Breast Reconstruction After Breast Cancer

Breast cancer is a social problem with increasing incidence. One out of every eight women has breast cancer worldwide. Early diagnosis and treatment saves life in breast cancer. In these patients, partial or complete removal of the breast (mastectomy) is performed for the treatment of breast cancer. Breast is important for women. It is one of the most important factors that make them feel like a woman. Cancer treatment and breast reconstruction may be applied concurrently.

The decision phase of mastectomy should necessarily consider the opinion of cosmetic surgery to obtain information regarding breast reconstruction.

When To Perform Reconstruction? 

Breast reconstruction may be performed concurrently, or lately in a second phase, as per the time of mastectomy. If cancer is diagnosed at early stages, it is more appropriate to perform concurrent surgeries, whereas breast reconstruction after the end of treatment for breast cancer would be more appropriate for advanced-stage breast cancer.

Before Surgery 

The method of surgery is selected by consensus by considering the body structure, breast size, and the requests of the patient as well as the doctor’s experience. Detailed information is obtained from the patient. Preoperative photographing is performed.

What Are The Methods Used For Breast Reconstruction? 

Its self tissue, silicon prosthesis, or their combination is preferred. None of the methods involves single session surgeries. It should be particularly explained to the patient that she will undergo multiple surgery sessions.

What Are Self-Tissues? 

Tissues from the abdomen (TRAM, DIEP), back (Latissimus Dorsi Muscle), inner thigh (TMG), and hip (SGAP) may be used for breasts. Abdominal tissue is the most preferred method.

This method is preferred if the abdominal tissue of the individual is acceptable. Abdominal tissue is the region that is most similar to the breast tissue.

Surgery 

General anesthesia is preferred for the breast reconstruction. The surgery may be bilateral as well as unilateral.

Surgeries using self-tissues take longer. Surgeries using abdominal tissue last for 5-8 hours, whereas surgeries using back tissue last for 2-4 hours. Tissue from the back may be removed together with the skin to reconstruct the breast, and also the muscle may be removed and prosthesis may be placed under it.

The duration of surgery is 1-2 hours for patients who will be operated using only prosthesis. In the first session tissue expander is placed. After the required expansion is achieved in the skin and muscle tissue, permanent breast prosthesis is placed.

Which Method Is More Appropriate For Me?

Patients with insufficient, weak abdominal tissue; patients with small breasts; patients with a history of abdominal surgery; patients for whom general anesthesia for a long time is inconvenient; and patients who do not want any scars in an additional part of their body are only candidates for breast reconstruction using silicone prosthesis.

Abdominal tissue, if sufficient, is the first choice in patients who are eligible for breast reconstruction with self-tissues. The back is considered as the second choice. If the tissue from the back is not sufficient, combination with prosthesis may be considered.

After Surgery 

Hospitalization takes 2-3 days in average. You will have an urinary catheter and drainage tubes inserted after the operation. Feeding usually begins on the following day. The patient is equipped with anti-embolism stockings. The patient is mobilized when the feeding begins. The urinary catheter is removed when the patient is mobilized. The drainage tubes can be removed when their intake is reduced. Your dressing may be opened 2-3 days after the discharge, and you will be allowed to take a bath. You may get back to work after 10-15 days but heavy activities should be avoided for 4-6 weeks.

Why Multiple Sessions Are Required? 

The two breasts may not be symmetrical after the first surgery. The second sessions are usually performed to make the opposite breast resemble the reconstructed breast. They are conducted by using breast enlargement, breast reduction, or breast lift. After symmetry is ensured, nipple is constructed in the 3rd session.

How Is Nipple Reconstructed? 

The procedure is performed under local anesthesia and clinic settings. Your own tissue on the reconstructed breast is folded with appropriate methods to create a 3-dimensional nipple. Then, the dark area around the nipple is created using tattooing methodology.

Side Effect 

There are certain risks of breast reconstruction. Tissue nutrition problems may occur after surgeries using self-tissues. This type of problems may require the repetition of the surgery.

Result 

Breast reconstruction will provide the individual with femininity again. Self-confidence and clubbiness in social environments are ensured.