Breast reconstruction

Breast reconstruction is performed in women after breast amputation due to cancer reasons and in Poland syndrome (congenital absence of breasts, pectoral muscles, sometimes also nipples with areola). The procedure aims to reconstruct the structure of the female chest. The surgery is performed under general anesthesia.

Immediate reconstruction:

The advantage of this method is that the breast is reconstructed during the same surgery as the mastectomy. This means the woman undergoes surgery and recovery only once, without experiencing the inconvenience of missing a breast.

Delayed reconstruction:

The advantage of this method is that it allows the woman to primarily focus on recovering from cancer treatment and strengthening her body. Delayed breast reconstruction also provides more time to choose options and make the appropriate decision regarding reconstruction.

Breast reconstruction options:

There are many possibilities for breast reconstruction. The choice of method depends on various factors, including:

•     Health condition
•     Body structure
•     Breast size
•     Amount of remaining tissues
•     Lifestyle
•     Personal choice

Breast reconstruction can be done using:

    - Tissue expander:

•     two-stage reconstruction
•     one-stage reconstruction

    - Woman's own tissues

    After discussing all possible options with a doctor, a decision can be made regarding the type of surgical procedure.

Procedure:

In the case of reconstruction after amputation due to oncological reasons, it can be performed during the amputation surgery or at least 6 months after amputation (when postoperative scars soften) and after excluding active cancerous processes (no metastases). It can be done using the patient's own tissues using pedicled skin-muscle flaps or microsurgical connections, or, which is less burdensome for the body and does not distort it, using tissue expanders and breast implants, or using a so-called Becker prosthesis (silicone prosthesis with the possibility of enlargement with saline solution). If the remaining breast is large, it may require reduction plastic surgery to adjust it to the size of the reconstructed breast. In an additional procedure, the nipple with areola can also be reconstructed. The surgery takes up to 2 hours.

Postoperative course:

After the surgery, elastic bandage dressings are applied, and wearing specialized bras is required. The dressings are kept for about 10 days, and the stitches are removed at the same time. During this period, physical activity should be limited. Swimming and raising arms upwards are prohibited for 6 weeks. The consequences of the surgery include pain, swelling, and weakness. The normal appearance of the breasts is achieved after several weeks, and complete healing takes about 2 months, with sports activities recommended only after 3 months.

Possible complications:

Complications and poor outcomes are extremely rare but can sometimes occur. The most common ones are: early complications (hematoma, infection, wound suppuration - these complications can cause prolonged healing, oozing wounds, unsightly scars, and may require corrective surgery in the future) and late complications (formation of a fibrous capsule around the prosthesis causing breast hardening).

Anesthesia:

The procedure is performed under general anesthesia.

Operative conditions:

A prerequisite for the surgery is normal results of basic laboratory tests and setting the surgery date after menstruation. Absolute contraindications to the surgery include: vascular disorders and coagulation disorders, uncontrolled hypertension and diabetes, purulent skin infection of the chest. Required tests include:

•     bleeding time and blood clotting test
•     blood count and blood type
•     indicated breast ultrasound or mammographic examination
•     ECG

The usual stay in the clinic is 1 day, and the absence usually lasts from 7 to 10 days.