Breast reconstruction: what it is and how it is done

Breast reconstruction is a type of plastic surgery that is usually done on women who have had to undergo mastectomy, which corresponds to the removal of the breast, usually due to breast cancer. Breast reconstruction is a surgical procedure that aims to give a new breast to mastectomized women, taking into account the size, shape and appearance of the breasts, in order to improve the self-esteem, self-confidence and quality of life of the woman who usually is impaired after breast removal.

The main objective of this surgery is to return the breast to the woman, or to leave the breasts symmetrical and similar in size, if only one breast has been removed, for example. For this, there are two main types of breast reconstruction with:

Implant, which consists of placing a silicone implant under the skin, simulating the natural shape of the breast; Abdominal flap in which skin and fat are removed from the abdominal region to be used in the breast region and to reconstruct the breasts. In some cases, flaps of the legs or back can also be used, if there is not enough in the belly, for example.

The type of reconstruction should be discussed with the doctor and varies according to the woman's goals, the type of mastectomy performed and the cancer treatments that were performed.

In many cases, if it was not possible to preserve the nipples during mastectomy, the woman may choose to try to reconstruct them 2 or 3 months after the breast reconstruction or leave only the breast volume, with smooth skin and no nipples. This is because reconstruction of the nipples is a very complex process that must be done by a surgeon with a lot of experience.

Surgery price

The value of breast reconstruction varies according to the type of surgery, surgeon and clinic where the procedure will be performed, and can cost between R $ 5000 and R $ 10, 000.00. However, breast reconstruction is a right of mastectomized women who are enrolled in the Unified Health System (SUS), but the waiting time can be quite long, especially when reconstruction is not done together with mastectomy.

When to do the reconstruction

Ideally, breast reconstruction should be done together with mastectomy, so that the woman does not have to undergo a period of psychological adaptation to her new image. However, there are cases in which the woman needs to do radiation to complete the cancer treatment and, in these cases, the radiation can delay healing, and it is recommended to also delay the reconstruction.

In addition, when the cancer is very extensive and a large amount of breast and skin needs to be removed during mastectomy, the body needs more time to recover, and it is also advisable to delay reconstruction.

However, while reconstructive surgery cannot be done, women can opt for other techniques, such as the use of padded bras, to improve their self-esteem and be more secure with themselves.

Care after breast reconstruction

After reconstruction, gases and tapes are usually placed in the surgical incisions, in addition to recommending the use of an elastic bandage or bra to reduce swelling and support the reconstructed breast. It may also be necessary to use a drain, which must be placed under the skin, to remove any excess blood or fluid that may interfere with the healing process and favor the occurrence of infections.

The doctor may also recommend the use of some medications to decrease the risk of infections, in addition to measures related to the hygiene of the place and regular medical monitoring. Recovery after breast reconstruction can take several weeks, with a progressive reduction in swelling and an improvement in the shape of the breast.

The new breast does not have the same sensitivity as the previous one and it is also common for scars related to the procedure. However, there are some options that can help disguise the scars, such as massage with moisturizing oils or creams or cosmetic procedures, which should be done under the guidance of the dermatologist.

Advantages and disadvantages of the type of surgery

The type of breast reconstruction cannot always be chosen by the woman, due to her clinical history, however, there are some cases in which the doctor allows to make this choice. Thus, the advantages and disadvantages of each method are summarized in the following table:

Benefits

Disadvantages

Reconstruction with implant

Faster and easier surgery;

Faster and less painful recovery;

Better aesthetic results;

Lower chances of scarring;

Higher risk of problems such as displacement of the implant;

Need to have a new surgery to change the implant after 10 or 20 years;

Less natural looking breasts.

Flap reconstruction

Permanent results, with no need for further surgery in the future;

Less risk of problems over time;

More natural looking breasts.

More complex and time-consuming surgery;

More painful and slower recovery;

Possibility of less positive results;

Need to have enough skin to make the flap.

Thus, although opting for the use of implants is a simpler option with an easier recovery, in some cases, it may bring a greater risk of problems in the future. The use of a flap, on the other hand, is a more complicated and time-consuming surgery, however, it has less risk in the long term, for using tissues removed from the woman herself.

See how recovery is and the risks of any plastic surgery on the breasts.