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Breast reconstruction after removal

After breast ablation/loss (usually after breast cancer surgery), it is possible to surgically perform a breast reconstruction to create a new breast.

The procedure can usually be performed 1-2 years after the original breast cancer surgery. There must be no signs of the original cancer, the oncological treatment is completed and the oncologist agrees with the procedure.

Form of intervention

The procedure is performed under general anaesthesia, followed by hospitalisation for several days.

Method and course of operation or procedure

A silica implant or the fat and muscle tissue from the abdomen are used for the surgery. With these techniques, it is possible to create a breast of appropriate shape and size, with visible scars, but otherwise of natural appearance (including the areola and nipple). If the second breast is large or sagging, it is sometimes necessary to adjust the shape and size of the second breast.

When reconstructing the breast with a silicone implant, the implant is inserted into a chest pocket created in the site of the previously removed breast. The procedure requires sufficient skin cover above the implant. If this is not enough, it is first necessary to insert an expander into the receiving area, which is a silicone bag with a filling flap. It is with this flap that we will start filling it at several-day intervals after the surgical wound has healed. The skin above the implant "grows" during this time, allowing the implant to be inserted during a subsequent procedure, approximately 1-2 months after reaching the required expander filling. In some cases, it is possible to prepare the space for implant insertion surgically shifting the tissues on the equilateral side. Then either an expander or a straight implant is inserted into this space.

During the reconstruction of the breast using the patient’s own tissue, an elliptical lobe is first created in the lower abdomen, which is fed by the vessels of one or both straight abdominal muscles and is formed by the skin and subcutaneous tissue of the lower abdomen. The lobe on the muscle stem is then freed and passed through a subcutaneous tunnel to the chest. The defect of the abdominal wall in the lower abdomen is reinforced with a plastic mesh and sewn together. Therefore, this procedure is combined with the cosmetic treatment of overhanging abdomen (abdominoplasty). At the receiving site on the chest, the lobe is modelled into the desired shape and fixed.

Because it is very difficult to create a new breast to be symmetrical with the other, healthy breast, it is often necessary to adjust the size of the healthy breast to the size of the reconstructed breast during the next surgery. So it does not have to be the only and last surgery. It is necessary to take into account the need for one or more subsequent procedures. It is also possible to reconstruct the nipple.

You and your doctor will discuss the procedure that is right for you.

Method and course of operation or procedure

In case of absence of complications, a resting regime is recommended for 3-4 weeks in the postoperative period, elastic underwear must be worn for 6-8 weeks, strenuous physical activity or sports are possible after 2-3 months at the earliest.

Form of payment

The procedure is fully covered by health insurance. The procedure is performed under general anaesthesia during a hospitalisation over several days.

 

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