With the development of increasingly innovative techniques and procedures, your reconstructive plastic surgeon can create a breast that is very similar in shape, texture and characteristics to the breast that has not been operated on.

Thus, the  breast repair surgery  It is usually performed on patients who have undergone (deferred reconstruction) or are going to undergo a mastectomy (immediate reconstruction). And they will be used, either artificial implants after passing through an expander (prosthesis reconstruction), or flaps of tissue extracted from another part of the body (autogenous reconstruction), or a mixed technique.

What is heterologous reconstruction, with expander and prosthesis?

  The main advantage of this technique is its simplicity and the short surgical time and hospital stay required. When an expander is placed, it must be refilled periodically (weekly) in the office over several months. When the size objective is reached, it takes around 6 months to carry out the replacement for the prosthesis. During this surgical time, symmetrization with the contralateral breast is performed, if necessary.

The main drawback of this technique is that the prosthesis does not change over time and therefore asymmetries appear between the reconstructed breast, which does not change, and the contralateral one, which varies over time.

In the case of having received radiotherapy, there is a more frequent complication, which is capsular contracture. When capsular contracture appears, the breast becomes hard and begins with discomfort in the breast that can radiate to the shoulder.

As in all cases in which  place a prosthesis, it has to be monitored by ultrasound at 3 years, at 5 years, and annually thereafter.

How is the autologous reconstruction, with own tissues?

  For reconstruction with autologous tissue, various donor areas can be used, such as the buttocks... but the abdominal area is the first choice. The breast is reconstructed with skin and abdominal fat. In order for the tissue to have vascularization, a flap is designed with the skin, the fat and the vessels that nourish them. These vessels are sutured by microsurgical techniques to the vessels below the ribs in the area of  the mom Subsequently, the new breast is shaped. The abdominal area is closed as if from a  aesthetic tummy tuck  it was treated

This technique represents a great advantage, which is the definitive reconstruction of a breast with a shape and texture very similar to those of the contralateral breast and that will undergo the same changes as the healthy breast over time.

The final reconstructive step is  reconstruction of the areola and nipple. The nipple is reconstructed with a small local flap to give it the proper shape. The areola and the new nipple must be  tattoo  to achieve the same color as that of the contralateral breast.

What is mixed reconstruction,  with latissimus dorsi flap and prosthesis or expander or lipofilling?

In this technique we use skin and the latissimus dorsi muscle of the back to form a new breast, as well as a prosthesis to achieve the necessary shape and volume in the reconstructed breast. This technique can also be done using an expander; as well as with lipofilling.

The first consultation

In the first diagnostic appointment, your reconstructive surgeon will give you specific information about the breast reconstruction operation, explain the possible procedures, take your medical history and measure certain parameters about your general state of health, your age, history...

We will request other complementary preoperative tests in order to guarantee the lowest possible risk during the surgical act. We will explain the special care before surgery. And we will proceed to read and sign the Informed Consent.   

The Preoperative

For your breast reconstruction operation, a preoperative is necessary, which we will request at the first diagnostic appointment.

Among the special care we recommend NOT taking aspirin, anti-inflammatories, ibuprofen or other drugs that can alter coagulation in the 10 days prior to the intervention. If you have any discomfort, you can take paracetamol or nolotil. Nor should you take herbal products from 15 days before the operation. Try not to smoke the days before. The night before you can have a light dinner; but after twelve o'clock at night you cannot drink or eat anything.

The operation

Remember to go fasting (do not eat liquids or solids from the night before). You have to go without makeup, without body and/or facial creams, without jewelry, nail polish, or metallic objects such as earrings, bracelets, rings... It is very important that you remember that you can NOT enter the operating room with dental prostheses or contact lenses . We also recommend that you wear comfortable shoes and loose clothing; and organize the return home accompanied and in a vehicle driven by another person.

The duration of the operation will depend on the complexity of the case and the technique used. We always perform breast reconstruction surgery in hospitals that have all the security measures and the highest quality guarantees, such as having an Intensive Care Unit (ICU) and a Blood Bank. The surgery is always performed under general anesthesia and under the strict control of an anesthesiologist in the operating room throughout the duration of the operation. We maintain one anesthesiologist per patient in each operating room; and we never allow an anesthesiologist to attend two operating rooms, since we consider this practice to be risky. Your surgeon will inform you of the usual and extraordinary measures taken into account for your safety. Once you have fallen asleep, we proceed to sterilize the surgical field and perform the intervention.

The Postoperative

After the operation and as a security measure, you will go through the Surgical Resuscitation Room (ICU) where you will stay the first night, before returning to your room with your relatives, where you will remain under observation and rest for a few more days. Do not remove the bandage with which you left the operating room. In this sense, all decisions must be agreed with your surgeon and only he will tell you when you can remove it. You should also follow the postoperative recommendations that your surgeon will give you:

• The presence of a companion during the entire period of postoperative admission until discharge is highly recommended.

• It is convenient that you do not get up if you are alone in the room.

• It is not uncommon to have a few tenths of a fever for one or two days after the intervention.

• Remember not to take any other medication without prior consultation with your surgeon.

• Try not to smoke the days before and after your surgery.

• All physical exertion should be avoided for at least a month.

• The post-surgery medication will be given to you with the discharge report by your surgeon.

• In no case is it advisable to take the sun or UVA rays.

• You will remain admitted according to medical indication.

• These instructions will help you to have a better recovery and to obtain a complete success in your breast reconstruction surgery.