BREAST RECONSTRUCTION SURGERY IN SPAIN. SURGERY AFTER A MASTECTOMY.

The breast reconstruction procedure can be started in the same mastectomy surgery or at any time afterwards.

Likewise, breast reconstruction surgey can be carried out using:

• A silicone gel implant (reconstruction with implant), usually preceded by the use of a tissue expander.
• The patient’s own tissue (reconstruction of autologous tissues)
• A combination of autologous tissues and an implant.

Traditionally breast reconstruction surgery was carried out months or years after the mastectomy. However, evidence of the benefits and the safety of the procedure from an oncological point of view make immediate breast reconstruction surgery the most common option in the majority of clinics.

The advantages of immediate breast reconstruction in contrast to delayed reconstruction include cost reduction, better aesthetic results and less psychological effects.  Not all patients are good candidates for immediate breast surgery; but it is an excellent option for women with early stages of the illness (Stages 1 and 2).

We have to recognize that some women are so overwhelmed by the diagnosis of breast cancer and all the information they have to take in that they don’t feel up to making a decision about the reconstructive process. In these kinds of cases, probably the best alternative is to carry out a delayed reconstruction, dedicating all the initial care to eradicating the tumour.

Once the defect caused by the mastectomy has been reconstructed, the next challenge is to achieve symmetry between the two breasts. The options available to us to achieve this symmetry are breast reduction, mastopexy (breast lift), breast enlargement or a combination of these techniques. These options should be discussed with the patient before starting the reconstruction process and it can be carried out during the same surgical procedure or at a later time. Our plastic surgeons are supporters of carrying out the treatment on the contralateral breast during the first surgical operation so that the patient can get symmetry as quickly as possible.

The final step in breast reconstruction is the reconstruction of the areola-nipple complex. Normally the reconstruction of the areola and nipple is done between 6 and 8 weeks after breast reconstruction. The most commonly used option to reconstruct the areola is tattooing. The nipple may be reconstructed using local skin flaps.

In patients with large breasts and a localized tumour, it is possible to do a breast reduction. The tumour can be removed with sufficiently wide margins and the aesthetic result that can be obtained is similar to a conventional breast reduction.

The surgery must always be followed by radiotherapy. By reducing the other breast, as well as achieving symmetry, the risk of cancer is reduced. Recovery is similar to that of a standard breast reduction.

This is a recurring question that patients tend to ask. It’s logical that when a person decides to go in for breast reconstruction surgery there is a feeling of uncertainty. And here is where computer simulations come into play as they let you see a before & after result. Recent progress in photography software allows the patient to get an idea of what will be the final result that they are trying to get after the surgery.

When the surgeons use the computer simulation, it is usually so that the patient and surgeon reach an agreement on the result that they want to achieve with the surgery. But the computer simulation should in no way be considered as what the final result will be.

Undoubtedly the surgeons and the patients are the most interested in getting the desired result. But we should not forget that the plastic surgery involves working with living tissue. To change the appearance of something specific on the computer is a matter of seconds, but the computer doesn’t take into account the quality of the tissue, the thickness of the skin, how aged the skin is, and the wound healing of the tissues during the procedure nor the possible complications.

In this regard, the majority of the scientific societies don’t recommend the publication of before/after images on web pages, as there is always the question as to whether they have been manipulated. It is precisely for the adherence to these ethical principles and to avoid speculation that we don’t show photos on our website.

This is one of the first questions that our patients ask. Breast reconstruction surgery cost depends on many factors. Without meeting the patient we don’t offer approximate prices as each patient is a different case. But we know that the economic factor is important when it comes to making a decision. Therefore, we offer the possibility for the patient to come to our facilities for a first free no-obligation visit. The patient can consult with the surgeon regarding all their doubts and worries. According to the characteristics of each patient, we will offer the best solution for each case.