Breast Reconstruction

What is the breast reconstruction?

Breast reconstruction is a surgery that is done through several procedures in order to restore the shape, look and size of a breast after a mastectomy. This procedure uses flap techniques to reposition the muscle, fat and skin in order to create or cover the affected breast; the extension of healthy skin to cover the breast implant; breast implantation and other techniques which allow the creation of nipples or areolas.

Even though this procedure can actually rebuild the appearance of a normal breast, the results vary greatly. A reconstructed breast does not have the same sensitivity as the original one. Furthermore, the incision marks are visible, as well as those on the donor area in case the flaps technique had to be used.

Am I a good candidate?

The best candidates are those patients that are currently dealing with the diagnose and the treatment correctly, they must not have any other medical conditions that may endanger their health, they cannot smoke and they must have a positive and realistic prospect for the surgery.

Are there other options?

Another technique used is one in which fat grafting is used to repair tissue and give more volume to the area. Breast reconstruction with implants and skin extension reduce the incision lines depending on the shape of the breast.

What does the surgery consist of?

Once the technique has been decided by Dr. Robles, you will be ready to enter the operation room. Then Dr. Robles will mark the areas in which he’ll perform the surgery and take pictures to compare the results afterwards.

At this point, the doctor’s assisting team will sedate you and anesthetize you. After this the surgery will begin.

Since there are several techniques to perform a breast reconstruction, this is a highly personal choice; each procedure has its own advantages. The correct one for a patient depends on its anatomy, what Dr. Robles believes is best and the wishes of the patient.

The best sensitivity is achieved with the flap technique, and this procedure is necessary in those cases in which the tissue or muscle that remained after the mastectomy is too small. There will be incision lines both in the donor area as in the reconstructed one. Finally, there is a remote chance of a partial or total tissues loss due to poor healing.

In some cases the mastectomy has left enough tissue on the chest wall to cover and support a breast implant. Using a breast implant for the reconstruction needs almost always the use of the flap technique or tissue extension.

Reconstruction through tissue extension allows an easier recovery than the one with flap technique.
Breast reconstruction is harder through techniques that rebuild the nipple and the areola. The surgery can be done in a single time, or in several steps depending on which technique Dr. Robles thinks is the most appropriate and the treatment used to deal with the cancer. Complete reconstruction is usually done in a process which lasts several months.

The flap technique for transversal abdominal muscles uses as donor zone for muscle, fat and skin the patient’s abdomen for the breast reconstruction.

The Latissimus dorsi flap uses muscle, fat and skin making way under the back skin and tissue of the patient to the breast that must be reconstructed, which means that it remains linked to the donor area keeping the blood flow intact. In some cases, the flap may be used for a complete reconstruction, but the usual is that it provides muscle and tissue to support the breast implant.

The breast implant may be added or it may be an alternative technique to the flap. Reconstruction through breast implant only needs the extension of tissue.

How is the recovery from the surgery?

Once the procedure is completed, you will be placed bandages on the operated areas, and you will have to wear a compressing bra to minimize the swelling in the area and also to support the reconstructed breast. In those cases with an excessive bleeding or fluid drain, you will be placed a thin tube that will go under the skin to perform the drainage.

Initially there will be swelling and discomfort in the donor areas due to the flap technique used. The prescribed medication will help you cope with the uncomfortable feelings. It is very important to take care of the wounds as Dr. Robles indicates and continue to use bandages, the bra and using ice or specific medication. A quick and satisfactory recovery depends on all of that.

In general, the stitches used in these techniques are non-removable or self-absorbing. If this is not the case, the stitches will be removed approximately 2 weeks after the surgery. At that moment, you’ll be ready to go back to work as long as it doesn’t imply too much strain.

Healing will continue for several weeks as the swelling wears off and your body gets used to the new shape and size of the breast.

What are the risks of the surgery?

The possible risks include bleeding, poor infection or healing. Flap technique means that there will be partial or total sensitivity loss in both the donor and the reconstructed area. Using implants implies a capsular contracture or rupture risk. Other than those, there’s always a risk when using anesthesia.

How long will the results last?

The final results of the breast reconstruction preceded by a mastectomy will help you fill physically and emotionally complete.

In time, part of the lost sensitivity will be recovered and the incision lines will improve, even though they will never disappear. A careful watch of the reconstructed breast through auto-exams, mammographies, and other diagnose techniques is vital for long-term results.

What do I need to get the surgery done?

After all the details have been confirmed with Dr. Robles, you will be given some documents related to the procedure. There, you will find the informed consent for the surgery, which is a written statement that you’ve been fully informed of the surgery you are about to be practiced, as well as the risks involved. You will also be given a sworn statement of your medical history. Both must be read and filled when they are given to you, however you’ll sign them the day of the surgery on Clínica Robles.

In order to assure your safety and to be certain that the surgery will go without any complications, Dr. Robles will perform some routine pre-surgical tests, including blood tests, ECG, surgical risk tests, and whenever necessary an ultrasound scan.

It is of the utmost importance that you have all of the medication and other elements that Dr. Robles had asked you in previous consults. A fast recovery will depend on that. Medication varies according to the type of treatment or your medical history. This is why that information must be the trustworthy.