Breast reconstruction aims to correct the sequelae caused by breast cancer surgery (mastectomy) and coadjutant treatments (radiotherapy), by reconstructing woman’s breast, and giving the appearance of the original one. In addition to the lost breast, the nipple and the areola are also reconstructed. In this way, the patient will recover not only an important part of her anatomy but also identity as a woman.
Daily gestures such as hugging, dressing, or looking in a mirror can be negatively affected. This is why we understand breast reconstruction as a process for the patient to recover her self-esteem, improve her quality of life, and feel “complete” again.
Breast reconstruction can be performed during the same operation in which the breast is removed (immediate reconstruction), or in a second surgical time after the mastectomy (delayed reconstruction).
There are different methods:
The method with tissue expanders consists of placing a device with a valve under the skin, where saline is introduced once a week for several weeks, until filling the expander. Therefore, the skin of the breast progressively achieves the desired volume. At this time, it will be replaced by a definitive prosthesis.
- The wide dorsal flap method consists of using the skin and a large back muscle to reconstruct the breast on the same side. This technique can be associated with the use of prosthesis if the breast to be reconstructed is large, or lipofilling if the breast is small.
- The method with microvascular flaps consists of a transplant of tissues from one area of the body to another. It is usually the technique of choice, since it provides more natural and long-lasting results. As general rule, two techniques are used:
- DIEAP technique: the breast is reconstructed with the excessive abdominal dermal-fat tissue. Apart from reconstructing the breast, the abdominal contour of the patient is also improved.
- PAP or TUG technique: the breast is reconstructed with excessive abdominal dermal-fat tissue from the inner thigh. It is indicated for patients who do not have enough tissue at the abdominal level.
In both techniques it is necessary to have a team of well-trained microsurgeons. Surgery involves the transplant of a tissue from one area of the body to another, requiring the ‘splice’ or anastomosis of a small-sized artery and vein, which is performed with the help of a microscope.
The procedure is performed under general anesthesia, the scars are hidden in discrete areas, and the patient will be discharged between 1 and 6 days after the surgery, depending on the technique used.