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What to Expect from Breast Reconstruction Surgery

What to Expect from Breast Reconstruction Surgery

Breasts have a very strong symbolic representation for women, as they are directly related to femininity, self-esteem, sexuality and motherhood, factors that are closely present in the female universe. A mastectomy - surgery for total or partial removal of the breast to treat the patient with breast cancer - can affect a woman's life psychologically and emotionally, in that sense, the surgical procedure for breast reconstruction becomes fundamental. Breast reconstruction is the surgery that will restore the shape, appearance and size of the breast and is directly related to the type of mastectomy surgery that was performed. Although in some cases it is not possible to perform the mastectomy and reconstruction in the same surgery, it is usual to do it simultaneously. Many factors interfere with this decision, such as the size of the cancer, type of tumor, whether chemotherapy or radiotherapy will be needed, and the patient's clinical condition.

How Breast Reconstruction Is Performed

In general, reconstruction of breast in more than one surgical time. Most cases require a second intervention and others, a third, until a satisfactory shape and appearance is achieved for the breast. The first surgical step is of great proportions, after which one or two minor steps are done. Although reconstruction is a large surgery, more aggressive than other plastic surgeries in the breasts, the patient's recovery is normal and can be compared to breast reduction surgery.

Types of breast reconstruction that can be done

In cases where a large part of the skin and fat were preserved in the mastectomy, the plastic surgeon could only use a silicone prosthesis for reconstruction, achieving a satisfactory result. In women, in whom a greater amount of skin and fat has been removed (but not all), there is still a little coverage, but there is not enough space for a common prosthesis, so the surgeon implants a prosthesis with an expander. This device acts as if it were a bladder, it is an empty prosthesis that is being filled gradually and consequently increases the volume of the skin, stretching it. When the breast reaches the appropriate volume, the expander is removed and gives rise to a definitive silicone prosthesis.

In situations where an even greater amount of fat and skin - including often the areola and nipple - has been removed reconstruction has to be done through a flap, a part of the skin of another region of the body, which is used to cover the place where there is scarcity of tissues. For this type of reconstruction there are several techniques, one of them is made with the skin of the abdomen, where the surgeon does an abdomen (abdominoplasty) in the patient, and removes the excess skin that it has below the navel. In this way the skin and fat removed from the belly give shape and size to the restored breast. Similarly, the skin of the back of the large dorsal region, which is located above the waistline, may be used.

It is possible to associate the use of abdominal or large dorsal flap with the silicone prosthesis. When the abdomen is made and the skin strip of the abdomen goes to the breast, there is usually a large volume of fat, so it is rare to use the prosthesis, since when the flap of the back is used, it is usually necessary the placement of the prosthesis.

Options that the patient has

In reconstructive surgery the patient can choose to correct or increase the breast that did not undergo mastectomy. For example, there are patients who have a breast with gigantomastia on one side, ie a large, sagging breast and on the other side have performed the mastectomy. In this case, the surgery can be done symmetrization, which associates the reconstruction of one breast and the reduction with elevation of the other. In situations where the patient has a family history of breast cancer, the mastologist, together with the plastic surgeon, may choose to remove the mammary gland from the breast that has no tumors, with the intention of a prophylactic measure, have cancer also in this breast. The plastic surgeon does the surgery and the patient gets two silicone implants in place of the mammary glands.The final result of breast reconstruction surgery can be very satisfactory, minimizing the physical and psychological impact of the patient, however, the breast will not remain as it was before. It is possible to compare its result with that of a reduction of breasts, in which the breast gets a good result, however there are the presence of scars. The size of the scar depends basically on the surgery that was done to remove the cancer. If it is necessary to use skin flaps in the reconstruction, there will always be scars on the breast. They are large surgeries and the scars can be round, square, depending on the absence of skin that was there.


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