In 2020, more than 2 million women were diagnosed with breast cancer in the world, according to the World Health Organization. Often, the treatment of this neoplasm involves surgeries, therapies, medication and the removal of one or both breasts, affecting the patient physically and emotionally, and may delay her process of reincorporation to daily life. That is why breast reconstruction plays a fundamental role. Next, Dr. Enrique Chau, reconstructive plastic surgeon at Clinica Ricardo Palma, helps us to answer some doubts about this very important procedure.

What is breast reconstruction?

It is a multiple procedure that helps restore the shape of the breasts after a mastectomy. This consists of two surgeries; in the first the glandular mammary complex is reconstructed and in the second the areola-nipple is reconstructed.

Can breast reconstruction be done right after a mastectomy?

Yes, immediate reconstruction can be done. This decision depends mainly on the mastologist oncologist surgeon, who removes the injured breast tissue, releasing the entire area, after which the immediate procedure is carried out, in the same operating room.

Is every patient a candidate for this type of surgery?

Most patients are candidates for immediate or delayed breast reconstruction. However, there are certain diseases that limit this type of intervention, as well as chemotherapy drugs that alter the regeneration process. For this reason, in these cases it is appropriate to wait until the end of the treatment to carry out the intervention; this decision is made together with the oncologist.

What are the different techniques used for these interventions?

The best-known techniques are:

• Latissimus dorsi reconstruction surgery

  In this technique, part of a back muscle called the great dorsalis is used together with the skin, which rotates from the back towards the mammary region through an internal tunnel-shaped tube reaching the area where breast tissue is missing. Most of the time, this muscle only provides external protection, so the volume is usually given with the use of a silicone prosthesis.

• TRAM technique (Transverse Rectus Abdominis Muscle)

  It consists of transferring the flap or transverse tissue that is below the navel together with the rectus muscle towards the breast area. This is a well-known technique, however it weakens the abdominal wall a lot, so it is recommended only in some cases.

• Microsurgical breast reconstruction

  This is one of the most modern techniques. It consists of carrying the tissue from the back or abdomen, cutting the micro arteries and then connecting them directly without tunneling to the breast area. In this way, the reconstruction is more functional and the patient has fewer side effects.

What are the benefits of a breast reconstruction?

Previously, this procedure was considered for cosmetic purposes only; However, from the psychological point of view, it fulfills an emotional objective, since it makes the process more bearable, allowing the recovery of the body image that has been altered.

What recommendations should be followed after this surgery?

Understanding that breast reconstruction usually involves two surgeries, the healing process must be taken into account, which takes between 6 months to 1 year. The patient must go to her fortnightly or monthly check-ups so that the scars, the shape and the breast volume are symmetrical between the breasts. It is also very important to go hand in hand with controls with the surgeon oncologist mastectologist.

Dr. Enrique Chau
Reconstructive Plastic Surgeon at Clínica Ricardo Palma