One of the issues related to breast cancer is breast reconstruction and how to do it, as breast reconstruction after cancer is done in different ways depending on the extent of the cancer, the patient’s request and the doctor’s diagnosis. The patient should have sufficient knowledge about the types of treatment methods to get the best results according to his body anatomy and general health.
What is breast reconstruction surgery?
The purpose of breast reconstruction surgery after cancer is to reshape the breast tissue and reconstruct the breast tissue after partial breast removal or complete breast removal.
- The first method (total mastectomy) is a surgical method in which the entire breast, including the nipple and areola, is removed for the purpose of treating or preventing breast cancer.
- The second method (mastectomy) involves removing the cancerous part of the breast.
It is worth noting that mastectomy (surgery to remove the breasts) has negative psychological effects on many women.
Fortunately and advances in technology, breast reconstruction surgery helps to change the shape of the breast after cancer treatment, the woman’s level of self-confidence increases, and she feels better during the cancer recovery period.
Methods of breast reconstruction after cancer surgery in Iran
There are four ways to rebuild the breast as follows:
- Use of saline or silicone breast implants
In this method, saline or a silicone prosthesis is placed under the skin or muscle under the breast tissue. In most patients, this procedure involves two surgical steps. In the first surgery, a tissue expander is placed under the skin of the breast or the chest muscles. This expander tightens the tissue like a temporary saline prosthesis.
After the recovery period, sterile saline is injected into the tissue. With this, the underlying tissues and muscles are tightened and the patient’s desired results will be achieved.
After this stage and when the chest is ready to receive the prosthesis, the second stage will begin, which includes removing the expanded tissue and placing either saline or silicone fillings.
- The use of tissue from other parts of the body, which is also called a skin flap.
In this procedure, tissue is taken from other parts of the body and transferred to the chest. Breast reconstruction using skin flaps is a complex procedure.
In some cases, a combination of the above approaches will be considered for the patient.
One of the benefits of this method of reconstruction is that the restored breasts look more natural. In the abdominoplasty method, skin, muscle and fatty tissue are transferred from the lower part of the abdomen to the chest to create a new breast.
- Simultaneous use of breast fillers and body tissues
Prostheses alone are not always sufficient to create and shape the breast. Especially if there is not enough skin on the chest. In this case, healthy tissue from another part of the body will be used to cover that part. The tissue used is usually a layer of skin and muscles from the back of the chest. This muscle is brought, while the vessels are connected to it, from the back to the front to fill the space created by the mastectomy, and then the breast implants are placed under this muscle.
- Breast reconstruction with fat injection
This method is used in certain cases and due to changes caused by fat in the breast tissue, it must be performed by an experienced surgeon. In this method, the surgeon injects the required amount of fat from the abdomen and sides into the patient’s chest.
This method is done to shape the breasts in a special case, and sometimes because the fat is absorbed by the body, injections need to be repeated to get the desired results.
Important points about breast reconstruction
- It is possible to rebuild the breast immediately after mastectomy surgery or sometime after surgery.
- Not all breast reconstruction surgeries are successful, so you should consult your doctor.
- Surgical repair can be affected by chemotherapy, radiotherapy, or previous surgery.
- For people who smoke, it is first decided to stop smoking for three months and then decide to have surgery.
- It is important to know that repair only helps restore the shape of the breast and does not restore “feeling” to the breast and nipple. Over time, the breast skin heals and can become sensitive to touch, but the sensation will never be quite the same as it was before the procedure.
- Being aware of the surgical options helps the patient to have more reasonable and realistic expectations of the results.
Instructions before breast reconstruction surgery
- How to take medicines
- The duration of the surgery
- Possible complications of surgery
- Postoperative care
In addition, the patient should:
- Quit smoking three months before surgery.
- It’s okay to take vitamins and supplements.
- Follow the doctor’s instructions regarding fasting on the day of surgery.
- It is recommended that a friend or family member accompany the patient on the day of surgery.
- Breast reconstruction surgery is mainly done under general anesthesia, which means that the patient is asleep during the surgery and will not feel any pain.
Important points after breast reconstruction and reconstruction in Iran
- Most people experience pain after breast reconstruction, and in such a case, hospitalization for several days will be required.
- To avoid complications with any breast reconstruction technique, carefully follow the postoperative instructions for this technique.
- Most of the cast should stay in for a few days.
- It is possible to shower according to the opinion of the doctor.
- There is no special diet.
The recovery period after breast reconstruction surgery
- It is completely normal for the patient to feel tired for one to two weeks after the surgery. Pain relievers are usually prescribed by a doctor to control pain and discomfort.
- A drain is placed in the wound area to drain excess fluid from the surgical area. The time to remove this drain will be determined by the doctor.
- An important point is that the patient must follow the instructions given by the doctor regarding the care of the stitches.
- In most cases, women will be able to resume their normal activities six to eight weeks after the surgery. If a flapless prosthesis is used, the recovery period will be much shorter.
Some points that patients should keep in mind are:
- Reconstructive surgery does not restore normal sensation to the breast, but some sensation will return over time.
- It takes about eight weeks to reduce swelling and bruising. So you must be patient to see the final results.
- It takes 1 to 2 years for the breast tissue to completely heal and the scars to fade.
- Doing intense physical activities, sports, lifting heavy objects, and having sex are prohibited for six to eight weeks. In this regard, be sure to consult your doctor.
- There is a possibility of silicone implants leaking or opening without the patient noticing any symptoms, so it is recommended not to forget the periodic check-ups performed by the doctor.
- If you notice symptoms such as skin changes, swelling, a lump, pain, or fluid discharge in the chest or armpits, you should report it to your doctor immediately.
- Women who have had a mastectomy to treat breast cancer should have regular mammograms. This test may be performed after breast reconstruction surgery for women. If the doctor detects a suspicious condition during the physical examination, a mammogram will be performed.
- If reconstructive surgery is performed with a prosthesis and a mammogram is required, this test should be performed in centers equipped so that the prosthesis can be moved and accurate images can be prepared. Silicone implants can cause problems in obtaining images of the inner breast tissue.
Risks of breast reconstruction after mastectomy
- Scars: No matter what type of breast reconstruction technique you have, you will have scars in the breast area. In most people, scars heal after a period of time and leave less scars than before, but they do not disappear completely. Of course, most scars are not visible in daily activities.
- Tissue damage: Sometimes, the tissues of the breast area may not recover completely and properly due to reasons such as pressure from the implant. The network of vessels responsible for supplying this area with food and oxygen may be damaged during surgery, radiotherapy, and for reasons such as smoking and diabetes, and as a result, the speed of recovery will be greatly reduced. These tissue failures are known in medicine as necrosis. Necrosis can be accompanied by pain, bleeding, fever, and a feeling of nausea. The skin of the dead area may turn black and an unpleasant odor can be emitted from this area. In the case of necrosis, the dead tissue must be removed by the surgeon.
- Implant displacement: If the amount of this displacement is small, it may be possible to return it to its original position with massage, and if the displacement is excessive, you should consult your doctor about this.
Common questions about breast reconstruction
Does breast reconstruction surgery lead to rapid recurrence of cancer?
The recurrence of breast cancer is related to the biological factors of the cancer itself, and the reconstruction process does not speed up its occurrence. Today, despite advanced diagnostic methods, breast reconstruction will not cause a diagnostic problem in cases of recurrence.
Is it possible to restore the breast immediately after its mastectomy?
It is possible, but the surgical work will take a long time, so we recommend that the restoration be performed in a second stage, as the breast will be removed first and then restored after a period of about a year.
Do breast implants cause cancer to return?
No, as studies have shown that there is no relationship between the return of cancer and transplantation, even if the cancer returns, the cysts have nothing to do with it.
What our doctors say about Ariana:
The surgical method is determined according to the patient’s body appearance, age, request for re-pregnancy, breast shape, radiotherapy records and comorbidities. Note that none of the treatment methods can be performed for every patient, and before the surgery, she should consult with the best breast surgeon in Iran for high reconstruction.
