Breast reconstruction surgery is used to rebuild the breasts of many women who have had breast cancer. More and more women who are at high risk for breast cancer because of their genes are also getting this surgery.
What is Breast Reconstruction?
Women who have had their breast(s) taken away to treat breast cancer can get their breasts back with breast reconstruction surgery. The breast is rebuilt by a plastic surgeon so that it is about the same size and shape as it was before the mastectomy. Surgery can also fix the nipple and the darker area around the nipple, called the areola.
Some women will get breast reconstruction at the same time as their mastectomy, while others may have to wait a certain amount of time. When the breasts are fixed right away, radiation therapy and scarring don’t hurt the chest tissue. Also, if the woman has reconstruction right away, she won’t have to have another surgery. On the other hand, if radiation needs to be done to the chest area after the mastectomy, it may be best to put off breast reconstruction. Radiation therapy after breast reconstruction surgery can make problems after surgery worse.
The process of breast reconstruction may need one or more procedures. The last surgery is usually a reconstruction of the nipple and areola.
Are You a Good Candidate for Breast Reconstruction?
The Emirates Oncology Society says that each year, more than 50.000 UAE and Non citizens are told they have breast cancer. Breast cancer is the most frequent cancer in females among UAE citizens (32.16%) as well as Non- UAE citizens (41.41%). Females in the UAE has the tendency to develop BC at least a decade earlier than their counterparts in western countries. Not every woman with breast cancer decides to get breast reconstruction, and some don’t even need it. For example, many women choose breast conservation surgery (lumpectomy or segmental mastectomy), which removes less breast tissue than a mastectomy. These women usually don’t need breast reconstruction.
But a lot of women who do this because they think they won’t need reconstruction end up with asymmetrical breasts because of the amount of tissue that was taken out or because of the way radiation therapy changed their bodies. So, these women end up needing surgery to fix their breasts anyway.
Some of the most important things that determine who can get breast reconstruction are:
- Your health as a whole.
- How far along your breast cancer is?
- How big your breasts are on their own?
- How much tissue can be used in a flap procedure?
- Your wish to have the same look as the other breast.
- Your wish for two surgeries to fix things up.
- Insurance coverage for the breast that wasn’t affected and other costs.
- How the cancer was treated and what kind of reconstructive surgery was chosen?
- How big the breast implant or reconstruction is?
Breast Reconstruction Types
There are various types of breast reconstruction surgery that plastic surgeons can do. You can get a new shape for your breast with a breast implant, a flap of your own tissue, or a combination of the two. A tissue flap is a piece of your own skin, belly fat, and muscle that is moved to your chest from your stomach, back, or another part of your body. The last step in breast reconstruction is the reconstruction of the nipple and areola.
Breast reconstruction with breast implants
The saline-filled implant is the one that is used most often with breast reconstruction. The outside of these implants is made of silicone, and they are filled with salt water. Breast reconstruction can also be done with implants filled with silicone gel. Recent research published in the journal Cancer showed that women who had breast reconstruction with implants after having breast cancer were happier with the way their new breasts looked and felt if they chose silicone implants instead of saline implants.
Clinical trials for breast reconstruction are looking at new breast reconstruction techniques, such as highly cohesive silicone gel implants, also called “gummy bear implants,” that might be helpful for breast reconstruction.
No matter which implant you and your surgeon choose, it will be put between the layers of chest muscle and under the breast skin that will be saved during the mastectomy.
Some women can get the implant right away, especially those with loose muscles and skin that stretches. This may allow the cancer surgeons to do a mastectomy that saves as much skin and tissue as possible. Women with tight chest skin and muscles, on the other hand, may need an expandable implant or a tissue expander, which is followed by a permanent implant in a two-stage operation.
Breast reconstruction with tissue flap
In tissue flap procedures, breast reconstruction is done by using tissue from the stomach, back, thighs, or buttocks. The TRAM flap and the latissimus dorsi flap are the two most common types of tissue flap surgeries. The TRAM flap uses tissue from the stomach, and the latissimus dorsi flap uses tissue from the upper back.
There are two ways to do the TRAM flap procedure. With the pedicle flap, the flap stays connected to its original blood supply and is tunneled under the skin to the breast area. In a free flap, on the other hand, the surgeon cuts the flap of skin, fat, blood vessels, and muscle away from where it was before and sews it to blood vessels in the chest area.
During the latissimus dorsi muscle flap procedure, a large muscle in the back, as well as the skin and fatty tissue underneath it, are taken away. The surgeon will use these tissues to put the breast back together. Adding fatty tissue helps make the breast look more natural, but the flap is usually only about an inch thick, so an implant is usually also needed.
These tissue flap surgeries require two incisions, so there will be scars where the tissue was taken and where the breast was fixed. Most of the time, women who smoke, have diabetes, connective tissue disease, or vascular disease can’t get tissue flap breast reconstruction. This is because blood vessels are involved, and all of these conditions can damage blood vessels.
The deep inferior epigastric artery perforator (DIEP) flap is a newer type of flap surgery. It uses fat and skin from the same place as the TRAM flap, but does not use muscle to make the breast mound. This procedure tightens the lower abdomen, which is the same as a “tummy tuck.” The procedure is called a “free flap,” which means that all of the donor tissue is cut away and then put back together.
The gluteal free flap is a more recent type of tissue flap surgery. During this surgery, tissue from the buttocks is used to change the shape of the breasts. It is an option for women who are too thin to use the stomach sites.
Reconstruction of Nipple and Areola
The last part of breast reconstruction is the reconstruction of the nipple and areola. This separate surgery is done to make the reconstructed breast look more like the original breast. Nipple and areola reconstruction is usually done as an outpatient procedure with local anesthesia. It is usually done three or four months after surgery, when the new breast has had time to heal. But sometimes, the nipple can be fixed at the same time as the flap surgery.
Tissue from your own body is used to rebuild the nipple and areola, such as from the newly formed breast, the other nipple, the ear, the eyelid, the groin, the upper inner thigh, or the buttocks. Tattoos can be used to make the areola and match the color of the other breast’s nipple.
Recovery after Breast Reconstruction Surgery
After having breast reconstruction, you may feel tired and sore. If you get breast reconstruction with implants, these effects will last for a week or two. If you get reconstruction with a flap, they will last longer. Medications can help you deal with your pain. Most women who have breast reconstruction leave the hospital between one and six days after the surgery (assuming there are no breast reconstruction complications). You may go home with a surgical drain to help remove extra fluid from the site while it heals.
There is no way around doing what your plastic surgeon tells you to do after surgery. Most of the time, you will be told not to do anything too strenuous for six to eight weeks after surgery. Your surgeon may suggest that you wear an elastic bandage or support bra to help reduce swelling. You will probably also be given a prescription for an antibiotic to lessen the chance of getting an infection after surgery. Take all of your medicines as prescribed for as long as prescribed, and go to all of your follow-up appointments.
Surviving breast cancer and having your breasts reconstructed can also be hard on your emotions. It can take some time to get used to how your new breasts look and feel. Reconstruction helps ease some of the feelings that come with a mastectomy for many women.
You might also feel worried or sad when you think about what you’ve been through and the chance that your breast cancer will come back. Rarely, if ever, breast reconstruction can hide a return of breast cancer. Talk to your oncologist about the best way to check for cancer, and stick to it.
Breast Reconstruction Surgery Risks
There are many possible risks with breast reconstruction, but if you carefully follow your surgeon’s instructions before and after surgery, you can lower your chances of getting them.
- Concerns about anesthesia.
- Dissatisfaction with the look of the results.
- The two breasts are different in size and shape.
- Problems at the donor sites for flap procedures, such as abdominal hernias and damaged or weak muscles.
- Lack of a normal feeling in the breasts. With time, the skin on the reconstructed breast may become more sensitive, but it won’t give you the same kind of pleasure as before you had a mastectomy.
- Arms that are swollen (lymphedema).
- Healing that is slow or not complete because of a previous surgery, chemotherapy, radiation, smoking, drinking, diabetes, taking certain medications, or other things.
- Necrosis, or death, of all or part of the flap.
- Problems at the donor site.
- Having to go through more surgeries to fix problems.
How Much does Breast Reconstruction Cost in Dubai
Breast reconstruction using implants typically costs 5,000 AED to 15,000 AED per breast, for a total of 20,000 AED to 30,000 AED if both breasts are reconstructed. plastic surgeons discuss estimated total costs for bilateral implant reconstruction without insurance.