of both methods.
The intervention is possible immediately after the breast removing (mastectomy), during the same operation, the patient being exempted from the unpleasant experience of waking up with an amputated breast or from a late reconstruction carried out weeks, months or even years after mastectomy. The next important step is the election of the reconstruction procedure.
After the assessment of the health condition and of the individual features, the surgeon will explain which reconstructive possibility is the most appropriate according to the age, heath condition, anatomy, remnant tissues and expectations. The mammary reconstruction after mastectomy improves the self image and confidence. The mammary reconstruction usually implies more than an operation, the first one being achieved at the same time with the mastectomy.
Mammary reconstruction with implants
It is a procedure that supposes the existence of good quality tissues with minimum, supple scars. If the reconstruction with implant is recommended, you should be informed about the implant which will be used. This reconstruction procedure can be achieved either using directly the implant or using a tissue expander which stretches the tissues after a mammary implant. The tissue expander is a temporary implant that is swollen gradually with saline in a couple of weeks to stretch slowly the skin. When the skin is sufficiently stretched, the expander is removed and replaced by a permanent implant. This secondary surgical time for removal and change of the expander could be avoided by using a permanent expander implant that can be adjusted postoperatively.
Reconstruction with flaps
The mammary reconstruction with flaps is a method that uses self tissues from areas where they are in excess (abdomen, buttocks, hip, back) in order to create a new breast. This tissue which is moved from an area to another one is called flap. The flap can be pediculated, being moved to the breast through a tunnel carried out under the skin, keeping the vascularization from the donor area or can be transported freely through vascular anastomosis with the vessels of the receiving area. Every of these procedures can be associated with a mammary implant if the transferred tissue does not offer a sufficient volume. For symmetry obtainment it is possible to be required the reduction or the augmentation of the contralateral breast.
One or two weeks after the operation there is a discomfort which can be controlled with medicines. According to the reconstruction procedure and the post-operative evolution, you will be able to leave the Clinic after 2 to 7 days. The reconstruction operation requires drain tubes in order to prevent the blood accumulation in the surgery area and they are removed in the first days after surgery.
Risks and complications
Theoretically, every woman that has lost a breast can use the reconstruction surgery, but it should be known that it is accompanied by risks and can be associated with specific complications. They can generally occur complications that are common for all the surgical interventions such as bleeding, hematoma, seroma, infection, necrosis, unaesthetic scars or problems associated with the anesthesia but these are relatively rare and can be reduced through a preoperative assessment and a correct technique.