In this age, marked by medical breakthroughs and technological advances, plastic surgeons have the ability to “design” a breast that resembles both in shape and volume with a natural breast. There are several ways in which breast reconstruction can be achieved: using only the patient’s own tissue, using only synthetic devices or by a combination of the two. The first step in breast reconstruction is to recreate the skin envelope and volume, either in the same time with the mastectomy, or as a delayed procedure. Afterwards, the nipple is reconstructed, the areola is recreated, sometimes by tattooing it, and the remaining breast is operated on to achieve symmetry.
This whole range of interventions after a mastectomy is complex and challenging, but dramatically increases the quality of life of patients diagnosed and treated for breast cancer. Dr. Sinescu specializes in all aspects of breast reconstruction, and with the guidance and support of our entire team, patients can choose individualized solutions, safe surgeries and predictable results.
Are you a suitable candidate for breast reconstruction?
Most patients with mastectomy may opt for some form of breast reconstruction, keeping in mind that the most important goal is the curative treatment of breast cancer. Also, it is absolutely necessary for the patient to fully understand the reconstructive possibilities that she has, the impact of the procedure and the results that can be achieved.
You can begin to think and plan your breast reconstruction at any time after making a mastectomy decision. Dr Sinescu will meet with you in advance to discuss the reconstructive options and to make sure you understand the procedure and its limits. Our team will also work with the oncology team to develop the best therapeutic strategy for your individual needs.
We will explain what surgical options are appropriate, depending on your age, general health status, local anatomy, type of tissue and your goals. We will describe the potential risks of the procedure, the place and duration of the surgery and hospitalization, the step-by-step technique and what you can expect before and after the procedure. We will discuss the costs and payment methods. We will answer all your questions. We’ll ask for medical history, information on cigarette and alcohol consumption and a list of all the medicines you use, including the over the counter ones. In addition, we’ll have you perform a mammogram or mammary ultrasound before surgery to certify the absence of any other medical problems. If necessary, our doctors will recommend a suitable medical imaging center.
How the procedure is performed
Breast reconstruction is generally a staged procedure. The first operation can be performed immediately after mastectomy or as a delayed surgery and requires 2-7 days of hospitalization. Restoring the nipple is usually done in local anaesthesia and as an outpatient, and the areola is usually tattooed.
There are patients where conservative surgery is applicable, so a part of the breast can be kept, depending on the type and size of the tumor. In these cases, Dr. Sinescu will work extensively with the team of oncological surgeons to provide adequate cancer treatment with the most aesthetic result possible.
For women in need of mastectomy, there are a number of reconstructive options. The simplest form of reconstruction involves placing a device called tissue expander under the skin and pectoral muscles, immediately after mastectomy. When the incisions are healed, the expander is periodically injected with a sterile saline solution, and after it has been filled to a sufficient size, a second operation is performed to remove the expander and place a permanent breast implant.
As another option, Dr. Sinescu uses the patient’s own tissue to create the new breast. There are a number of muscle or musculo-cutaneous flaps that can be used, some of these procedures involving the use of an operating microscope. All of these variations will be discussed with you in detail, and then we will establish a correct and complete operating plan.
What to expect after surgery
Activity – Moment
Hospitalization – 2-5 days
Removing sutures – 7-10 days
Shower or bath – Once the drainage tubes are removed
Back to work – 1 – 2 weeks after surgery
Driving – Usually within 2 weeks
Physically contact with breast – 4 weeks after surgery
Intense physical activity – 3 to 6 weeks after surgery
Fading of scars- a few months / up to one year
Risks and complications of surgery
Any surgery has a degree of risk, and breast surgery is no exception. During the first consultation, Dr. Sinescu will evaluate your individual risk level, all potential problems will be discussed and we will establish together if you have a strong indication for breast reconstruction. Strict adherence to all pre- and postoperative medical recommendations is crucial to reducing any danger. We will always be at your side to achieve a satisfactory and safe end result.
The most common complications include:
– capsular contraction (if an implant is used)
– partial/total flap necrosis
– pathological scars
How long do the results last?
Although the reconstruction cannot duplicate exactly the natural breast, it can give women who have lost a breast because of cancer or other diseases a natural look and improved quality of life. Breast reconstruction is permanent, but the effects of gravity and the passage of time do not forgive anyone.
Frequently Asked Questions
Does breast reconstruction have any role in cancer recurrence?
Reconstruction has no known effect on cancer or breast disease recurrence, nor does it interfere with chemotherapy or radiation therapy in cancer cure. There is a certain type of lymphoma discovered in the last 5 years that occurs in a small percentage of patients using implants. All of these aspects will be discussed with you in detail in the preoperative setting.
Is the surgical intervention covered by health insurance?
For several years now, breast reconstruction is covered by the health insurance in Romania. Our team will give you all the necessary additional explanations.
What alternatives exist for breast reconstruction?
Some women choose not to reconstruct breast immediately after breast removal, but to wait until they are ready for another surgery or to wear an external prosthetic breast. It is a personal and individual decision.
Are there ways to correct the appearance of the remaining breast if it is not symmetrical with the new one?
We do plan symmetry operations in most cases to provide a match of size and shape of the natural breast with the reconstructed one. These may be reductions, mastopexies, augmentations or combinations of techniques. We aim to complete the reconstruction procedure with a fitting aesthetics and a pair of resembling breasts.