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Breast Reconstruction following mastectomy

The term breast reconstruction includes all procedures for breast reconstruction after mastectomy or after another malady (injury, burn, congenital anomaly). In particular, it includes the surgical manipulations (a) for the regeneration of the removed breast mass, (b) the restoration of the nipple-areola, and (c) the surgery which is required in the contralateral breast to achieve symmetry. Reconstruction breast surgery offers physical and psychological joy to women.

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It usually includes more than one surgical operation, which takes place at various stages. The procedure can be performed either straight after mastectomy or some time after, as the patient heals and recovers from possible radiotherapy in which she has to be subjected. There are many reasons that may lead a woman to this particular procedure. The most important are:

• The development of better and safer techniques.
• The medical community’s understanding that breast reconstruction does not cause metastasis and does not conceal any local recurrence.
• The great number – nowadays – of good results.
• Women’s persistence for reconstruction.

Breast reconstruction may be performed with autologous tissue (latissimus dorsi or rectus abdominis muscle), or heterologous tissue, i.e. skin expanders. Therefore, every woman who is scheduled for or has already been submitted to mastectomy is in theory eligible for surgery. The procedure can be performed either straight after mastectomy or some time after, depending on the patient’s wish. In many occasions, the result exceeds all expectations.

Breast reconstruction can be made with an incision in the inframammary fold or with an incision made at the top of the armpit which allows very good access to the area underneath the muscle.

Frequent Questions

Breast reconstruction is performed in a hospital environment under general anesthesia in the safest conditions. Post-operation, patient will need to wear a special bra for approximately 3-4 weeks. Strutures are removed two weeks after surgery. Patients are advised to avoid sports activities and weight lifting. Patient she can return to her activities after a week of her recovery.

Some women are unable to breastfeed even without surgery. There are techniques that do not affect the breast’s milk ducts. This way future lactation is possible. However, it is very difficult to guarantee such result.

It is often impossible to achieve good symmetry between the restored breast and the other. This is understandable when using silicone as this material does not absorb / prevent the natural fall of the breast. In order to achieve better symmetry, it is possible to perform a breast lift or reduction on the contralateral breast. These recovery procedures are usually done in a second phase, when replacing the disruptor with an implant.

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