Everything about breast reconstruction after mastectomy

What is Mastectomy?

Removal of the breast is called Mastectomy. Mastectomy is of five different types, namely, Simple or Total Mastectomy, Radical Mastectomy, Modified Mastectomy, Subcutaneous Mastectomy, and Partial Mastectomy.

Total or Simple Mastectomy is the removal of the entire breast. Sometimes, removal of the whole breast may not be required, and the expert may consider the only removal of the lymph nodes from the underarm area. The surgeon may not even remove the muscle from under the breast. This is mostly done to prevent the impact of breast cancer.

Modified Mastectomy is the removal of lymph nodes and breast tissues. The aim is to examine the lymph nodes so that spread of cancer can be prevented beyond the breast.

Radical Mastectomy aims to remove the breasts completely. The underarm lymph nodes and chest wall muscles from under the breasts are also removed.

Partial Mastectomy means removing the cancerous part of the breast tissue.

Nipple Sparing Mastectomy or Subcutaneous Mastectomy is the removal of the breast tissue sparing the nipples.

Why Breast Reconstruction after mastectomy?

Many women who have undergone a Mastectomy may want to have their breasts back. After all, breasts are an important part of a woman’s body that gives the perfect shape to her body. It helps to give them the lost confidence and bring a smile to their face. Rebuilding and reshaping the breast through surgery is called breast reconstruction.

There are several options in front of the woman who wants to do this because Medical Science has come a long way. Implants like saline or silicone are used for the rebuilding of the breasts. Tissues from some other parts of the body are used for the reconstruction of the breasts. Sometimes both the tissue and the implant are used for the reconstruction of the breast.

Some women want to get the reconstruction done right after the Mastectomy. It is the immediate reconstruction of the breast. However, others wish to wait and get the reconstruction done after the incisions for Mastectomy are healed. It is called Delayed reconstruction. Such surgery can happen after a few months or years of Mastectomy.

It is important to note here that at times during the final stage of breast reconstruction, the surgeon may need to recreate the nipple and areola in case these were not left intact during Mastectomy.

What are the factors that impact breast reconstruction?

A couple of factors influence the kind of reconstruction surgery required in a woman.

• Age and health of the woman.
• The shape and size of her breasts.
• History of past surgeries.
• Risk factors involving the surgery.
• Reasons related to the tumour.
• Availability of autologous tissue.
• Women having a history of abdominal surgery is not the right candidate whose tissue from the abdominal area can be used for the breast reconstruction.

These are some of the factors that lead to the final decision of breast reconstruction. The patients have to discuss these factors with the expert. The experts investigate these matters and then examine all the factors to give a green signal for the surgery.

Let us consider the facts related to breast reconstruction:

1. Implant reconstruction

Surgery and recovery

• There should be enough skin and muscle in the breast area remaining after Mastectomy for the reconstructive surgery to follow.
• It requires a shorter surgical procedure and has a little blood loss in comparison with autologous tissue surgery.
• The recovery period is also shorter than the autologous surgery recovery period.
• Follow-up visits are required.

The possibility of complications does exist in the implant reconstruction.

• The patient may develop an infection. She may develop a lump of clear fluid within the reconstructed area.
• Blood clots.
• The implant may break through the skin.
• Rupture may also happen in the implant leading to leakage of the silicone.
• There may develop hard scar tissue around the reconstructed area.
• If the patient suffers from conditions like obesity or diabetes and is a smoker, then she may face complications.
• Another rare complication is the development of a form of immune system cancer, anaplastic large cell lymphoma.

However, other considerations also exist:

• If the lady has undergone radiation therapy in the chest, then she is not the candidate to undergo this surgery.
• Women with large breasts should not consider undergoing this treatment.
• It cannot last for a lifetime.
• Sensitive to touch, especially silicone implants.
• It is recommended that women having silicone implants should undergo regular MRI screening to detect a rupture in implants.

2. Autologous Tissue Reconstruction

Surgery and recovery

• The surgical procedure is longer than the implant surgical procedure.
• The initial recovery period is also a long one.
• Pedicled flap reconstruction takes a shorter period for surgery compared to free flap reconstruction. The latter is a long surgery that should be performed by a surgeon with microsurgery experience.

The patient may develop complications as indicated below:

• Transferred tissue may die.
• Blood clots.
• Weakness and pain in the donor site.
• Women who have diabetes and obesity may develop complications.

A few other considerations:

• Looks more natural than implant surgery.
• Soft and natural feel
• The donor site may leave a scar.

Women undergoing mastectomy due to breast cancer can experience breast numbness because nerves that connect and give sensation to the breast are cut and tissue is removed.

A word of caution: Breast reconstruction will fail if healing is not proper. If such conditions occur, then the patient will have to get the implant/flap removed. A second reconstruction may be a possible requirement.

CosmeSurge has an exceptional team of surgeons and experts to execute such surgeries in an organized fashion. They investigate all the observations and then recommend the right path of surgery to the patient. The experts ensure that the patients undergo the corrective measures post-operation and complete the healing procedure with all follow-ups and medicines required to make the surgery successful.

This surgery is one of the cosmetic surgeries that can help women to get their lost confidence and beauty back. A well-shaped body with the required curves can boost self-love and care in women suffering from low self-esteem after Mastectomy.