Back to Surgery, Therapy

Breast Reconstruction After Mastectomy

Fortunately, several breast reconstruction methods are available to restore the harmony of body and soul for those women who underwent a partial or full mastectomy. With early diagnosis and treatment, breast cancer is not a fatal disease anymore.

The goal of Breast Reconstruction surgery is to substitute the lost tissue and breast volume. Symmetry is a key issue as well since tumor removal usually affects one breast (except for more severe cases, or preventive mastectomy).

For the best explanation, we present the types of tumor removal surgery, then possibilities of restoration.

The Types of Tumor Removal Surgery

1. Simple mastectomy

Removal of the breast tissue – the glandular and fat tissue –, with the preservation of lymph nodes in the armpit. In some cases, in order to prevent metastasis, the axillary lymphatic glands are affected as well, because they are the closest to the breasts.

2. Radical mastectomy

Removal of the full breast, lymph nodes in the armpit, and breast muscles (pectoralis major and minor). Used in patients with advanced and/or recurrent breast cancer.

3. Modified radical mastectomy

Removal of the full breast, lymph nodes in the armpit, but preserving breast muscles. It enables a thorough examination of the lymph nodes, but compared to the previous solution, means easier recovery.

4. Skin-Sparing Mastectomy

Removal of the affected breast tissues from an areola incision or side incision. Not applicable in the case of cancers involving epithelial tissues (eg. causing inflammation).

5. Nipple-Sparing Mastectomy

Removal of the affected breast tissues without the nipple and the areola. In the past, it was applied only pre-childbearing patients with benign tumors. Today, more and more research demonstrates that it is an appropriate solution to the cancerous tumors that are not near the nipple.

6. Preventive mastectomy

Removal of the full breast in healthy patients who are genetically prone to certain breast cancer types (BRCA1 or BRCA2 positivity). It involves all breast tissue between the skin and muscles. (With the removal of the ovaries in some cases.)

Types of Breast Reconstruction

1. Primary Breast Reconstruction

“One-step” operation: tumor removal or mastectomy and Breast Reconstruction at the same time. Mostly for stage I or II breast cancer patients, with the oncological recommendations in mind. The advantage is that the patient wakes up with an aesthetically pleasing result from the anesthetic, so she does not lose one of the most important symbols of feminity for even a short period of time. Breast Reconstruction is usually made with implants.

2. Secondary Breast Reconstruction

“Two-step” solution. Two separate interventions happen at different times: a tumor removal or mastectomy at first, and then – after a certain period of waiting time, eg. for radiation therapy – comes the reconstruction with plastic surgery techniques.

Options for Breast Reconstruction

1. Silicone Implants

This is one of the most widely used methods to replace the missing breast tissue, but by no means the only one. It is perfect by itself if the chest muscles stayed intact, and there is enough breast tissue left to embed the implant.

2. Tissue Flap Surgery

It is possible to replace the missing breast tissue – or a part of it – with the patient’s own tissues. We often use a so-called flap (a complex network of blood vessels and fat tissue) from the lower abdomen. This is DIEP-flap or TRAM-flap surgery. Replacement of the pectoral muscles can also be solved with own tissues, eg. from the wide back muscle (latissimus dorsi).

3. Fat Transplant (Lipofilling)

To complement the methods above, it is ideal to use the patient’s own fat tissues from the abdomen, waist, or thighs. After the liposuction and a specific processing procedure, the fat tissues are injected into the breasts in tiny droplets to become adherent. This procedure increases breast volume and promotes the connection between the implant and the tissues, giving even more natural results. Lipofilling also plays a role in scar regeneration after radiation therapy.


Breast Surgery Info

Complex information page with a description of the breast surgery procedures, a unique glossary - an explanation of the most important terms - and essential knowledge on the pre-and post-operative period.


Ask the plastic surgeon!

Dear Doctor,
I was operated because of breast cancer 10 years ago. Unfortunately my breast had to be completely excenterated. An adjustable breast implant was inserted under the muscle, but over the years it has creased. I put on some weight because I was reached by menopause therefore the difference between my breasts has become significant. I always have to stuff my bra with textile insertions to make my breasts look alike to a certain degree.
My question is: is there any way of reconstructing my breast from my own tissues?
I look forward to your answer, which I thank you in advance!
Yours faithfully,
Erica

Click here to see the answer 2011-12-18

Dear Dr. Pataki,

I had a breast surgery eight weeks ago – a corrective surgery after breast tumour with implants. My left breast is still 1,5 – 2 cm higher than the other, the skin on it is visibly brighter, and the shape of it is rounder as well. (I hadn’t got any glandula on this side, because it had to be removed two years ago, I only had my aerola.)

I would like to know whether it is possible that all these might change two months after the surgery? Will my breasts look alike to a certain degree?

Thank you for your help!

Yours faithfully,

Valeria

Click here to see the answer 2011-09-05

 Do NOT follow this link or you will be banned from the site!
error: Copyrighted Material.