Indications for the procedure:
- absence of the breast after mastectomy due to cancer,
- underdevelopment of the breast due to disease,
- post-disease and postoperative breast deformities.
Before the surgery:
Before breast reconstruction a consultation with the plastic surgeon is recommended, during which the specialist doctor answers all the patient's questions and discusses the procedure details. The patient should bring a current breast ultrasound and previous test results relating to the operated site to the consultation. Before the procedure itself a series of preoperative tests must be completed including an ECG (for patients over 40 years of age). Additionally, for a minimum of 10 days before the procedure blood-thinning agents (e.g. aspirin) must not be taken, and the procedure date should not be scheduled just before menstruation.
General nutritional recommendations before the procedure:
To better prepare for the breast reconstruction procedure it is also worth following nutritional recommendations. The diet before the procedure must not be restrictive, as protein deficiency impairs healing of postoperative wounds. However, certain modifications are worthwhile. The diet should be easily digestible and fatty, bloating products should be eliminated. Smoking and alcohol should be stopped. It is worth paying attention to preparations that may cause excessive bleeding, e.g. preparations containing vitamin E, ginkofar, and medications containing acetylsalicylic acid (aspirin and its derivatives). Also chilli, cayenne, garlic, ginger, saffron, onion, celery, and horseradish may increase the risk of bleeding.
Type of anesthesia:
General anesthesia.
Duration of the surgery breast reconstruction:
Depending on the method – from 1.5 to 4 hours.
Course of the surgery:
Breast reconstruction using an expander-prosthesis involves the insertion of an implant that initially serves as a tissue expander and stretches the skin. Once the optimal result is achieved it becomes the permanent prosthesis.
Hospital stay:
From 2 to 5 days.
Postoperative recommendations:
A restful lifestyle. Wearing a bra. Check-up appointments to fill the expander or until complete healing (3–4 times after surgery). With implants it is relatively difficult to achieve complete similarity to the healthy breast (absence of ptosis of the reconstructed breast). Use of scar ointments is recommended.
Recovery time:
From 3 to 8 weeks depending on the method.
General nutritional recommendations after the procedure:
The diet after surgery is extremely important, and proper balance ensures supply of nutrients essential for correct wound healing. Meals should be prepared so that they are easily digestible and nutrients well absorbed. The daily menu must include products that are sources of high-quality protein. Zinc, iron, and vitamins also play an important role in the recovery process and adequate intake in the diet should be ensured. Consumption of fibre-rich products prevents constipation that may occur after surgery. Products such as chocolate, tea, coffee, sweets, and starchy foods should also be avoided as they slow intestinal motility.
Example results of breast reconstruction:
Breast reconstruction – other methods:
- using a tissue expander exchanged after approximately 6 months in a second operation for a permanent prosthesis (the expander serves to stretch the tissues and prepare them for implant placement)
- in patients who have undergone radiotherapy or have very poor scarring, own tissues from the back (latissimus dorsi muscle with skin island) and an expander-prosthesis or prosthesis can be used depending on the size of the healthy breast
- using only own tissues (harvesting a flap from the lower abdomen, between the navel and the pubic symphysis, and using it to create a breast) – a two-stage operation. In the first stage the flap is raised, in the second stage the main operation is performed. The result is an abdominal wall plasty effect and a more natural breast.
