Saturday, May 1, 2021

Breast reconstruction techniques for after a mastectomy

 

For some women, their breast cancer treatment involves removing a whole breast—either one or both. Some also pre-emptively remove them to reduce the risk of cancer. This removal of breasts is called a mastectomy, double mastectomy if both are removed.  Once the cancer is out the women may consider breast reconstruction to restore the shape and size.  Breast reconstruction is a major milestone in the fight to be cancer-free. It prevents women from having an ugly constant reminder of the profoundness of cancer and provides a way to move on with life without feeling impaired being without breasts.

When you decide to have a mastectomy, you will have one of these techniques to choose from. Let’s explore them below.

Breast reconstruction using implants

Using breast implants, surgeons can restore the shape and volume of breasts.  Mostly done as a cosmetic procedure, surgeons can use either silicone or saline breast implants to creates breasts that are a near-perfect replica of the removed.  Unlike natural breasts, reconstructed breasts will hold shape for longer for example if you age or lose weight, it will impact the natural breast more than it can the implanted one because of less breast tissue.  This may cause the need for a corrective rebalancing surgery later in their lifetime.  Reconstruction using implants is advisable for women with firm and small breasts because there is less need for tissue from other parts of the body.

You can expect scarring from an implant reconstruction to vary with the area and type of incision.  Often the scars are horizontal on the breast but some implantations can happen through the darker part of the breast—the areola to hide it. You can ask the surgeon to play with the position and length to make it as invisible as possible.

Breast reconstruction using your own tissue

Surgeons will mostly use flaps of your tissues, some skin, fat, and muscles to fashion a new breast after a mastectomy. Mostly, these flaps are taken from the abdomen, thigh, or even buttocks.  There may be a slight mismatch of complexion if the skin used comes from another body part but that is a small hiccup to getting breasts again. Reconstruction using flaps works well for women with medium to large size breasts and it can be done immediately after the surgery or delayed until all treatment is completed i.e. radiotherapy and chemotherapy.  While the surgery may be a comprehensive one, breast reconstructed from your own tissues may be a better match than implants over the long term. They will react like normal breasts to things like weight gain or aging and end up looking natural. 

Breast reconstruction using your breast

If flaps will mean that your breasts may have a different complexion then a reconstruction using your own breast will solve this problem. Sometimes some breast reconstructions can conserve the breast if instead of deleting the breast, the cancerous cells were hollowed out and a small layer of normal breast tissue was left all around it. This is the best way to remove cancer and still retain the symmetry and the shape of the breast.  The resulting hollow can usually be filled by moving the remaining breast tissue around but this usually leads to a breast reduction and you will likely go for another reduction procedure to match the symmetry. Alternatively, the lost tissue can be replaced with tissue from another body apart. Commonly the tissues come from the back—a tissue flap called latissimus dorsi flap. Because no foreign skin or and the tissue measured breasts reconstructed by using your breasts feel more natural than the rest.

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