Suffering a breast cancer is one of the hardest situations that a woman can suffer and, even more so, if a mastectomy is finally performed in which the breast is eliminated. But now surgery has advanced to provide techniques that allow the reconstruction of the breast in a natural way , very similar in shape, texture and characteristics to the breast not operated. I have an own and specific unit for breast reconstruction in which we apply the latest techniques, which will be explained below.
Cutaneous expansion technique:
The technique of skin expansion is the most widely used and is based on expanding the skin to subsequently place a prosthesis. After the mastectomy, we place an expander under the skin and chest muscle. Through a valve mechanism, we introduce a solution of saline once a week, for several weeks, until filling the expander. When the skin has given itself enough, the expander is removed and replaced by a silicone breast prosthesis. And there are some expanders that are designed to remain as definitive implants. This procedure is performed under general anesthesia, with a hospital stay of 24 hours normally. The nipple and areola are reconstructed later, by local anesthesia and on an outpatient basis. It is important to bear in mind that the prostheses used in this type of breast reconstruction contain medical silicone , and note that no relationship has been shown between breast cancer and the use of breast prostheses.. It should also be noted that its use is approved in all European countries.
Technique that uses own tissues:
This technique is based on the mobilization or transplantation of tissues from other areas of the body such as the abdomen, back or buttocks. In some cases, these tissues are still attached to their original site, conserving their vascularity, and are transferred to the breast through a tunnel that runs under the skin.. In other cases, they are completely separated from their original site and transplanted to the chest by connecting to the blood vessels.. It is the most complex technique , leaves more scar and the recovery period is longer, but the aesthetic result is much more natural. For this intervention general anesthesia is used and a three-day hospital stay is required. ç
We are currently performing with great success a technique that manages to unite the best of the previous two, that is, that combines the placement of a prosthesis with the injection of fat from the patient to achieve more natural contours both in sight and touch. This technique is especially indicated in patients who have undergone radiotherapy or have a skin with little elasticity, since the injection of fat produces a very beneficial effect on the skin and scar due to its high content of stem cells. In these cases we perform a first session to remove the fat by liposuction, with the consequent improvement of the body contour in the cases that is appropriate and, in that same intervention, the fat is treated to purify it and injected under the skin of the thorax, around and inside the scar of the previous mastectomy. Later, once the elasticity and the thickness of the skin were improved, we carried out the implantation of the expander. The injection of fat can be reused already in the final phase of the reconstruction to improve the contours or symmetrize the breasts. This combined technique achieves aesthetic results very close to the most complex microsurgical reconstructions and lacks many of its drawbacks.
Any of these three techniques can be used for an immediate reconstruction , that is to say that the mastectomy and breast reconstruction are performed in the same surgical act. Of course, the cutaneous expansion technique will involve a second surgery for the placement of the definitive implant, although an immediate reconstruction can be performed with the placement of the prosthesis directly without going through the entire expansion process. This can be achieved thanks to the implementation of a special sheet that protects the prosthesis without having to expand the skin for weeks. In this way, the patient who enters the operating room with the trance of suffering a mastectomy, leaves the same with his chest completely rebuilt in a single time.
In any case, the choice of one of the three techniques will depend on the patient. Personally I always advise the best option according to the case and always to end up obtaining the expected results.
We must also remember that the results of a breast reconstruction are definitive and allow us to make an absolutely normal life, even the reconstructed breast can have a firmer appearance and look more rounded than the other breast.. The contour may not be exactly the same as before the mastectomy, and there may be some differences in symmetry with the uninvolved breast. However, these differences are usually only visible to the patient, not being perceived by others.
Finally, it is important to note that breast reconstruction has no effect on the recurrence of breast disease , nor does it interfere with the treatment of chemotherapy or radiotherapy, although the disease recurs. Nor does it interfere with subsequent analyzes that may be necessary in relevant reviews.