What is Breast Reconstruction and When is it Recommended?

The practice of breast reconstruction is an increasingly frequent decision in oncologic patients. In this article, we'll take a look at the indications and the existing approaches to this procedure.
What is Breast Reconstruction and When is it Recommended?

Last update: 06 July, 2021

Breast reconstruction is a procedure that restores a relatively normal appearance to the breasts. It’s a surgery that doctors perform in different ways, depending on the conditions of each woman and the underlying health issue.

It’s usually necessary after a mastectomy for cancer. A mastectomy is an operation that consists of removing one or both breasts in order to treat or prevent breast cancer.

Unfortunately, breast cancer is one of the most common cancers in women. In addition, breasts have a remarkable importance in a person’s confidence and self-esteem.

Therefore, in this article, we’ll explain everything you need to know about breast reconstruction and how specialists perform it.

Why do people get breast reconstruction?

Breast reconstruction, as we explained in the introduction, is a procedure that doctors usually perform after a mastectomy. Mastectomy is an operation performed to treat or prevent breast cancer.

Reconstruction, according to the Spanish Society of Aesthetic and Reconstructive Plastic Surgery, improves the image and facilitates the emotional stability of the woman who has had to face a mastectomy. In addition, it allows the attitude towards the disease to be more positive and to have a lesser impact on daily life.

The aim of breast reconstruction is to restore the natural appearance of the breast. The idea is to fill the gap or deformity left after the mastectomy. It’s also intended that both breasts are as similar as possible. In most cases a nipple and areola are recreated to improve the result.

There’s often a tendency to think that breast reconstruction can only be performed with implants. However, thanks to advances in medicine there are more and more ways to do it. In fact, concern and awareness about the importance of this issue has increased.

In many countries, such as Spain, reconstruction is part of breast cancer treatment. As soon as the diagnosis is made, the strategy is usually planned. Both oncologists and plastic surgeons work together to find the best solution and the most aesthetic and safe result.

When can you get breast reconstruction?

Breast reconstruction can be performed in almost all women who have undergone mastectomy. However, this depends on the health conditions of the patient. Above all, the state of the cancer.

In some cases, specialists perform it during the mastectomy operation itself. It’s called immediate reconstruction. It has the benefit of requiring less income and interventions. It also has less psychological impact on the patient.

However, this isn’t always the case. As an article from the National Cancer Institute explains, it’s essential to consider whether or not the woman will require radiotherapy.

The problem is that radiotherapy causes complications in the wound, such as difficulty in healing. However, there are cases in which this isn’t considered a contraindication.

The type of cancer is also a determining factor. If the breast cancer is of the inflammatory type, it’s usually necessary to remove a lot of skin during the mastectomy. It can therefore be complex to reconstruct at that time.

pink ribbon for breast cancer
Breast cancer is a common disease among women and the consequences are not only physical, but also psychological.

The importance of medical advice

Medical advice is of fundamental value in breast reconstruction. As we’ve seen in the previous sections, the strategy is usually agreed upon by different medical specialties.

The patient must understand what the treatment options are and evaluate them. There are many factors that influence the type of technique chosen for reconstruction. For example, age, breast size and shape. Of course, they must assess everything on an individual basis.

In addition, a woman may prefer to choose the timing of breast reconstruction. Some women don’t wish to have it done immediately.

On the other hand, it’s important to note that plastic surgeons are very familiar with this type of procedure. Therefore, their judgment is usually objective and very indicative of the outcome.

Breast reconstruction options

Specialists can perform breast reconstruction using different techniques. As we’ve explained before, we try to find the most suitable one for each patient. In the following sections we explain the main options.

1. Reconstruction with implants

One of the most commonly used options for breast reconstruction is to use breast implants. According to Mayo Clinic specialists, these are devices that help reshape the breast, giving it volume. They’re usually filled with saline solution or silicone gel.

Many times, doctors place the implants immediately during the mastectomy itself. However, sometimes several subsequent interventions are necessary. In some cases, specialists place an expander in that first operation.

The expander is a device that stretches the skin of the breast. In addition, it helps to make room to place the prosthesis at a second time. This instrument progressively increases the creation of this space.

When the desired expansion has been achieved, the implants are placed. Subsequently, specialists usually perform surgery to reconstruct the nipple and areola, which we’ll explain later.

2. Reconstruction using the body’s own tissues

Doctors can perform breast reconstruction using tissues from another part of the body. These are grafts or flaps. According to an article in Breast Cancer, the tissue is obtained from areas such as the thighs, belly or buttocks. Once obtained, doctors use it to reshape the breasts.

Since it’s fatty tissue from elsewhere, it can be fattened or thinned depending on how the woman’s weight varies. The main benefit is that the result is usually more natural than that of implants.

The problem is that it leaves more scars. One in the place where the tissue was from and another in the breast itself. In addition, specialists usually have to perform several interventions.

On the other hand, doctors don’t recommend this technique for women who have blood circulation problems. Nor if they’re smokers, diabetics or have any type of connective tissue problem.

3. Posterior reconstruction of the nipple and areola

The nipple and areola are the most visible part of the breast. Breast reconstruction usually requires an intervention to repair these tissues. This makes the breasts more similar to each other. The doctor attempts to match them in position, shape and size.

A specialist usually tattoos the areola. The nipple, on the other hand, can come from the skin of another part of the body. If the other nipple is large and intact, a small part can be removed and placed in the reconstructed breast.

There are even techniques to project a new nipple with the skin of the same breast. In general, doctors perform this procedure about 3 or 4 months after surgery.

A doctor with a patient
The treatment of breast cancer is long and includes different stages that everyone must respect.

Limitations and complications of breast reconstruction

It’s important to keep in mind that breast reconstruction doesn’ always achieve the desired results. It’s a technique that can be complex. It depends on the situation from which you start and how the breast was before.

In addition, as in any other surgery, there may be complications. For example, infections, hematomas and delayed healing. In some cases there are seromas, implant rupture or even implant extrusion.

Reconstruction requires recovery time

Breast reconstruction is a very useful surgery to try to return the breasts to a natural, symmetrical, and attractive appearance. This way, the woman who has had to undergo a mastectomy has greater self-esteem and self-confidence.

However, it’s still a surgical procedure that can be complex. Like any other surgery, it requires recovery time and many considerations. Therefore, it’s essential to always follow the specialist’s advice.

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