Definition
Breast reconstruction involves the plastic reconstruction of a breast. Various methods can be used for this. Breast reconstruction can be performed using the patient’s own tissue or artificial implants. Which procedure is suitable for a patient depends on her physical situation.
Indication
Breast reconstruction is performed especially in patients with breast cancer and removal (mastectomy) of the diseased breast. For cosmetic and psychological reasons, the patient often expresses the wish to restore the original breast shape including the nipple. A reconstruction of one or both breasts can also be performed after congenital malformations. More and more frequently, breasts are also removed as a precautionary measure if, for example, a family predisposition exists. In this case, the breasts are reconstructed with implants or the patient’s own body tissue.
Time of the operation
Breast reconstruction can be carried out in the same operation as the breast removal, or it can be performed at a later date. Which procedure is the most appropriate depends on a number of factors. On the one hand, the right time depends on the type of cancer and the resulting therapy.
An immediate reconstruction of the breast can usually only be carried out if the cancer treatment is also completed with the removal of the breast. If the mastectomy is followed by chemotherapy or radiation therapy to treat the cancer, it is advisable to wait another six months until an operation can be planned because of the wound healing. Since mainly psychological aspects are involved in this decision, this time can also be bridged with an implant. Many patients feel more comfortable with restoring the normal state as quickly as possible. Subsequently, a reconstruction with the patient’s own tissue can still be carried out.
Preparations
The operation should be performed by a gynaecologist and a plastic surgeon. A good and planned cooperation, also achieves an optimal result. Often the plastic surgeon is involved in the treatment of the patient from the time of diagnosis of breast cancer.
In this way, the doctor gets to know the patient and her wishes and concerns, and the patient can build up trust in her treating physicians. In addition, the patient should be informed early enough about the planned operation, both about the removal of the breast and the possibility of reconstruction. Together with the treating doctors, the right method for the patient will be found.
In addition to a thorough physical examination, the patient is given a comprehensive explanation. This should include the different methods of reconstruction, the respective advantages and disadvantages and which complications and risks can occur. Furthermore, the patient will be informed about her behaviour before the operation.
Ten days before the operation, the patient should not take any blood-thinning medication and should also avoid nicotine and alcohol. At the same time the patient has to inform the doctor about regular medication and allergies or other diseases. After the consultation there should be enough time for the patient to think about everything again and to clarify any open questions in a possible further appointment. For many patients an accompanying psychological support can be very helpful. Here she can share possible fears and worries, but also be professionally prepared for upcoming situations.
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