Breast reconstruction

Several techniques restore your breast image and give you the confidence you have lost.

Following mastectomy, a woman may face psychological problems: She comes face to face with a different reality, feels she has lost her femininity and wants to fire up her partner’s sex desire again. Breast reconstruction aims at helping her feel whole, both physically and psychologically, after one or both of her breasts have been removed either because of mastectomy or due to another condition (injury, burn, congenital abnormality).

Breast reconstruction is a procedure that a woman should do only for herself. It is not completed in one day, as it involves more than one surgical operations that take place in multiple stages. Breast reconstruction is often performed at the same time as mastectomy. There are of course cases where reconstructive surgery starts after the patient’s incisions have healed and after she has recovered from any additional treatments, such as radiotherapy.

1. The classical methods of reconstruction

Flaps

Tissues from the patient are transferred from a healthy part of the body (donor site) to the front part of the chest. The flaps usually include muscle, fat and skin and have their own blood supply. Flaps give the breast a more natural appearance and feel compared to the implants. We prefer flaps following radiotherapy because in that case the use of implants is not advisable. Unfortunately the disadvantage of these flap techniques is that they are time consuming, leave the patient with some scars at the donor area and the woman spends more time in the hospital.

Silicone implants

The implants used in breast reconstruction are similar to the ones used in breast augmentation. Reconstruction is relatively safe with them but it is performed in multiple stages. In the beginning the implant (expander) is inserted and “expanded” with saline like a “balloon”. This procedure lasts almost three months. The aim is to stretch the skin and the pectoralis muscle. With a second operation the permanent implant is inserted. This method is not advisable after radiotherapy.

Reconstruction of the nipple is made with:

Transfer of skin grafts and local flaps (tissue)
Use of cartilage pieces
Tattoo

2. The new methods of breast reconstruction

Simple hypodermic mastectomy and modern reconstruction:

In this method which is mainly applied to prophylactic mastectomy, the breast is removed along with the nipple, the areola and a small ring of skin around the areola. That means there is almost no skin removed and the incisions are restricted to the nipple limits. Reconstruction is best done with a pedicle or a free abdominal flap. This method gives the best aesthetic results.

Reconstruction with a free flap of perforans vessels (abdominal or gluteae) – (DIEP or SIEA flap):

In this microsurgical procedure (using surgical microscope) the last generation flaps do not consist of any muscle but only of skin and fat from the abdomen. Their great advantage is that there is no muscle lost, the pain is minimal, hernias are reduced, recovery is faster and the woman stays fewer days in the hospital.

Reconstruction with the fourth generation implants:

These implants are made of more compact silicone, which does not cause the problems of the older generation implants. The fourth generation ones have more anatomical shape that looks like the one of the normal breast.