Breast reconstruction – you decide

What method to choose?

A lost breast can be reconstructed using either the patient's own tissue or an implant. Most popular reconstruction methods using autologous tissue include DIEP flap, TRAM flap and transplant of the patient's own fatty tissue after a suitable preparation of the mastectomy area. DIEP flap is the patient's own tissue harvested from the abdomen together with a small blood vessel. This vessel will be connected to the vessels of the chest to form a new breast from the tissues. The method is very good, especially for the reconstruction of large saggy breasts. As an additional 'bonus' the patient receives a nice, tight abdomen because harvesting the flap is nothing else but a tummy tuck. Used less and less frequently due to possible complications, a TRAM flap enables the formation of a similar breast as the DIEP flap method.

Breast implants have been used for breast reconstruction for several dozens of years. In most cases, before the implant can be placed, the tissues need to be stretched with an expander. If the patient was subjected to radiotherapy it will be necessary to use the flap from the latissimus dorsi muscle. The use of the expander/implant enables to form a breast that will not sag. The best outcomes can be achieved with medium or small breasts.

A lost breast can be reconstructed using either the patient's own tissue or an implant. Most popular reconstruction methods using autologous tissue include DIEP flap, TRAM flap and transplant of the patient's own fatty tissue after a suitable preparation of the mastectomy area. DIEP flap is the patient's own tissue harvested from the abdomen together with a small blood vessel. This vessel will be connected to the vessels of the chest to form a new breast from the tissues. The method is very good, especially for the reconstruction of large saggy breasts. As an additional 'bonus' the patient receives a nice, tight abdomen because harvesting the flap is nothing else but a tummy tuck. Used less and less frequently due to possible complications, a TRAM flap enables the formation of a similar breast as the DIEP flap method.

Breast implants have been used for breast reconstruction for several dozens of years. In most cases, before the implant can be placed, the tissues need to be stretched with an expander. If the patient was subjected to radiotherapy it will be necessary to use the flap from the latissimus dorsi muscle. The use of the expander/implant enables to form a breast that will not sag. The best outcomes can be achieved with medium or small breasts.

Are there better and worse methods?

The best method is the one chosen by the patient. The factors influencing the decision are the expected aesthetic result, the appearance of the donor area and the appearance of the unaffected breast. Also significant is the experience of the surgery clinic and of the operating plastic surgeon. The choice of breast reconstruction method is made exclusively by the patient but participation of the surgeon is recommended because the decision should be based on specialist knowledge and experience.

Is breast reconstruction a necessity?

Certainly not. Fatigued after long cancer treatment, many women decide not to undergo reconstructive procedures. In such cases, an external prosthesis is a solution which helps conceal the visible results of mastectomy.

Breast reconstruction is for you!

Not for your husband, family or friends… Breast reconstruction is your conscious choice. Reconstruction of a lost breast is also not a whim. It is a very important stage of the medical process, whose main element is of course cancer treatment.

Dr Michał Charytonowicz, plastic surgeon