What is a simultaneous breast reconstruction surgery?

After a mastectomy a woman loses one or both of her breasts and this may cause serious psychological issues for patients. The reconstruction surgery that takes places immediately after the mastectomy has the advantage to eliminate at least one surgery reducing therefore expenses, recovery time and, most importantly the psychological trauma of losing your breast. The procedure requires thourough study and planing by the doctor in order to respond to each patient’s specific needs, depending the amount of tissue removed, and to offer a breast as symmetrical and as natural as possible.

Who’s a good candidate?

A simultaneous breast reconstruction surgery concerns patients with no other serious medical conditions besides cancer. If patient is about to have radiation after the mastectomy she may not be a good candidate since radiation may affect the appearance of the reconstructed breast. In that case the doctor will suggest a delayed breast reconstruction once she has completed her therapies. Lastly, candidates should haver realistic expectations and be aware that their new breast will not feel nor look exactlly the same as their old one.

Facts I need to know

The simultaneous breast reconstruction surgery can be performed with several, different techniques. The most common ones are the use of implants or of the patients own tissue and in some cases both techniques can be combined. Simultaneous breast reconstruction is performed in the hospital under general anesthesia, it is a complex procedure that takes a few hours and patients are required to stay in the hospital for as long as the doctor instructs them to. The doctor chooses the appropriate surgical method depending on the patient’s body type, her general health state and the size of the mastectomy. When a simultaneous breast reconstruction is performed the oncologist must first complete the mastectomy and then the plastic surgeon takes over and continues with the implants or the tissue flaps reconstruction. In this way the two surgeries are decreased to one and patients wake up with their new breast. We should not forget the areola that must also be reconstructed since it is removed with the rest of the breast. The areola reconstruction is performed with the use of tissue flap from another part of the patient’s body in a way that it has the colour and the texture of the natural nipple.

Recovery Time

In the case of a simultaneous breast reconstruction the patient must recover from a double surgery. Therefore symptoms like pain may be more intense because of this double surgery. Usually patients return to their usual routine 6 to 8 weeks later. During recovery they notice swelling and bruising that gradually subside. The doctor gives explicit instructions about every day activities, such as taking a bath and caring for the incisions. Once recovery is over results become fully visible. These results are long lasting and they significantly boost the patient’s self confidence and improve her psychological state.

Doctor’s Remarks

When breast reconstruction is performed right after a mastectomy then patients have the psychological benefit to immediately enjoy a new breast which, in many cases looks even better than the one they used to have. The surgery is performed with the breast surgeon’s and the oncologist’s approval and cooperation.
I have been trained in this procedure at the oncology hospital WOHK Agioi Anargiroi, in the department of Plastic and Reconstructive Surgery, in the Metaxa Hospital, department of Breast Surgery, in the University Hospital Sapienza Rome and in the University Hospital IRCCS AOU San Martino Genova.