Everything You Need to Know About Breast Reconstruction

Breast cancer not only affects the body but deeply impacts the lives of those who face it. It’s a diagnosis that stirs fears, questions, and often a sense of vulnerability. However, it also marks the beginning of a journey toward strength and hope. Every battle is unique, every decision brave, and every step toward recovery reinforces the power of resilience.

Breast cancer is the most common type of cancer among women worldwide. According to the WHO, around 2.3 million new cases are diagnosed annually. Despite these alarming numbers, advances in early detection and treatments have significantly improved survival rates.

Women who overcome breast cancer face a new challenge: rebuilding their bodies and self-esteem. Breast reconstruction is not a luxury but a procedure that every woman should have access to as an integral part of her physical and emotional healing process. Today, advanced reconstruction techniques restore the appearance and symmetry of the breasts, helping patients regain their confidence and quality of life after this battle.

When Can Breast Reconstruction Be Performed?

Breast reconstruction is a crucial step in the holistic recovery of women who have faced breast cancer. There are several times when it can be performed:

• Immediate Reconstruction: This is done during the same surgery as the mastectomy. It is indicated for patients in early stages of breast cancer or those with mutations (BRCA1, BRCA2, CHEK2) undergoing prophylactic mastectomies. These patients may be candidates for any reconstruction method.
• Immediate-Delayed Reconstruction: This is indicated for patients who undergo a skin-sparing mastectomy and wish to reconstruct with breast implants but must first continue their oncological treatment with radiation therapy. This reconstruction occurs in two stages: first, a tissue expander is placed during the initial surgery, and in a second surgery, the expander is replaced with a breast implant 6 to 12 months after radiation therapy is completed.
• Delayed Reconstruction: This is indicated for patients who undergo total or radical mastectomy and need to continue their oncological treatment with radiation after mastectomy. The reconstruction is usually performed 6 to 12 months after completing adjuvant therapy.

What Breast Reconstruction Method Is Right for Me?

It is essential to understand that there is no single reconstruction method suitable for all patients. Each case must be individualized, considering clinical variables such as cancer stage, adjuvant therapies, body mass index, comorbidities, surgical history, and, of course, the patient's preferences.

Breast reconstruction methods can be divided into three categories

• Alloplastic Devices: Tissue expanders and/or breast implants are used. It’s a simpler method with a shorter surgical time, though in the long term, complications like breast asymmetry or capsular contracture may arise, potentially requiring additional surgeries.
• Autologous Tissue: The patient's own tissue, such as from the abdomen or back, is used to form a new breast. It provides more natural results in terms of touch and shape, with durable outcomes and high patient satisfaction.
• Hybrid Reconstruction: In some cases, using autologous tissue alone is not sufficient to achieve a breast that is symmetrical in shape and volume compared to the contralateral breast, so it is combined with breast implants.

DIEP Flap: The Best Breast Reconstruction Method Available Today

Breast reconstruction with the DIEP (Deep Inferior Epigastric Perforator) flap is one of the most advanced techniques in breast cancer reconstructive surgery. This method uses autologous tissue, meaning tissue from the patient's own body, specifically from the abdomen, to form a new breast.

During the surgery, abdominal tissue is transferred to recreate a new breast, and the blood vessels from the flap are connected to those in the chest under microscopic magnification to ensure viability. This allows for the reconstruction of a breast with a natural appearance and feel. The DIEP flap is an excellent option for women seeking a permanent solution and wishing to avoid implants.

Benefits of the DIEP Flap

• Natural Appearance and Feel: By using fat tissue from the abdomen, the breast reconstructed with the DIEP flap has a much more natural appearance and feel compared to implants. This tissue behaves similarly to original breast tissue, providing superior aesthetic results.
• Durability and Adaptability: Unlike breast implants, which may require replacement over time, autologous tissue ages naturally with the body, reducing the need for future surgeries or touch-ups.
• Improved Abdomen Appearance: An additional aesthetic benefit is that the abdomen becomes flatter, and the separation of the rectus abdominis muscles can be corrected, similar to the results of an abdominoplasty.

Breast reconstruction is an important decision that should be made in consultation with a specialized medical team. Whether opting for immediate or delayed reconstruction, or for alloplastic or autologous methods, the ultimate goal is to improve the patient’s quality of life by offering a solution that fits their needs and expectations.