Breast reconstruction is a radical operation, but one that can be very meaningful in a patient's life. After a mastectomy or removal of a lump or tumour during breast-conserving surgery, breast reconstruction is the logical next step for many women during cancer treatment. In this article, I like to explain how breast reconstruction works.
How does breast reconstruction work?
In mastectomy (also called mastectomy), the skin and volume of the breast are removed. In breast-conserving surgery, as little breast tissue as possible is removed, as little as the size and possible metastasis of the tumour allows. The aim of breast reconstruction is thus to restore the volume and shape of the breast and replace the skin, to achieve a natural breast. Breast reconstruction is a major procedure and must be done in a hospital.
Techniques for breast reconstruction
Breast reconstruction may involve the use of breast implants, whether or not combined with the patient's own fat and skin (autologous tissues). An autologous tissue reconstruction is preferred, mainly because of the disadvantages of breast implants. These include a higher risk of infection, implant migration and capsular contracture. Capsularisation can occur as the body's reaction to the prosthesis and can be greatly affected by radiotherapy, for example. Indeed, in a disease process such as cancer, treatment often continues after breast reconstruction. The unwanted consequence is distortion of the reconstructed breast, necessitating follow-up surgery. Furthermore, breast implants need to be replaced by a plastic surgeon over time.
The autologous or home tissue breast reconstruction
In autologous breast reconstruction, the patient's own tissue (skin and fat tissue) is used, usually from the abdomen, sometimes from the buttocks. Using one's own tissue has the great advantage that the breast permanently integrates nicely into the body and no follow-up surgery is required. Moreover, the breast looks natural and evolves naturally with the body.
Does the reconstruction of both breasts take place at the same time, or separately?
Although it is possible to try to get both breasts symmetrical at once during reconstruction, I advise against it. A reconstructed breast needs to integrate well into the body. Especially if there is a follow-up treatment, a double operation is tough ánd its effect on breast shape is uncertain beforehand. I would rather recommend modelling the reconstruction side first and then, after waiting 4-6 months, making the healthy breast symmetrical.
