In Spain between 10 and 20% of women who have had breast cancer decide to rebuild her breast. This low rate is due to various reasons, mainly because of the lack of information about the different possibilities and reconstructive global approach offering plastic surgery on breast pathology.
Doubts about breast reconstruction
When a woman faces the possibility of breast reconstruction it is usual that many doubts arise about. Even today there is the false belief that this process must be done within a few years after mastectomy and after finishing radiotherapy and / or chemotherapy. Other patients have doubts about whether the surgery could complicate or be harmful to cancer treatment or hinder the posttreatment follow-up. Sometimes the conflict is that certain patients come not to consider the idea of rebuilding the breast, others believe they are too old or even do not see this type of intervention as a part of the comprehensive treatment of breast cancer. Therefore, it is important to contact a specialist in Plastic Surgery to answer any questions that you might have.
Currently, there are two major groups of techniques which involve the application of implants and / or expanders and employing body's own tissues, called "flaps".
In the first option, the new breast volume and shape thanks to the implementation of a breast implant are obtained, of which, today, there is a wide range. Often after mastectomy is not enough skin to provide the necessary coverage to the implant, which is required to "win" skin in the area by a similar prosthetic device but which is inflatable and expandable, the expander. This applies in the area where would the breast and is regularly being inflated in the weeks after the operation until a sufficient volume to have the necessary skin. In a second operation, the provisional sloughs expander breast prosthesis definitive, generally silicone gel.
Furthermore, the flaps are transfers own tissues vascularization between a donor site and a receiving body, in this case the breast. Although it is possible to make this exchange from different areas of the body, the most popular and effective are the area of the back (latissimus dorsi) and abdomen (TRAM or DIEP flap type, depending on whether they are pedunculated or microsurgical). Other areas are the buttocks or inner thigh. These methods, although giving greater naturalness in the final result, involve greater complexity, especially those requiring microsurgery, and more aggressive, having to take a tissue from a healthy donor area, resulting in scar, etc., but in principle, avoid the use of prostheses and, as required to win the skin expansion previously, only require surgery.
Although the expansion is a longer process in time (two surgeries and an extension period) are conceptually simpler surgeries, less aggressive than flap, so they are still the best option in many cases.
How to choose the best option
The recommendation of the most suitable technique for each case is the responsibility of the Plastic Surgeon, since it is the specialist who has all the tools or reconstructive techniques (prosthesis, expanders, flaps or even microsurgery). In addition, not only is to recreate a breast, but mainly to seek a global harmony in the body, chest, so often recommend additional steps in the healthy breast, to reduce it , raise it if it is too lowered or even increase if hypoplastic or "empty". All with the aim of obtaining symmetrical breasts. Not so much that large or small breasts reconstructed with one technique or another, but that two as close as possible and symmetrical breasts.
Although the final decision in choosing the ideal technique rests with the plastic surgeon, it must be supported by consensus and by the multidisciplinary team that is part of treatment. In addition to applying to the particularities of each case and adapt to the concerns and aspirations of each patient reconstructive. Here again it highlights the importance of prior patients about the different options to choose information.
Operation chest in men
Breast cancer in men accounts for approximately 1% of the total, so it is not as frequent, but there. The basic approach is similar: surgical resection and, depending on the case, raise adjunctive radio and / or chemotherapy. The fundamental difference is not to reconstruct the breast; rather, what we do is try to recreate the normality of a male chest, despite the loss of soft tissue. It is a reconstruction of the thoracic defect (skin, soft tissue) to compensate asymmetries and restore a normal chest so that trying to recreate such a complex anatomical and aesthetically structure, such as the female breast.