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Breast cancer has become a common health concern in recent times. A breast reconstruction surgery is a procedure to reshape your breasts after a mastectomy following breast cancer. The amount of reconstruction depends on mastectomy and the size of your tumour. 

Are you about to undergo breast reconstruction surgery? Then, read this article to get a better understanding of this surgery.

Breast reconstruction is a method commonly adopted by women who have undergone surgery in order to treat breast cancer. Surgical procedures like mastectomy or lumpectomy are mandatory for treating breast cancer and can affect the breast size. Breast reconstruction can be mandatory after this. There can be multiple breast reconstruction techniques.

Breast reconstruction most frequently follows an operation to treat or prevent breast cancer. Sometimes, it is used by practitioners to reconstruct damaged or missing tissue and remodel breasts. They might carry out this procedure in order to regain symmetry, and by doing so, they ensure that both breasts are the same size and form. Additionally, medical professionals also repair breast tissue caused by congenital anomalies (birth defects).

There can be more than one surgery type for breast reconstruction. It depends on the severity of your cancer. Here are the different types of breast reconstruction.

1. Flap Reconstruction

This is the most popular type of breast reconstruction. The surgeon takes tissues from your body, which are then used to form a breast. Usually, the tissues are procured from your lower abdomen (belly). In other cases, surgeons also consider tissues from the thigh, back or bottom. They remove skin, fat, muscles and blood vessels from these body parts to form a new breast. 

This tissue is a flap. Flap reconstruction is often considered the best type of surgery when it comes to breast reconstruction. Here are the types of flap reconstruction. 

• DIEP Flap: In this, surgeons take skin, blood vessels and fat from your lower belly. However, it does not consider the underlying abdominal belly muscles. A microscope (microsurgery) is used while completing this surgery. This is beneficial as it allows you to retain abdominal strength while reconstructing your breast. 
• TRAM Flap: This is a contrast to the previous procedure. In this, surgeons remove abdominal muscles besides the skin, blood vessels and fat from your belly. While it can make you weaker in the abdominal area, it can improve your breast shape. 
• SIEA Flap (or SIEP Dlap): This procedure is again similar to the previous one. However, the blood vessels are different. Only a few patients have the required blood vessels for this procedure. Therefore, it is not used frequently. 
• Latissimus Dorsi (LD) Flap: For this procedure, surgeons remove tissues and muscles from the back. In this process, they transplant the LD flap, which is still connected to its own blood supply. The transplantation is done through the back to the breast area.
• IGAP Flap: Surgeons use flaps from the individual's buttocks in this procedure. The flaps mainly include tissues and not muscles. These are used to reconstruct the breasts. 
• SGAP Flap: It is similar to the IGAP flap. It also removes tissues from your buttocks, not muscles, to reconstruct your breasts. However, the blood vessels used here are different.
• PAP Flap: Your surgeon removes tissue from the inner and back of your thigh for this surgery. However, it does not transplant muscles from your thigh. Surgeons use these flaps to develop a new breast.
• TUG Flap: This is similar to the PAP flap. It removes tissues from the inner and back of your thigh. It also removes muscles and tissues, differentiating them from the PAP flap. 

Benefits

• Tissue flaps look and feel more natural

• You can keep more strength in your abdomen 

Success Rate of this Surgery

The success rate of this type is approximately 91% to 99%.

Cost of Surgery 

The approximate cost of flap repair surgery is around ₹ 30,000 to ₹ 1,00,000.

2. Implant Reconstruction

This type of surgery requires the surgeons to use saline or silicone implants to recreate breast tissue. Surgeons also use a combination of implants and tissue from your body for this procedure. One can also do a mastectomy alongside this procedure. Here are the types of implant reconstruction. 

• Above the Chest Muscle: As the name suggests, the surgeons will place the implants on top of the chest muscle. It is preferable since it keeps your chest muscles in the original position. 
• Under the Chest Muscle: Your surgeon will likely lift the chest muscle. They place the implant below this muscle to recreate your breasts. 
• Implant With Tissue Expander: Your surgeon will place an expander under your skin, and they will be responsible for filling up this expander with saline every week. Your skin will gradually expand and stretch, and surgeons will place the implants once it has expanded enough to cover it. 
• Benefits 
  • It is comparatively a less invasive method. 
  • This method doesn’t require harvesting tissue from other parts of your body. 
• Success Rate of this Surgery
  • Not Available
• Cost of Surgery 
  • The approximate cost of flap repair surgery is around ₹ 100,000 to ₹ 500,000.

3. Oncoplastic Reconstruction After Lumpectomy

Patients who undergo lumpectomy are likely to benefit from oncoplastic reconstruction. Your oncologic breast surgeon will determine if you are capable of undergoing breast conservation. You might require radiation when surgeons conduct a lumpectomy. 

Surgeons use breast reduction techniques while conducting a lumpectomy while competing with oncoplastic reconstruction surgery. A breast reduction or breast lift allows the surgeons to fill in the defect created by the lumpectomy. 

It also helps them to improve their breast shape. You might require a breast lift on the other breast to maintain a shape consistency. 

• Benefits
  • Allows medium to large-breasted women to conserve their mammary glands while removing the same breast tissue. 
  • Is a good option for inflammatory breast cancer 
• Success Rate of this Surgery
  • The overall success rate is around 95% and the disease survival rate is approximately 90% with an average of 4 years follow-up. 
• Cost of Surgery 
  • Not Found

Breast reconstruction surgery is a complicated one, and it can cause some risks and side effects. While some of these are mild, others can seriously affect your health. 

Here are the common risk factors you can face. 

• Blood Clots: These usually appear after any kind of flap reconstruction surgery. You can get these clots for 2-7 days after the surgery. Because of the clots, your legs or the surgery sites might swell and feel warm to the touch. 
• Different Shapes of Breasts: After a reconstruction, you might feel a difference in the two shapes. One might be firmer, and the nipples and areolas may not be symmetrical. This happens rarely. 
• Bruising or Scars: Usually, this surgery leaves a scar on your breasts. In a few cases, you might also experience bruising in the area. It will heal in a week or so. 
• Infection: You might also get an infection at the surgery site. Doctors usually suggest antibiotics to get rid of the infection.
• Pain and Discomfort: Pain is natural after a long surgical procedure. Especially with transplants, you might feel some discomfort, as your body is not used to the weight. Doctors might suggest pain reliever medicines. 
• Itching and Numbnes: The wound from the surgery might itch as it is healing. However, it is important to avoid scratching it to avoid further scarring. Moreover, you can feel numbness or tingle in the areas of surgery up to almost 12 months after the surgery. 
• Fluid Collection Under the Wound: Fluids might be built under your surgery site. This might continue even after the drainage tubes are removed after the surgery. It unusually drains itself after some time, but if it does not, you might need a surgeon to drain the fluid with a syringe.

Now that you know what breast reconstruction is, you must know more about the ways to prepare for this surgery. If surgeons have selected this procedure, you have recently undergone a mastectomy or lumpectomy. 

Moreover, if you are recovering from breast cancer, you might also require chemotherapy or radiation before breast reconstruction surgery.

To know about the preparations, you will have to seek a professional medical practitioner for a comprehensive exam. They might measure and photograph your breasts. You will have to discuss your family medical history, health, medications and details of previous surgeries with your surgeon. They might ask you to stop taking any medicines before the surgery.

A breast reconstruction surgery is performed in a hospital. You will receive general anaesthesia during the procedure, which will help you avoid feeling surgical pain. Surgeons will start the surgery once you receive the anaesthesia. 

They will place the implant in or under your chest if you undergo an implant reconstruction procedure. On the other hand, if you are having a flap procedure, they will take tissues from one part of your body and then use the same for recreating a new breast. 

Often, surgeons might insert a drain, like a thin tube, under your skin. The end of this tube will stick out of your chest. It will help to drain fluid and blood while you recover from this surgical procedure. Surgeons will remove these tubes once you recover and do not need these anymore.

After breast reconstruction surgery is over, you will need some time to recover before returning to your original routine. Surgeons usually suggest patients stay in the hospital for about a week. During this time, the breasts will heal as suggested by the doctors. They might suggest surgical bras initially to reduce breast swelling. 

Once you successfully recover after a week, you will be discharged, and the doctors and nurses will provide detailed instructions on the right ways to look after your body. 

Moreover, you will also receive tips on the ways to manage pain after surgery. They might suggest prescription or over-the-counter pain medication to manage pain.

You can call the doctor if:

• You want to regain your chest shape. 
• Your clothes are not fitting perfectly. 
• Your chest is looking unbalanced.

The alternative to breast reconstruction surgery is the use of a prosthesis.

A typical breast reconstruction surgery in India typically exceeds ₹ 80,000 and it usually ranges between ₹ 100,000 – ₹ 300,000.

Now that you know the meaning of breast reconstruction, you must be curious to know its benefits. Some of them are listed below. 

• Permanent Solution: Most breast reconstruction procedures, especially flap procedures, have high success rates, almost 98%-99%. The recovery period is also short. Moreover, once completed successfully, this surgery lasts a lifetime. It will keep your breasts in shape. 
• Protects the Abdominal Wall Muscles: The flap procedures usually take tissues and muscles from the lower abdomen to recreate your breasts. These surgeries leave the rectus of your abdominal muscles intact, which allows the patients to maintain the strength of the abdominal walls. It also lowers the risks of post-surgical hernia. 
• Feels Like Natural Tissue: Even if the surgeons bring tissues from other body parts to recreate your breasts, it still feels like natural tissues. These tissues get even softer with time and look 100% natural. It is, therefore, a much more peaceful and comfortable method. 
• Safer and Shorter Surgery: When it comes to implant surgeries, on the other hand, the entire surgical procedure is much shorter. It requires even less time to recover than flap surgeries, and the hospitalisation time is lower. 
• Maintains Shape: These surgeries help you maintain your breast shape for a long time. The flap surgeries even provide the additional benefit of having a flat stomach by removing fat from there. Moreover, the implants come with cohesive gel, which holds the original shape of your breasts for a long time. 
• Low Risk of Leakage: When it comes to implant surgeries, there is a minimum risk of leakage. The modern versions of implant surgeries have an extremely low rupture rate compared to the traditional procedures. Doctors also suggest regular MRIs annually to identify any signs of leakage instantly.

Patients generally can return to their usual lifestyles within 6-8 weeks of the surgery. However, the recovery time is much shorter if the surgery includes implants without flaps. It might take up to 8 weeks for the swelling to go away. 

On the other hand, your tissues can take almost 1-2 years to heal and fade the scars. You need to stay in constant touch with your surgeon to understand when you can return to a normal routine. 

Therefore, as this article pointed out, breast reconstruction surgery can be complicated. It mainly helps you recover from breast cancer and bring back the original shape of your breasts. You need to be careful while recovering from this surgery and take consultations with the doctor regarding any complications.