Breast Reconstruction
BREAST RECONSTRUCTION
What is meant by breast reconstruction?
Breast reconstruction is a surgical procedure which is done to recreate a new breast to replace the natural breast which was surgically removed due to cancer
What is the aim of breast reconstruction?
The main aim of breast reconstruction is the presence of an aesthetically pleasing new breast with a resemblance in shape and size to the other normal breast
How is breast reconstruction done?
Breast reconstruction can be done using silicone implants or by using muscles and fat from the body (especially the back and tummy)
Which patients are suitable for breast reconstruction?
- Most patients who will undergo mastectomy and don’t have advanced disease that has reached the skin are candidates for breast reconstruction
- Sometimes it is advisable to delay breast reconstruction in case of the presence of medical disorders that can increase the complication rate
When can breast reconstruction be done?
- Some patients may prefer to do the reconstruction at the same operation as removing the breast, while others prefer to delay breast reconstruction after finishing the treatment plan.
Immediate breast reconstruction
The main advantage of immediate breast reconstruction is the preservation of breast skin and possibly the nipple which aids in obtaining a reconstructed breast that resembles the other normal breast in shape and appearance
Advantages of immediate breast reconstruction:
(1) Avoiding the psychological depression of removing the breast
(2) Better cosmetic results
(3) Avoiding the need for further surgeries
(4) Lower surgery cost
Delayed breast reconstruction
- Breast reconstruction can be done in another operation after finishing treatment.
- Surgery to the other breast is usually needed to improve the symmetry in shape and size between both breasts
Advantages of delayed breast reconstruction:
(1) Avoiding the risk of treatment delay in case of complications
(2) Avoiding the side effects of radiotherapy
(3) Having more time to consider reconstruction options
What are the types of breast reconstruction?
There are 3 main types of breast reconstruction
(1) Breast reconstruction using silicone implants:
- Silicon implants can be inserted either above or below the pectoralis major muscle
- Sometimes a tissue expander can be inserted first and filled gradually with saline, then it can be exchanged for a permanent silicone implant after finishing radiotherapy
Advantages of breast reconstruction with silicone implants
Short operative time and hospital stay
Early return to normal activities
No other scars on the body
Disadvantages of breast reconstruction with silicone implants:
Higher complication rate in comparison to autologous reconstruction
May need further operations in the future
(2) Breast reconstruction using autologous tissue:
- Options include muscles of the back or abdomen
- Can be done using flaps of fatty tissue only from the abdomen or thighs
Advantages of autologous breast reconstruction :
Results look more natural than implant-based reconstruction.
Lower rate of complications than implant-based reconstruction
Results are more long-lasting than implant-based reconstruction
Usually, surgery on the other breast is not needed
Disadvantages of autologous breast reconstruction
Lengthy operation
May need a longer hospital stay than implant-based reconstruction
Needs a longer recovery time than implant-based reconstruction
The presence of additional scars on the body
How is the method of breast reconstruction decided?
There are many factors that decide the optimal method for breast reconstruction:
Tumor stage and whether radiotherapy is needed
Breast size
Body mass index
Presence of medical disorders such as diabetes and hypertension
Smoking
Patient’s desire
Does breast reconstruction increase the risk of reappearance of cancer?
Breast reconstruction doesn’t increase the risk of return of cancer, and follow-up with imaging tools can be done safely and accurately in the reconstructed breast
