Breast Cancer and Breast Reconstruction

This surgery treats breast cancer, now offering greater preservation of the skin and gland, leaving major resections and mutilations in the past. Today, it is possible to control the disease with conservative surgery and immediate reconstruction, restoring a near-to-normal shape.

 

SURGERY AND POST-MASTECTOMY OPTIONS

 

It can be performed with autologous tissues, that is, by using the patient’s own tissue or implants and tissue expanders. Choosing amongst the many different reconstruction techniques can vary due to many factors, such as the person’s age and the anatomical shape of the breast.

 

After lumpectomy, which is the removal of the tumor and of a small rim of breast tissue around it, flaps of the gland itself are mobilized to provide a proportional breast cone.

 

Silicone implants are used in cases of small breasts or after nipple-sparing mastectomy, where there is the preservation of own nipple and skin.

 

In mastectomy, after the gland, the nipple and the areola are removed, you may choose to reconstruct the breast with tissue from different donor sites, such as  myocutaneous flaps from the abdomen or dorsal region.

 

The most frequent option today is tissue expanders. They are empty breast implants  that can be permanently or temporarily filled with normal saline. When temporary, they are replaced by silicone implants on a second surgery.

 

Liposculpture  or lipofilling, that is, an autologous fat removal from the abdomen, flanks or inner knees, is used to restore the contour and volume of partial breast retractions. It is usually indicated for the second stage of the reconstruction surgery.

 

The nipple-areolar complex reconstruction may be done by means of tattoos, the skin grafting by means of groin donor site, and the nipple by means of flaps from your own local reconstructed breast tissue.

 

ANESTHESIA

General anesthesia is applied for immediate reconstruction, with hospitalization from 1 to 2 days.

 

Minor revision surgeries or procedures to reconstruct the nipple-areolar complex may be done under local anesthesia and sedation.

 

RECOVERY

Use of dressings and taping for 15 days.

Drains can remain from 48 to 72 hours.

Use of medications to aid the healing, control the pain and reduce the risk of infection.

Use of support bras for 30 days.

Limited arm movements on the side of the operated breast.

Restricted physical exercises from 30 to 60 days.

Avoid sun exposure for 2 months.

 

RESULTS

Upon leaving the operating room wearing support bra, the patient already has the shape of her breast restored. If implants or muscle flaps are used, the definitive volume will be already present. On the other hand, when expanders are used, the volume increases gradually over the following 2 months.

 

Reconstruction is a job of modeling the breast and the nipple areola complex, which may require many surgical steps.