breast reconstruction mastectomy

       Statistics show that one in six women suffer from breast cancer and perception and fear of illness are the main obstacles to diagnosis in early stages of breast cancer.
       That’s how most of the patients get to the doctor late, when the treatment options are difficult to follow, painful and psychologically exhausting, and mastectomy (removal of the mammary gland) is the most appropriate procedure to ensure the chance of survival as great as possible.
       Although the reconstruction of the breast should be absolutely normal, thousands of women who have gone through a mastectomy remain mutilated for life, each in her drama. Most do not have information about this issue, they are not advised!
Do not be discouraged by anything! If you defeated a disease like cancer, you can do anything! It is worthwhile to go all the way.
Reconstruction of the breast after mastectomy is a necessity!
       The psychological impact due to the removal of one or both breasts in case of breast cancer is devastating.
The development of adjuvant treatments for breast cancer and mammary implants has made it possible nowadays to reconstruct the breast immediately to reduce the psychological impact of mastectomy – breast removal to treat or prevent cancer. Thus, the quality of life and the rapid psychosocial reintegration of patients have become possible.

     What does breast reconstruction work for?

       Breast reconstruction is the surgery by which the shape and dimensions of the breast lost after the mastectomy operation are restored. It is a complex surgery requiring a multidisciplinary team (an oncologist, plastic surgeon, chemotherapist, radiotherapist, oncologist and psychotherapist).
       Reconstruction of the breast can take place in a single stage or in several stages, immediately after mastectomy (in the same operation) or late, one year or more from mastectomy. It is also possible to reconstruct the nipple and mammary areole (the darker circle around the nipple).
       The appearance of the reconstructed breast is similar, but not identical, to that before mastectomy. The resemblance increases when the patient wears the bra.

     Types of breast reconstruction

       The type of breast reconstruction should be chosen based on age, health status, type of mastectomy, and complementary treatments for cancer (chemotherapy, radiotherapy).
Breast reconstruction can be performed using:

  • Breast implant – is a procedure that takes place in a single step. It shows the disadvantage that the size and shape of the reconstructed breast can not be adjusted later.
  • Tissue Expansions – are implant-like devices filled with physiological saline, the volume of which progressively increases until the desired volume is achieved. In the second step, it is necessary to replace the expander with a breast implant.
  • Implant-expander – are two-chamber implants, on the outside are filled with cohesive gel, similar to regular implants, and on the inside they have a chamber whose volume is variable, filled with physiological serum. It has the advantage that it does not require replacement with a definitive implant.
  • Tissues – skin, fat and muscles in the region of the abdomen, back, buttocks used to rebuild the shape and size of the breast. It is harvested from the mentioned regions and moves to the chest, after which the blood vessels that feed them are rebuilt, using a microscope. They are long-lasting surgery and result in large scars in the abdomen, back or buttocks.

       Choosing the moment of immediate or late mammary reconstruction is done through an interdisciplinary consultation: oncologist, oncologist, chemotherapist, radiotherapist, the final decision being made taking into account the patient’s wish.

     Preparing for surgery

       This will begin with the assessment of health. Depending on the type of breast reconstruction and timing, you will be able to explain the advantages and disadvantages of the procedure together with the possible risks.
Regardless of the type of reconstruction you choose, you will be asked to quit because the healing period is delayed and complications related to tissue survival may occur.

     The recovery period after breast reconstruction

       You may be tired and have pain for a few weeks after surgery. Your doctor may prescribe medications for pain control.
       You will also have scars after surgery. Scarring is permanent, but scars fade over time. Returning to normal activities can take 6 weeks or more. Your doctor will notify you of the various restrictions you should keep in mind, such as avoiding overhead or soliciting physical activity.
       The recovery period after immediate or late mammary reconstruction is approximately 6 months, taking into account that after mastectomy you will have a drain tube in the axilla where the lymph glands have been removed.
       Subsequently, after 6 months, a breast symmetry intervention will follow. At this stage, it is the other breast that can be lowered or just raised to resemble the reconstructed breast. Also, reconstructed breast can make shape, contour or volume improvements by injecting its own fat and reconstructing the areola and nipple.
       The end result after a breast reconstruction is achieved after 1-2 years.
       This intervention is not only a reconstruction, it is a relationship of trust and communication between the surgeon and the patient, so that it is possible to establish and plan the stages of the treatment by mutual agreement. Regular checks are made according to each stage we are in, until the end. Subsequently, in addition to periodic oncological controls, controls are performed on the plastic surgeon. After one year they are optional, annually or when needed.
       Breast reconstruction does not hide a return of cancer nor does it represent an impediment to treating it. Examination of reconstructed breast is possible both through clinical and imaging examination.

     Screening for breast cancer in the future

       If you had only one rebuilt breast, you will have to perform mammogram screening regularly on the other chest. Mammography is not required on breasts that have been rebuilt. You can choose to carry out examinations on the natural skin and the surrounding area from the rebuilt chest. This will help you get familiar with your chest changes after surgery, so be careful about any changes.
       Keep realistic expectations when anticipating the outcome of surgery. Breast reconstruction offers many benefits, but it does not make you look or feel exactly as you did before mastectomy.

     What are the benefits of breast reconstruction?

  1. Give a contour to the breast;
  2. Provides a symmetrical improvement of the breasts, so they look similar under clothes or a swimsuit;
  3. Helps to avoid the need to wear an external prosthesis;

     Reconstruction of breasts can:

  1. Improve your self-esteem and body image;
  2. Requires additional surgery to correct reconstruction problems.

     Reconstruction of breasts can not:

  1. Make you look the same as before;
  2. Make you feel the same as having regular breasts.



       The importance of early diagnosis was also underlined by Mihaela Sofrone, one of the women who survived breast cancer: “Initially, I discovered a nodule. I immediately went to a doctor who, although he told me it was a benign formation, a fibroadenoma, recommended me the surgery. Because of some fears and the fact that I was very busy (from a professional point of view), I decided to postpone this intervention for six months. Unfortunately, after about four months, the nipple began to bleed. It was breast cancer, an early stage, over which he had to intervene by mastectomy and chemotherapy. That’s why I advise all women to go to a doctor as soon as they identifies something wrong with one of her breasts, cooperate, and accept medical advice. ”
       Mihaela is, however, only one of the thousands of patients diagnosed annually with breast cancer who underwent a mastectomy and benefited from a breast reconstruction surgery.
       She accepted the disease and struggled with her, and she is now a beautiful, complete, optimistic woman.
       In the same situation was found Tereza Mărginean, a patient who benefited from breast reconstruction. She wants to convey a message to women that the disease does not take age into account. In addition, she also recommends going to a doctor whenever we have a suspicion of something wrong, taking into account doctors’ advice, following exactly the recommended treatment, and doing preventive analyzes every year – ultrasound or mammography.
       The Intermed Quality Team is at your disposal for any questions.
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