The deficiency that occurs after breast removal due to personal, familial or sexual relationships may cause demoralization and even depression in women. However, it is possible to reconstruct breasts using their own tissues and/or silicone prosthesis in suitable female patients by examining the cancer stage and other findings. Restoring the breast structure, which is an important part of sexuality and femininity, will increase the quality of life and morale.
Deciding on the operation method
After consultation with the plastic surgeon, general surgeon and oncologist, immediate reconstruction in the same session after mastectomy can be an acceptable method. In other cases, delayed reconstruction is a viable choice. To determine this, the patient's medical history, type of breast cancer, and whether there is postoperative radiotherapy are evaluated.
Attempts for reconstruction may be only the placement of a silicone implant (prosthesis), the use of a pedicled or free musculo-skin flap (TRAM or Latissimus Dorsi) to create a new breast, or a combination of prosthesis and flap. The other breast should also be symmetrical with this newly made breast. A reduction or lift mammoplasty may be required for the other breast, which may be large and drooping.
Surgery and treatment process
Surgery is performed under general anesthesia. If there is no unexpected situation, the patient is discharged within 3-5 days after the operation. It takes an average of 6 weeks to fully recover from mastectomy reconstruction or flap surgery.
Regular examinations should be performed to ensure the success of breast reconstruction. The patient's medical doctor organizes other check-ups – for example, if only one breast is taken, mammography, computed tomography or even magnetic resonance are used to detect remaining breast tissue or local recurrences in the chest wall. Suspicious radiological findings should be coordinated with physical examination findings.
As a result, a new breast appearance was formed, which can satisfy the patient much more than the image formed after breast removal. The nipple (nipple) is reconstructed with a local operation (three star flap) approximately 3 months after the main operation. For the pigmented appearance around the nipple (areola) tattoo (tatuaj) is done with medical paints.
What is Breast Reconstruction?
Breast reconstruction, that is, breast reconstruction for patients who have lost their breasts due to cancer or any other reason, and the woman's regaining a normal appearance is an application that is frequently requested today and has become much easier with the latest technological developments. With newly developed techniques and tools, plastic surgeons can now make breasts that are very close to the original and natural looking. In today's modern breast cancer surgery, patients who undergo surgery to have their breasts removed due to cancer are lifted with their newly made breasts. In other words, the repair is done immediately and the patients never experience the psychology of being without breasts. This repair can be done immediately or after a while after the breast is removed. But this is more difficult and troublesome than doing it right away. All over the world, this system is not fully established and patients experience psychological stresses such as organ loss, disability, and being half human after cancer surgery due to socio-economic reasons.
The aim of breast reconstruction is to prevent a woman who lost her most important and visible genital organ, which is difficult to hide, from seeing herself as a half and disabled person despite the disease she was caught. The patient who recovers from this psychological condition will be stronger and healthier, and will be able to fight his illness more easily.
Who Are Suitable Candidates for Breast Repair?
Many breast cancer patients are eligible for breast reconstruction immediately after breast removal. In other words, almost all patients with breast cancer are candidates for breast repair immediately after the breast is removed. However, some patients do not want an extra surgical event at the beginning or they want to wait with the advice of general surgeons and repair in a second session. In addition, patients whose health condition cannot afford this surgery, those with severe obesity, those with high blood pressure and those who smoke can be kept waiting for repair later. However, such patients whose breasts will be removed should be prepared psychologically in advance and informed that this repair can be done in the future, and they should have a more positive outlook on the future.
What Are the Risks?
Smoking should not be smoked as it will delay wound healing. Side effects such as bleeding and infection are as common as any surgery. These are minimized by providing careful surgical practice and sterile operating conditions. Breast reconstruction does not cause breast cancer to recur. Some patients who have been without breasts for a long time may experience adaptation difficulties after breast reconstruction.
Patients with breast cancer can also start planning for the repair without breast removal surgery. Ideally, the general surgeon who will take the breast and the plastic surgeon who will do the repair should work together to determine the best strategy and technique. After examining the patient's health status, plastic surgeons explain what type of surgery will be performed, which technique will be more appropriate, and the objectives. Breast reconstruction will not only improve the appearance of the patient, but also ensure that the patient regains their self-confidence, making them happy and their morale higher during the treatment of the disease. The patient is examined with various tests and analyzes performed before the operation and it is determined whether there is an obstacle to the operation. If necessary, smoking is stopped and some drugs that increase bleeding, such as aspirin, are discontinued.
How is Breast Reconstruction Surgery Performed?
Breast reconstruction is an operation in which more than one operation is performed together and it must be performed in a full-fledged hospital. Depending on the type of surgery to be performed, it requires staying in the hospital for 1-3 days. General anesthesia is applied. There are many surgical methods for breast reconstruction, and the plastic surgeon will talk to the patient and decide together which one will be more appropriate.
Skin Expansion Technique
It is the most commonly used method. In the first session, the patient's skin in the area where the breast was taken and a special balloon placed under the muscle are slowly inflated and expanded within 1-2 months with a special balloon called tissue expander. Then, when the skin expands enough, this balloon is removed in the second session and a breast prosthesis with permanent silicone gel or salt water is placed in its place. Then the nipple is made. Some patients do not need augmentation and the surgeon places the permanent breast prosthesis in the first session.
In this technique, tissues taken from other parts of the patient's own body are used instead of prosthesis to make breasts. For example, the back, abdomen, or hips. For example, a new breast is created by transferring the skin, fat and muscle tissue from the lower abdomen or back to the chest area and reshaping it. Tissue areas are closed. Later, minor interventions such as nipple reconstruction or revisions can be performed under local anesthesia. If the patient wishes, the other breast is made compatible with the newly made breast.
Within 1-3 weeks, the patient returns to his normal life. According to the preference of the plastic surgeon, the patient can leave the hospital in 1-3 days. The scars fade to a large extent over time. Lifting heavy loads for 4-6 weeks, sports activities that require a lot of effort and sexual activation are inconvenient.
How Will The New Image Be?
Since patients who have breast reconstruction surgery at the same time as breast removal surgery will not experience the absence of their breasts, their adaptation will be much easier. The new breast will be slightly harder and rounder than the old one. Those who have breast repair surgery after a period of removal will have a serious body image improvement, they will get rid of the discomfort of the substances they have put here to fill and their self-confidence will be restored.