Breast reconstruction: Breast cancer continues to be a significant health issue affecting one in eight women. The reconstruction and repair of a breast, whether entirely or partially removed surgically due to breast cancer, is one of the crucial areas of reconstructive surgery. Patients who have undergone lumpectomy, partial or total mastectomy, or those identified with genetic mutations opting for preventive mastectomy are suitable candidates for breast reconstruction. Breast reconstruction can be performed simultaneously or after the surgical treatment of breast cancer, depending on various factors. During this surgery, interventions can also address other conditions causing deformities in the breast, resulting in achieving the desired appearance.

1. Reconstruction with Implants

2. Reconstruction with Autologous Tissues (using tissues from your own body)

3. Combination of Autologous Tissues and Implants for Reconstruction

While breast reconstruction generally yields satisfying results, patients should be aware of possible risks. Common problems encountered after reconstruction include:

Early Stage:

- Pain

- Bleeding

- Hematoma (accumulation of blood inside), seroma (accumulation of bodily fluid inside)

- Infection

- Wound healing problems

- Sensory issues

- Partial or complete loss of flap tissue

- Need for implant removal

Later Stage:

- Implant loss, exposure from the skin, painful/visible contraction in the implant capsule

- Noticeable scars

- Hernias

- Asymmetries

- Unsatisfactory appearance

Before breast reconstruction, many patients receive chemotherapy. The expected duration for breast surgery is sufficient for reconstruction. While breast reconstruction is usually a positive experience, potential risks should be communicated to patients. Early problems in wound healing may cause delays, and postoperative complications can potentially postpone the initiation of chemotherapy.

Radiation has detrimental effects on the newly reconstructed breast, particularly for breasts reconstructed with implants, leading to significant complications. If radiation is deemed necessary, breast reconstruction can be delayed until after radiation therapy. In uncertain cases, an essential option is to preserve the skin valuable for reconstruction using a balloon tissue expander until the situation with radiation becomes clear. In such cases, late reconstruction with only autologous tissue or a combination of autologous tissue and implants are the primary options.

Personal preferences and lifestyle are important, but other factors are considered:

- Age, general health

- Stage of cancer

- Whether you will receive postoperative radiation and/or chemotherapy

Simultaneous reconstruction with preservation of the healthy breast skin and, in some cases, the nipple, can achieve a nearly normal, highly satisfactory breast appearance. Reconstruction can be done with silicone implants without taking tissue from another part of the body. The suitability of this method is crucial as it depends on the patient's desire not to undergo surgery in another area of the body, having a sufficient breast pocket, and not having received or planning to receive radiation therapy.

Advantages of Reconstruction with Implants:

- Fewer scars

- Shorter surgery, faster discharge times

Disadvantages of Reconstruction with Implants:

- Reconstructed breasts may not mimic the characteristic teardrop shape and sagging of natural breasts.

- Significant asymmetry problems may be noticeable, especially when compared to the natural breast on the opposite side.

- Implants may need to be replaced during your lifetime.

- The cost of reconstruction with implants may be higher.

Autologous Tissue Reconstruction involves reshaping and repairing using tissues taken from other parts of the body. Autologous tissue reconstruction, due to the similar qualities of tissues, will provide the most natural results. The most commonly used source of tissue is the abdominal area. Other areas such as the hips, back, and thighs can also be used as sources of autologous tissue.

Advantages of Autologous Tissue Reconstruction:

- Achieving a natural appearance and character of the breast

- Improved appearance by transferring excess tissues (for the abdomen)

Disadvantages of Autologous Tissue Reconstruction:

- Longer surgery, longer hospitalization, slower recovery

- Requires a surgical team experienced in microsurgery

- Additional scars in the abdomen/other areas

The best option for you can only be determined after a discussion and examination with your plastic surgeon.