Breast reconstruction is the general term for surgical procedures performed to restore the normal shape, symmetry, and appearance of the breasts following congenital or acquired loss. Reconstruction may also be performed following a preventive mastectomy (prophylactic mastectomy) in individuals who are at high risk for breast cancer. The decision to undergo breast reconstruction is an extremely personal and private one, and it is beneficial for the patient to be well-informed about the reconstruction process.
Breast reconstruction can be performed either at the same time as the mastectomy or at a later date. Reconstruction procedures are divided into two categories based on the technique used: implant-based reconstruction or flap reconstruction, which uses the patient’s own tissues.
The choice of surgical procedure depends on the patient’s body type, the type of mastectomy, and the type of cancer treatment to be administered afterward.
In cases where only one breast is reconstructed, procedures such as reduction, lift, or augmentation may be performed on the other breast to ensure symmetry.
After breast reconstruction, the breast’s volume and the woman’s unique shape are restored. This improves the individual’s body image, boosts self-confidence, and contributes to psychological well-being during cancer treatment.
For breast reconstruction to be performed:
The patient must be in good overall health. She must be informed about breast cancer and the reconstruction process, and her expectations must be realistic. (She should be aware that scars may be present on and around the breast, that sensation in the reconstructed breast may not be the same as in the other breast, and that in flap reconstructions, scars may also form in different areas of the body.)
BREAST RECONSTRUCTION WITH IMPLANTS
In cases where there is sufficient breast skin after mastectomy—particularly after prophylactic mastectomy—the aesthetic results and comfort achieved with breast implants placed during the same procedure are better, and postoperative recovery is faster.
FLAP-BASED BREAST RECONSTRUCTION
In flap-based breast reconstruction, the missing tissue in the breast area is replaced by tissue harvested from different areas of the body (abdomen, back, thigh, etc.) and transferred to this region, where it is reshaped. The tissue can be transferred to the breast area through subcutaneous tunnels without being separated from its original blood vessels, or breast reconstruction can be achieved by connecting the blood vessels of the transferred tissue to the blood vessels around the breast using microsurgical techniques. Implants can also be added if necessary during flap reconstruction.
RECOVERY PROCESS
Swelling, bruising, bandages, and drains present in the early stages gradually subside over time. It may take up to two weeks for patients to return to work. Vigorous exercise is not permitted for 4–6 weeks.
NIPPLE RECONSTRUCTION
Although the need for nipple reconstruction has decreased in recent years due to advances in nipple-sparing mastectomy techniques, it is possible to create a nipple using various techniques from the transplanted tissue in cases where the nipple and areola cannot be preserved.
BREAST RECONSTRUCTION REVISION SURGERY
Breast reconstruction is a highly complex procedure that requires technical and artistic skill as well as experience. Patients may require secondary revision surgery to achieve optimal results.
FOLLOW-UP
Patients are taught self-examination techniques. In addition, they are monitored using ultrasound, mammography, and magnetic resonance imaging.
