BREAST RECONSTRUCTION

Breast reconstruction is a reconstructive surgical procedure for the rebuilding of a breast, usually in women. It involves using patient’s own (autologous) tissue or prosthetic material to construct a natural-looking breast.

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Breast reconstruction

The goal of breast reconstruction surgery is to restore breasts to near normal shape, appearance, symmetry and size following mastectomy, lumpectomy or congenital deformities.

When is breast reconstruction surgery done

Breast reconstruction surgery may be done after removal of a whole breast (mastectomy recovery) or part of the breast (breast-conserving reconstructive surgery). It often involves multiple procedures performed in stages and can either begin at the time of mastectomy or be delayed until a later date. In addition, a breast lift, breast reduction or breast augmentation may be recommended for the opposite breast to improve symmetry of the size, shape and position of both breasts.

You can have breast reconstruction at the same time as breast cancer surgery (immediate reconstruction) or months or years later (delayed reconstruction). There are a number of factors that should be taken into consideration when choosing which option is best: type of mastectomy surgery (whether or not the skin of the breast can be preserved), following cancer treatments (radiation therapy should postpone the reconstruction due to higher complication rates), significant medical comorbidities (high blood pressure, obesity, diabetes, smoking), patient's body type etc. Your doctor will explain which one is likely to suit you best.

What you should know about mastectomy recovery procedures

Some women are advised not to have a breast reconstruction procedure because of other existing medical conditions that might increase the risk of complications following surgery. For example, radiotherapy following mastectomy can increase the risk of hard scar tissue forming around an implant or even your own tissue (this is known as capsular contracture). That is why you may be advised to delay reconstruction for up to 12 months.

You should also know that a reconstructed breast will probably not look the same as the breast you have lost (it will be a slightly different size and shape). Also, you won’t get the same feeling as before from a reconstructed breast and you may have no sensation at all.

A good candidate for breast reconstruction should:

Be able to cope well with diagnosis and treatment of the primary disease
Not have additional medical conditions that may impair the healing process
Have a positive outlook and realistic goals for restoring body image

Breast reconstruction options

Breast reconstruction surgery generally falls into two basic categories: implant-based reconstruction or flap reconstruction. Implant reconstruction relies on breast implants to help form a new breast mound while flap (autologous) reconstruction uses the patient's own tissue from another part of the body (the back, abdomen or buttocks) to form a new breast. Autologous reconstruction also may include an implant.

Both main techniques for reconstructing your breast have their own pros and cons. Reconstruction using implants is easier on the front end: the surgical procedure is easier to perform and easier to recover from. Flaps are more difficult to perform, the procedure is more time-consuming, and a recovery takes more time, too. On the back end, however, there is a different story. Over time, implants are more prone to problems and often require additional procedures to correct these problems, while flaps perform better over time – actually, a flap done well should not need more attention over the course of a lifetime.

Preparation for the procedure, including getting anesthesia, may take two hours. Once it begins, the reconstruction will take anywhere from one to six hours.

After breast reconstruction is complete you may want to consider nipple reconstruction, too (usually the nipple is removed during mastectomy). Nipple reconstruction is typically an outpatient procedure done with local anesthesia. Surgeons can make a nipple using tissue taken from the back or abdominal flap. It’s then tattooed to resemble the natural color of a nipple.

Recovery and expectations after reconstructive surgery

After the breast reconstruction surgery, gauze or bandages may be applied to incisions (an elastic bandage or support bra will minimize swelling and support the reconstructed breast). A small drainage tube may be temporarily placed under the skin. The healing process will go on for several weeks, the swelling will gradually decrease and breast will improve its shape and position. Continue to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled. During the course of time, some breast skin sensation may return, and scar lines will improve, although they will never disappear completely.

The final results of breast reconstruction can help lessen the physical and emotional impact of mastectomy. Besides, careful monitoring of breast health through self-exam and other diagnostic techniques is essential to your long-term health.

Breast reconstruction cost (price)

Cost for breast reconstruction surgery may vary based on surgeon’s experience as well as geographic location. Breast reconstruction costs may include surgeon's fee, hospital or surgical facility costs, anesthesia fees, prescriptions for medication, post-surgery garments and medical tests and imaging.

Plastic surgeon prof. Dr Milan Jovanovic

Prof. Dr Milan Jovanovic is a specialist in plastic reconstructive and aesthetic surgery. As a surgeon with 27 years of surgical experience, Dr Jovanovic is one of the best experts in anti-ageing, plastic, reconstructive and aesthetic surgery in the region.

He is a professor at the Faculty of Medicine, University of Belgrade, where he teaches general education to students of the fifth year, as well as at the postgraduate education for doctors who specialize in the field of plastic, reconstructive and aesthetic surgery. He is the Head of the Department of Plastic, Reconstructive and Aesthetic Surgery at the Faculty of Medicine, University of Belgrade.

About the Surgeon

Hospital for plastic and aesthetic surgery

Health institution General Hospital – Medical System Belgrade – MSB is a system which combines all medical and dental specialties.

Exceptional and complete services in the fields of anti-ageing, plastic, reconstructive and aesthetic surgery are provided by the Center for Aesthetic Surgery MSB (Medical System Belgrade). Along with the necessary safety, quality, comfort and discretion, our main goal is – a satisfied patient.