Breast cancer is the most common malignant tumor in women. It is estimated that 1/8 women will develop cancer in their lifetime.
Thanks to early diagnosis, breast cancer is a curable disease today. In early stages, surgery and complementary treatments achieve cures of the disease, without relapses over the years.
Once the patient is free of disease after applying combinations of different treatments (surgery, chemotherapy, radiotherapy, hormone therapy, etc.) it is time to reconstruct the breast (if the patient wants).
Breast reconstruction means for the woman to regain her femininity, her confidence, to feel alive and free of disease, without stigmata or marks; it often allows her to dress again without having to wear pads inside her bra… and the results, thanks to the progress of surgery are impressive. There are different techniques that are used alone or in combination with others, and whose results make breast reconstruction a very desirable process for women.
Procedures
- Lipofilling or breast fat grafting. It is used in lumpectomies or to correct minor defects; it involves filling areas with reduced volume, retractions, depressions, hollows, etc., with adipose tissue. Fat also significantly improves the radiation-induced lesions that often develop in the breasts after treatment.
- Expander implant and prosthesis. Reconstruction with an implant often involves two stages: in the initial stage, the breast that has undergone a mastectomy has insufficient skin and tissue to support an implant. Therefore, a tissue expander (an empty water-filled bag) is inserted and gradually filled with saline solution over several weeks and months, allowing the skin to stretch and the scars to heal properly. In the second stage, once the skin has been expanded and is well supplied with blood, the expander is replaced with a permanent prosthesis.
- Reconstruction with pedicled flaps (latissimus dorsi). Sometimes, mastectomy resection and radiation therapy cause significant damage to the skin, making standard prosthetic reconstruction contraindicated. In these cases, it is necessary to reconstruct the breast using healthy tissue—for example, the latissimus dorsi flap—and to place a tissue expander underneath it. The latissimus dorsi provides tissue in good condition that is ready to be safely expanded.
- Reconstruction using microsurgical flaps (DIEP) is the gold standard for breast reconstruction following a mastectomy. It is performed using fat and skin tissue from the patient’s abdomen; an artery and a vein (the deep epigastric vessels) are dissected together and transferred to the breast, connecting this “flap” to an artery and a vein near the (the mammary arteries and veins). This type of reconstruction functionally preserves all the abdominal muscles; only fat and skin are removed. It also avoids the use of breast implants because the flaps are typically voluminous. It is a complex procedure that requires microsurgical skills.
- Reconstruction of the areola-nipple complex using 3D hyperrealistic tattooing (link to hyperrealistic tattooing).
In conclusion, each woman’s reconstructive process is different. There are different types of oncologic resections, different types of breasts and multiple options for reconstruction. The reconstruction process has to be established and agreed with each patient according to the professional’s advice and the patient’s preferences.
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