Reconstructive surgery of the breast

Breast reconstruction, although an intervention not frequently used in Romania for financial reasons, is vital for patients who were diagnosed with cancer, but also for women who are suffering from various congenital disorders or are simply not satisfied with the result of previous cosmetic surgery.

Informations about the medical procedure

Breast reconstruction restores self-esteem to patients, it makes them feel as women again, especially those who have survived cancer. A mastectomy that is not followed by breast reconstruction surgery causes psychological trauma. However, after such an operation, women can resume their normal life without wearing the stigma of a physical disability.

Breast reconstruction surgery can be performed either with the help of a special prosthetic or with own tissues. Although very often used, the reconstruction procedure with breast prosthetics can be done by using directly an implant or a special expander designed for tissue (tissular). This is placed under the chest muscles, it is gradually inflated with saline until the skin is sufficiently stretched and the expander can be replaced with a permanent implant.

The second reconstruction technique, with own tissues, is performed by lipofilling or free microsurgical transfer of tissues, taken from areas where they are in excess (abdomen – DIEP, buttocks – SGAP, internal thigh – TMG), in order to create a new breast. The flap is grafted in the breast area by micro surgically connecting the mammary or the armpit vessels.

In both cases, the intervention is followed by reconstruction of the areola and mammila, after the reconstructed has breast healed and stabilized in its final form and position. First the mammila is reconstructed, then the areola, through a skin graft (harvested from an area where the skin is darker) or an artistic tattoo. For the end result to be natural and harmonious, the plastic surgeon must possess both reconstructive surgery skills and thorough knowledge of cosmetic surgery.

Breast reconstruction surgery is not a whim, it is a necessity for a woman who has gone through the drama of cancer. Financial considerations should not be the criterion by which a woman takes on or not such an operation, therefore, the State is obliged to ensure that the right to a normal life is respected also for patients who underwent mastectomy.

Consultation

The surgeon will begin by assessing the health of the patient, subsequently explaining the reconstructive techniques available and the most suitable method for each case. Post-mastectomy breast reconstruction removes a disability and restores confidence in women, but it is important for them to expect a radical improvement in the appearance of the breast, rather then perfection.

Duration

Varies between one and seven hours.

Anesthesia

The operation is performed under general anesthesia.

Hospitalization

Depending on the reconstruction procedure used and the postoperative course of the patient, they may be discharged after two or ten days.

Side effects and surgical risks

One to two weeks after surgery, the patient may have a sensation of fatigue and may also feel a discomfort, which can however be controlled by medication. Arm movement, on the side with the operated breast may be more difficult. Also, there is the risk of hematoma or seroma formation – they can be prevented by proper surgical technique - as well as of unaesthetic scarring or breakage of the implant, if the surgeon opted for reconstruction with silicone implants (the situation is very rare).

After surgery advice

The patient will receive a bustier which she will wear for eight weeks, and after healing of the incisions, she will massage daily the reconstructed breast skin with body oil or a cream. This artifice will keep the skin supple, resulting in a nice texture. Bath in the tub is prohibited for the first weeks, so is intense physical effort. Smokers should know that nicotine jeopardizes the vascularization of tissues and delays healing, so it is necessary to give up cigarettes for at least three weeks before and after surgery.

Contraindications

The operation can not be performed when patients show positive margins on the histopathological exam.

Recovery

It can last from seven days to several weeks, depending on the procedure performed.