Breast reconstruction after mastectomy

Reconstruction of the mammary glands after mastectomy is performed to restore the appearance, lost volume, size and shape of the breast. The main goal of this procedure is to reduce psychological discomfort in a woman who has undergone surgery. Restoration of the mammary glands using the reconstruction method does not affect the risk of relapse.

It should be noted that reconstruction of a woman's breast is a rather complex surgical manipulation that requires the use of special medical equipment and includes several microsurgical stages. Before this procedure, the doctor explains to the patient in an accessible form all the nuances of the operation, talks about possible problems of the postoperative period in order to psychologically prepare the patient for such a responsible step.

The reconstructive method is based on plastic surgery and can be used simultaneously with breast removal surgery. A number of subsequent microsurgeries are possible. At the moment, there are 2 types of surgical interventions: using prostheses and using the patient's own tissues. Sometimes a mixed type of surgery is possible, in which implants are used together with autologous tissues. The choice of surgical intervention depends on the woman's condition and preferences, as well as the amount of remaining breast tissue.

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Technique breast reconstruction after mastectomy

Breast reconstruction after mastectomy is aimed at restoring the previous appearance of the breast and is performed at the request of most women who have undergone the operation. By giving preference to this method, the patient, first of all, seeks to restore femininity and beauty in order to feel whole again and start a new life after a difficult breast removal operation.

Breast plastic surgery after mastectomy is a safe and very effective manipulation aimed at restoring the natural shape and size of the breast. This step is very important for women who have lost their breasts as a result of oncology (cancer, sarcoma), any pathologies (purulent process with gangrene), or as a result of serious injuries. Breast plastic surgery helps restore both the physical and emotional state of a woman. After the procedure, you can again wear clothes with a deep neckline, sunbathe on the beach, etc. Visually, the artificial breast will have the same shape as the real one, but will be devoid of sensitivity.

Women who are psychologically ready to undergo a full course of treatment and are absolutely sure that they have made the right decision can agree to mammoplasty. An important nuance is the absence of contraindications for surgical intervention, as well as diseases and pathologies that can hinder the rehabilitation process and cause negative consequences.

Mammoplasty can be performed immediately after amputation of the mammary glands, or some time later, after the wound has healed and the body has recovered. It should be emphasized that the success of the operation will largely depend on the psychological readiness and emotional state of the patient. It is very important that the doctor explains to the woman in advance that the new breast may initially cause slight discomfort, and in general, mammography will not give a perfect result, since after the operation, lines from surgical incisions will remain on the breast and in the donor areas.

Breast prosthetics after mastectomy

Breast reconstruction after mastectomy is a serious operation that allows artificially restoring the shape and original appearance of the breast after amputation. Sometimes several procedures are required to achieve the desired result. Reconstruction can be done simultaneously with mastectomy surgery, when the woman is still under anesthesia, or later, some time after the surgery. If the patient needs chemotherapy, doctors prefer to postpone this procedure. Complications after breast reconstruction are extremely rare, most often these are infections, scars, bleeding.

Breast prosthetics after mastectomy is necessary to "fill the void". Before such an operation, the surgeon clearly determines the size of the implant, the location of the future incision, and outlines the contour depending on the anatomical features of the patient's body. Prosthetics is the only method that allows for the most accurate restoration of the shape, original appearance, and size of the breast.

Prostheses can have different shapes and are made from the following materials:

• silicone (closest to the natural appearance of the breast);
• polyurethane foam;
• foam and fiber filler (such “lightweight” prostheses are recommended to be inserted at the end of the recovery period, since they are considered the most comfortable for physical activity).

Ideal prostheses should exactly match the appearance of real mammary glands, both in shape and weight. Modern surgical methods allow making cosmetic sutures barely noticeable. Prostheses can be installed through different surgical approaches ‒ the choice of incision sites depends on the decision of the operating surgeon.

Modern breast implants are bags filled with silicone elastomer or saline solution. As for the technique of inserting the implants, it is quite simple: empty bags are inserted through small incisions in the skin and filled with solution.

Restoration of breast nipples is a separate issue that requires a competent approach. The patient may prefer artificial nipples made of polyurethane and as close as possible to real ones in consistency, shape and color, which are attached to the chest with small suction cups. Other options include tattooing or plastic surgery. Nipple reconstruction is most often performed 2-3 months after mammoplasty, when the swelling of the mammary gland subsides.

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Breast Implant After Mastectomy

Breast reconstruction after mastectomy is a restorative procedure that is performed after both complete and partial removal of the breast along with the malignant tumor. Almost all patients who have undergone mastectomy resort to the most effective method of breast restoration - reconstructive plastic surgery, in order to return to a full life and feel feminine and attractive again.

A breast implant after mastectomy is inserted in one stage ("one-stage reconstruction"). Most often, the implant is made of silicone (or rather, silicone gel and saline, taken in equal proportions). The implant is inserted through a small incision under the pectoralis major muscle.

It should be noted that after the implant is inserted under the skin, a capsule-shaped fibrous tissue may form around it. This is a natural process associated with normal wound healing. In approximately 15-20% of cases, such a “capsule” can cause discomfort and provoke deformation of the mammary gland. In order to prevent such a process, the patient is recommended to do physical exercises and is prescribed a special restorative massage. Radiation therapy increases the risk of formation of a scar capsule by 40-50%. Sometimes implants can shift ‒ in this case, a special massage is necessary. It should also be noted that in most implants, over time (after about 10 years), minor leakage of the contents is observed. This process does not cause harm and does not cause dangerous consequences.

The advantages of introducing a silicone implant are the promptness of the surgical technology and the low trauma of such an operation. The disadvantages include the high cost of the procedure due to the relatively high cost of endoprostheses.

Recurrence of breast cancer after mastectomy

Reconstruction of the mammary glands after mastectomy is carried out by inserting a prosthesis or expander, depending on the specific situation. This operation can be performed during the mastectomy, or postponed for several weeks until the wounds heal and the body recovers.

Recurrence of breast cancer after mastectomy means the recurrence of oncology after a certain time after surgical treatment and chemotherapy. Unfortunately, this process occurs in most cases, especially if the cancer was diagnosed at the last stages. Most often, the tumor develops in the primary site, but a new tumor may appear in the other breast or another area of the mammary gland. The term "recurrence" itself means the "return" of the disease. If the tumor is diagnosed in another place (internal organs, skeletal system, lymph nodes), this means that the cancer has "let out" metastases.

Of course, a relapse of cancer greatly frightens a woman and raises many questions about the correctness of the treatment method and the operation performed. Most often, such a problem arises because malignant cells cannot be completely identified and destroyed, and they enter the surrounding tissues with the blood or lymph flow.

If we talk about time frames, then usually a relapse occurs in the period from 2 to 5 years after the course of therapy. If there is a suspicion of the development of such a process, an in-depth examination of the patient's body is carried out (MRI, PET), as well as a histological examination or biopsy.

Among the prognostic indicators that allow predicting cancer recurrence, one can single out an aggressive course of the primary disease, a large size of the malignant neoplasm, and diagnosis of a late stage of the primary disease. Recurrence is often caused by neoplasms containing certain oncogenes, as well as the presence of malignant cells with a high atomic index. After surgical treatment of the patient, the oncologist must assess the situation for the possibility of recurrence in the future.

Palpation of the mammary glands is one of the main methods of detecting cancer. During the development of a relapse, the following symptoms may be observed:

• any changes in the nipple (shape, color, atypical discharge);
• itching and burning of the chest;
• changes in the structure and size of the mammary gland;
• redness or any change in the color of the skin of the mammary gland, change in temperature.

In case of relapse, local treatment is prescribed, including radiation therapy and surgery, as well as systemic treatment, which involves hormonal and chemotherapy. If there is no relapse in the first 5 years after treatment, then most likely there will be no repeated oncology.

Care after the procedure

Reconstruction of the mammary glands after mastectomy is performed with the aim of immediate restoration of the breast, i.e. the shape and volume of the mammary gland.

Rehabilitation after mastectomy of the mammary gland includes a set of measures, the main goal of which is to return the woman to a full life and improve its quality. The oncologist should warn the patient about the difficulties and problems that may arise during the recovery period after the operation. Typical complications after surgery are post-traumatic in nature. These are hypercoagulation, asthenic conditions, the so-called "phantom pain". Postoperative stress is often accompanied by deterioration of wound healing, the formation of a rough postoperative scar, as well as an extension of the period of lymphorrhea. In addition, it is necessary to highlight such symptoms and consequences as:

• pain syndrome that occurs in the shoulder joint;
• decreased muscle strength at the site of surgery;
• swelling of the upper limb;
• atrophy of the muscles of the shoulder girdle;
• poor posture.

The rehabilitation program is related to the manifestation of postmastectomy complications and depends on the results of an objective examination and the patient's complaints. The rehabilitation program should be developed individually for each patient. The effectiveness of such a program will have a positive effect on the restoration of the woman's ability to work.

Reconstruction of mammary glands after mastectomy is a question that must be approached responsibly, with all seriousness, taking into account the peculiarities of the course of the disease in each individual case. Plastic surgeons from different countries of the world agree that reconstructive surgery is one of the main stages of cancer treatment, a safe method of rehabilitation.

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