Breast cancer is the most common type of cancer among women in Brazil and worldwide, excluding non-melanoma skin cancer. In 2023, approximately 66,280 new cases were reported. However, early diagnosis and advances in medicine bring hope, quality of life, and self-esteem to patients before, during, and after treatments.
Each case is unique, and the choice of surgery depends on several factors such as the size and location of the tumour, the stage of cancer, and the woman’s overall health. Therefore, it is essential to discuss the best plan for all stages with the oncologist, their multidisciplinary team, and, of course, to include another professional at this stage: the plastic surgeon.
“The reconstructive procedure can be started at two different times. Immediate reconstruction is done during the surgery (mastectomy) and allows the patient to wake up with reconstructed breasts, making it less traumatic. In other cases, we postpone the procedure due to other obstacles or tests, and it can be done weeks or even months later,” explains plastic surgeon Md. Marco Aurélio Guidugli.
Understanding the Options:
According to Dr Marco Aurélio, the goal of these surgeries is to restore the shape, size, and appearance of the breasts, providing both emotional and physical well-being to patients. The techniques available include: Breast Implants, Tissue Flaps, Tissue Expanders, and Reconstruction with Autologous Fat.
“We use a silicone or saline implant in breast reconstruction, a simpler procedure with the advantage of a shorter recovery time. This procedure is indicated when the skin and local tissue are preserved, but in some cases, over time, it may be necessary to replace or adjust the implants,” Guidugli points out.
For patients who do not wish to use implants, the plastic surgeon also explains that reconstruction can be performed with tissue flaps to build the breast (skin, fat, even muscle), which are taken from other areas of the body, such as the abdomen or back. While this provides a more natural appearance, it is a more complex surgery in terms of recovery, and the scars on the affected area will not be removed.
Dr Marco Aurélio is optimistic about the medical advances for breast cancer patients. In addition to the examples mentioned, the tissue expander followed by an implant is ideal for those who have undergone a mastectomy and have little skin in the area. This expander is placed under the patient’s skin or muscle and is gradually inflated with saline solution to stretch the skin until there is enough space for a permanent implant.
“It is also possible to reconstruct the areola and nipple using medical tattooing techniques or a skin graft. However, the decision about the type of reconstruction should be made in conjunction with a multidisciplinary team that follows the case, taking into account all the patient’s emotional and physical factors,” concludes the plastic surgeon.
