Breast Reconstruction
Breast Reconstruction in Cyprus, Greece and Malta
Breast Reconstruction is a reconstructive surgery performed to rebuild the shape and look of the breast after mastectomy, lumpectomy or congenital deformities. Women undergo a mastectomy because they have been diagnosed with breast cancer (curative mastectomy) or are at very high risk of developing breast cancer in the future (prophylactic mastectomy).
Innovative medical techniques and state-of-the-art devices are available today, making it possible for plastic surgeons to create a new breast that matches the appearance of a natural breast.
Breast reconstruction may involve multiple procedures performed in stages. It depends on the patient’s unique case whether breast reconstruction will begin at the time of mastectomy or at a later date.
Women thinking of having breast reconstruction should talk to Dr. Stavrou before they have surgery to remove the breast or tumor. This way, all involved doctors and surgeons can plan out the best overall treatment for the patient.
What Is Breast Reconstruction?
Women who had surgery to treat breast cancer might opt for additional surgery to create a new breast mound.
The goal of breast reconstruction is for the new breast to have a natural shape, size and projection while being in balance with the rest of the body and symmetrical with the other breast. Breast reconstruction after mastectomy can make patients feel better about their bodies and more confident.
There are several breast reconstruction options. Choosing a breast reconstruction type depends on the patient’s unique case, while the process often involves more than one operation.
- Implant reconstruction uses breast silicone implants and tissue expanders to help form a new breast mound.
- Flap reconstruction (or autologous reconstruction) relies on the patient’s own tissue, like skin, fat and muscles from other parts of the body, to create a new breast. It is very common for implant and flap reconstruction to be combined during breast reconstruction.
- The surgeon may also apply specialized techniques to maximize the breast reconstruction results, such as fat transfer or tissue substitutes – especially in cases where the patient’s tissue is lacking.
- If the reconstructive procedure involves only one breast, the plastic surgeon might suggest an adjunctive procedure to the other breast, such as breast augmentation, mastopexy, or breast reduction to achieve symmetry.
The nipple-areola complex may be reconstructed in a later stage, about three months after breast reconstruction. Many women opt for nipple-areola reconstruction to enhance the cosmetic result. The surgery requires general anesthesia and the surgeon performs medical tattooing for the areola area.
Breast Reconstruction Before & After Photos
What Type Of Breast Reconstruction Is Best For Your Case?
- Location of breast cancer
- Size of tumor
- Size of breast
- Extent of breast cancer surgery – lumpectomy, full mastectomy or partial mastectomy
- Certain health conditions
- Surgical risk factors
- Type of cancer treatment
- Body shape & weight
- Amount of available tissue
- Whether one or both breasts need treatment
- Patient’s willingness to have more than one surgeries
- How the surgery will affect other parts of the body
- Costs & recovery time
Comparing the two basic types of Breast Reconstruction:
Breast Implants vs. Natural Tissue Flaps
Implant Reconstruction | Flap Reconstruction | |
|---|---|---|
Surgery | 1-2 hours Less invasive reconstruction procedure, more suitable for women with small to medium-sized breasts with little or no sagging. | 4-10 hours More invasive & complex reconstruction procedure, using tissue from the patient’s abdomen, buttocks, thighs, or back. |
Sensation | Loss of sensation in the affected breast area. | Loss of sensation in the affected breast area and in the body area where the tissue was taken. |
Look & Feel | Mimics the look of a natural breast, especially when silicone implants are used instead of saline.
Fewer scars. | A better choice for results that mimic the look of a natural breast.More scars. |
Hospital stay | 1-2 nights when done at the same time as a mastectomy. Potential need for follow-up procedures on an outpatient basis. | 2- 4 nights Potential need for follow-up procedures on an outpatient basis. |
Repeated Surgery | Silicone or saline implants must be replaced after some years. | Tissue flaps can’t be replaced. In case of complications, some procedures can’t be repeated. |
Recovery | 3-4 weeks | 4-6 weeks |
Risk of Complications | Low risk of surgical complications – mainly in the breast area. | Low risk of surgical complications in the breast area and in the body area where tissue flap is taken. |
Risk of Reconstruction Failure | Low risk, yet higher than flap breast reconstruction.
Also depends on radiation therapy and skin quality after mastectomy. | Low risk- of partial or complete flap loss. |
Comparing the two basic types of Breast Reconstruction: Breast Implants vs. Natural Tissue Flaps
Implant Reconstruction
Surgery: It may last 1-2 hours. It is less invasive, more suitable for women with small to medium-sized breasts with little or no sagging.
Sensation: Loss of sensation in the affected breast area.
Look & Feel: Mimics the look of a natural breast, especially when silicone implants are used instead of saline. Fewer scars.
Hospital Stay: 1-2 nights if done at the same time as a mastectomy. Potential need for follow-up procedures on an outpatient basis.
Repeated Surgery: Silicone or saline implants must be replaced after some years.
Recovery: 3-4 weeks
Risk of Complications: Low risk of surgical complications – mainly in the breast area.
Risk of Reconstruction Failure: Low risk, yet higher than flap breast reconstruction.
Also depends on radiation therapy and skin quality after mastectomy.
Flap Reconstruction
Surgery: It may last 4-10 hours. It is more invasive & complex. The surgeon uses tissue from the patient’s abdomen, buttocks, thighs, or back.
Sensation: Loss of sensation in the affected breast area and in the body area where the tissue was taken.
Look & Feel: A better choice for results that mimic the look of a natural breast. More scars.
Hospital Stay: 2- 4 nights. Potential need for follow-up procedures on an outpatient basis.
Repeated Surgery: Tissue flaps can’t be replaced. In case of complications, some procedures can’t be repeated.
Recovery: 4-6 weeks
Risk of Complications: Low risk of surgical complications in the breast area and in the body area where tissue flap is taken.
Risk of Reconstruction Failure: Low risk- of partial or complete flap loss.
What our patients say!
When To Have Breast Reconstruction?
The timing of breast reconstruction is a widely discussed topic in reconstruction research. The sure thing is that each breast cancer case is unique; therefore, it requires a unique approach in regards to the type of breast reconstruction and timing.
Before the patient decides when to have breast reconstruction, the entire team of doctors should meet as a group and discuss the patient’s case. The doctors involved might be your breast surgeon, radiation oncologist, medical oncologist, plastic surgeon and other caregivers.
Hence, depending on what will work best for the patient’s unique situation, breast reconstruction can be done at the same time as the mastectomy or lumpectomy surgery or after cancer treatment and breast surgery (ranging from months to years after).
1. Immediate Reconstruction
Immediate breast reconstruction is performed at the same time as mastectomy surgery. The breast cancer surgeon removes a part or the whole breast as required and then the plastic surgeon reconstructs it either with an implant or with tissue from another body part (or both). The entire work gets done in one operation, and the patient wakes up with a rebuilt breast.
In the case of prophylactic mastectomy performed on healthy women to reduce a high risk of breast cancer, breast reconstruction is always done immediately. Yet, immediate reconstruction might not be possible if the patient needs additional cancer treatments, such as chemotherapy or radiation therapy.
2. Delayed Reconstruction
Cancers larger than 5 centimeters and have spread to the lymph nodes are likely to need chemotherapy and radiation therapy after mastectomy or lumpectomy surgery. These cancer treatments can cause severe changes to a reconstructed breast, such as volume loss, changes in the skin color, texture and appearance, scars that get worse over time, pains, tightness and more.
Most surgeons advise patients to wait until chemotherapy and radiation are finished before having breast reconstruction. This means that reconstruction might be done from six months to many years after mastectomy or lumpectomy. In these cases, the patient can wear an artificial breast called breast prosthesis, designed to replicate a natural breast’s shape, size, and weight. Breast prostheses can fit inside different bra cup sizes and are made of silicone gel or similar soft material.
3. Delayed-immediate Reconstruction
Delayed-immediate reconstruction is a relatively new approach to breast reconstruction. The plastic surgeon inserts a breast implant or tissue expander under the chest muscle right after the breast has been removed. This technique preserves the breast’s shape and skin during the upcoming radiation treatment. About four to six months after the additional cancer treatment is complete and tissues have recovered, the plastic surgeon removes the implant or tissue expander in a second surgery and replaces it with a flap from the abdominal donor site.
Breast Reconstruction Surgeon,
Dr. Demetris Stavrou
Dr. Demetris Stavrou is a board-certified Plastic Surgeon, leading the European Institute of Plastic Surgery (EIPS) since 2012. He was trained in top Medical Institutions in Greece, London and Israel.
Dr. Stavrou is regularly invited to speak about breast surgery in comprehensive symposiums, dynamic workshops, and webinars. He has extensive experience in all types of breast procedures and approaches each patient with compassion to make them feel secure, comfortable and confident. For Dr. Stavrou, paying attention to the details is what makes the difference in breast reconstruction procedures.
“Excellence is in the details. Give attention to the details and excellence will come.”
Dr. Demetris Stavrou
Recovery After Breast Reconstruction
The time it takes for a patient to recover depends on the type of breast reconstruction. Most women begin to feel better after the first week post-op and return to usual activities within a month.
Women who had implant reconstruction might feel tired and sore for one or two weeks, while the discomfort from flap reconstruction lasts longer. Bruising and swelling might take up to 8 weeks to go away. Dr. Stavrou will suggest how to take care of your surgery sites best to speed up recovery.
Sometimes the surgeon might use drains – small tubes inserted into the wound to remove extra fluid from the site as it heals. A follow-up visit is required for the safe removal of the fluid drain.
It is essential to keep in mind that breast reconstruction does not restore normal feeling to the breast. Yet, partial feeling might return after some years following the surgery.
FAQs for Breast Reconstruction
Is breast reconstruction a major surgery?
Indeed, breast reconstruction is a major surgery that might require more than one procedure at different times. Whether the patient has an implant or flap reconstruction, they need to stay in the hospital for a few days. Recovery time is longer than other breast surgeries, especially for patients who undergo skin flap surgery.
How long do you have to wait for breast reconstruction?
Most patients diagnosed with breast cancer may have a lumpectomy or partial or full mastectomy to remove the tumor and affected lymph nodes from the breast and underarm areas (axilla).
Patients diagnosed with stage I or stage II breast cancer are less likely to need chemotherapies or radiation therapies after mastectomy. These patients are often good candidates for immediate breast reconstruction, performed at the same time as the mastectomy surgery. The same applies to women who undergo prophylactic mastectomy - mastectomy to reduce a high risk of getting breast cancer later in life.
However, patients diagnosed with stage III or stage IV cancers almost always need to undergo further cancer treatment after mastectomy or lumpectomy, such as radiotherapy and chemotherapy. Most doctors suggest all cancer treatments be complete before the patient opts for breast reconstruction. It might take from 6 months to several years after mastectomy or lumpectomy for the patient to be ready for breast reconstruction surgery.
Which silicon implant is right for me?
Today, breast implants are innovative, tech-advanced and much safer. The type and projection of the implant depend on the patient’s cosmetic goals, skin, breast tissue and anatomy.
Designed with your safety as our top priority, the smooth silicone implants look and feel more natural, mimicking the natural breast tissue and maintaining softness over time.
Changes in breast sensation after breast surgery & breast reconstruction
During a mastectomy, most of the breast nerves are cut and the area becomes numb. Breast reconstruction can restore the appearance and feel of the natural breast to a certain degree to whoever touches it. However, the patient won’t feel much sensation in the treated area when it’s being touched. This part can be hard for most women as breasts are an important erogenous zone.
Fortunately, the nerves have the potential to regrow after some years post-op. Some women experience great sensitivity to touch in the armpit next to the reconstructed breast, which can be a new erogenous zone.
Can breast reconstruction make cancer come back?
Studies have shown that breast reconstruction does not make cancer come back.
If cancer comes back, reconstructed breasts do not cause problems in diagnosing cancer or treating it. Therefore, breast reconstruction does not affect the risk of a future cancer diagnosis.
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