What to do if the breast has to be amputated?

A mastectomy has far-reaching consequences. The loss of a breast after cancer treatment has a drastic effect on many women. However, every woman deals with this loss differently. Some women feel mutilated by the altered body image. For others, the asymmetry reduces their quality of life and for others it becomes part of everyday life. They try to get used to it. Not all patients had access to an onco-plastic surgeon when they were diagnosed with cancer. Many are unaware of the current options for breast reconstruction or think that living without breasts for a while is beneficial for the disease.

Breast reconstruction will have no effect on the course of breast cancer, nor will it mask a flare-up. Instead, a new breast means the restoration of symmetry, the ability to wear all types of clothing, to feel unhindered when exercising and the restoration of physical integrity. In this respect, the aim of breast reconstruction is always to give patients a better quality of life once their oncological treatment has ended.

Many different breast reconstruction alternatives

Breast reconstruction requires skin and volume. Either the patient's own tissue or an implant can be used for this. In the autologous tissue technique, a block of skin and fatty tissue is used for reconstruction. In contrast, with implant reconstruction, an expander must first be used to stretch the skin and several sessions are required in which the expander is filled with saline until the desired effect is achieved. After a certain period of time, the definitive implant can then be inserted. This technique is not an option following radiotherapy, as irradiated skin can no longer be stretched. The use of the body's own tissue is the most natural way to restore the breast. In contrast to implants, it results in a soft, warm and natural breast shape. As it is the body's own tissue, there is no rejection reaction as with silicone implants. Furthermore, there is no need to change the prosthesis. It can therefore be regarded as a permanent solution.

Reconstruction surgery: much shorter and better tolerated today

How does such an operation work? Depending on the patient's build and breast size, tissue is removed from the abdomen, hips or buttocks. This block of tissue consists of skin, fat and a vascular stalk. The vascular pedicle is carefully dissected out from between the muscles so as not to cause any damage. The blood vessels are then reconnected to the vessels in the chest wall. As these are very small, a surgical microscope must be used for this. The new breast can now be moulded and the donor site closed again. The scars at the donor sites are planned in such a way that they lead to an improvement in body shape: if tissue is taken from the abdomen, for example, this can be combined with a tummy tuck. Nowadays, such an operation only takes 3 hours. This is thanks to improved surgical techniques, a better understanding of the anatomy and a highly specialised team. The first 24 hours after the operation are critical for the blood circulation, as thrombosis could occur in the small blood vessels. You will be encouraged to mobilise on the first postoperative day so that you can usually go home on the fifth day. A recovery period of around 6 weeks should be expected. Three months after the first operation, the nipple is reconstructed in a second operation and, if necessary and desired, the other breast is equalised in a symmetrisation operation.