Breast reconstruction after removal of the breast due to a tumor or another disease is one of the most successful operations of plastic surgery. Thanks to new technologies in medicine, surgeons can now create a breast that closely resembles a natural breast. Today, these operations can be performed simultaneously with breast removal surgery (mastectomy). Thus, when the patient comes out of the operation, he has a new breast and gets rid of the psychological distress that a period without breasts can cause.

However, it should be kept in mind that; Breast reconstruction after mastectomy is not a simple operation. There are many options available to be decided by you and your doctor. Below you are given basic information about the surgery; such as when the surgery was performed, how it was performed, and what kind of results would be obtained. However, it is not possible to answer all questions. Therefore, speaking one-on-one with your surgeon will provide you with better information.

Who is the Best Candidate for Breast Reconstruction?

There is no medical obstacle to breast reconstruction in almost all mastectomy patients, and most patients are suitable for simultaneous reconstruction with mastectomy. However, the best candidates for breast reconstruction are patients whose cancer has completely disappeared through mastectomy. There are many reasons to wait; for example, some patients do not want another surgery, some have difficulty accepting the diagnosis of cancer, and cannot consider breast reconstruction options. Some patients may have been advised by their surgeon to wait, especially when the breast is reconstructed with the patient’s own tissue (flap transfer). In cases such as obesity, high blood pressure and smoking, patients may be advised to wait.

Planning the Surgery

From the time you are diagnosed with cancer, you can start discussing reconstruction. Ideally, your general surgeon and plastic surgeon will plan and operate together. After your health assessment, your surgeon will give you the best options, taking into account your age, anatomical structure, tissues and wishes. Your surgeon should be very honest with you about this. Breast reconstruction after mastectomy can improve your appearance and increase your self-confidence; However, remember, this surgery can only improve the result, not perfect it. Your surgeon should also provide information about anesthesia, the place where the surgery will be performed, and the costs.

Expanding the Skin

The most commonly used technique is widening the skin and then placing a prosthesis. After a mastectomy, a tissue expander is placed under your skin and chest wall muscle. A valve-operated port is placed under your skin, and from there, your surgeon injects saline to inflate your tissue expander for weeks or months after surgery. After it is understood that your skin has expanded enough, a secondary surgery removes the tissue expander and a more permanent prosthesis is placed. Some tissue expanders are designed to be left on permanently. The areola (brown round skin around the nipple) and the nipple are done later. In some patients, there is no need for skin augmentation and a prosthesis can be placed with mastectomy.

Flap Reconstruction

As an alternative to the prosthesis method, a breast can be made by taking a tissue from the back, abdomen or hip. This is called flap reconstruction. In one type of flap surgery, the skin, subcutaneous fat layer and muscle tissue remain connected to the original attachment area by a vessel stem and are shifted to the area where the breast will be formed with the help of a tunnel made under the skin. As it can form the breast alone, a prosthesis can be placed under this tissue. In another type of flap surgery, the tissue is completely separated from the abdomen, back or hip region to which it is attached, and its vessels are sutured to the vessels in the recipient area and are kept alive (reconstruction with a free flap). In order to perform this operation, the plastic surgeon must also be experienced in microvascular surgery. Because it is possible to stitch thin veins together under the microscope.

Both surgical methods mentioned above are more complex operations than the prosthesis method. There will be scars both in the places where the tissue is taken and the breast is made, and the healing process is longer than the prosthesis method. On the other hand, in breast reconstruction made with your own tissue, the result is more natural and there is no concern with silicone. Sometimes, improving the shape of your abdomen and getting rid of excess skin and fat can be a separate benefit for you.