Reconstructive Surgery for Cancer Patients: Breast Reconstruction After Mastectomy

Breast cancer is one of the most common cancers affecting women worldwide, including in Nigeria and across Africa. For many women diagnosed with breast cancer, mastectomy (surgical removal of one or both breasts) is a life-saving procedure. However, while mastectomy helps eliminate cancer, it can leave many women feeling physically incomplete, emotionally distressed, and struggling with self-confidence.

Breast reconstruction surgery offers hope and healing, allowing women to regain their feminine form, confidence, and sense of self after cancer treatment. The goal of breast reconstruction is not just cosmetic—it is an integral part of post-cancer recovery, helping women feel whole again after their battle with cancer.

This article explores the importance of breast reconstruction after mastectomy, the different surgical options available, the benefits and risks, and what women should expect when undergoing this transformative procedure.

THE IMPACT OF BREAST CANCER AND MASTECTOMY

For many women, breasts are not just body parts but symbols of femininity, beauty, and self-identity. When breast cancer requires a mastectomy, the loss can be physically and emotionally devastating.

✔ Physical Changes: Loss of one or both breasts can affect body proportions, posture, and balance.
✔ Emotional & Psychological Effects: Many women struggle with depression, low self-esteem, and social anxiety after mastectomy.
✔ Challenges in Clothing & Intimacy: Wearing fitted clothes or feeling comfortable in intimate situations can become difficult.

Breast reconstruction surgery aims to restore confidence and well-being by creating a new breast shape, helping women feel like themselves again after cancer.

WHAT IS BREAST RECONSTRUCTION SURGERY?

Breast reconstruction is a surgical procedure that rebuilds the breast after mastectomy. The goal is to:

✔ Create a natural-looking breast shape
✔ Restore symmetry to the chest (especially if only one breast was removed)
✔ Rebuild the nipple and areola (if removed during mastectomy)
✔ Help women regain self-confidence and normalcy

Breast reconstruction can be performed immediately after mastectomy (immediate reconstruction) or months to years later (delayed reconstruction).

TYPES OF BREAST RECONSTRUCTION SURGERY

There are two main types of breast reconstruction:

1️⃣ Implant-Based Reconstruction – Uses silicone or saline implants to rebuild the breast.
2️⃣ Autologous (Flap) Reconstruction – Uses tissue from the patient’s own body (such as the abdomen, back, or thighs) to reconstruct the breast.

The best choice depends on factors like the patient’s body type, cancer treatment history, and personal preference.

1. Implant-Based Breast Reconstruction

✔ How it Works:

• A silicone or saline breast implant is placed under the chest muscle to recreate the breast shape.
• In some cases, a tissue expander is used first to stretch the skin before placing the implant.

✔ Who is a Good Candidate?

• Women who do not have enough extra body tissue for flap reconstruction.
• Patients who prefer a shorter surgery and faster recovery.

✔ Advantages:
✅ Shorter surgery and recovery time
✅ No additional scars on other body parts
✅ Easier to match both breasts if only one was removed

✔ Disadvantages:
❌ Not suitable for women who had radiation therapy, as radiation can affect implant success.
❌ May require replacement in the future due to implant aging.

2. Autologous (Flap) Breast Reconstruction

✔ How it Works:

• Tissue from the abdomen, back, thighs, or buttocks is used to create a natural-looking breast.
• The most common types of flap procedures include:
• DIEP Flap (Abdomen): Uses skin and fat from the lower belly without damaging muscles.
• TRAM Flap (Abdomen): Uses abdominal tissue, but removes part of the muscle.
• Latissimus Dorsi Flap (Back): Uses muscle and skin from the upper back.

✔ Who is a Good Candidate?

• Women who want a natural-looking and permanent breast reconstruction.
• Those who have undergone radiation therapy, as implants may not work well.

✔ Advantages:
✅ Uses the patient’s own tissue, making the breast feel more natural.
✅ No need for implants, reducing risks of complications.
✅ More permanent results (no need for implant replacement).

✔ Disadvantages:
❌ Longer surgery and recovery time.
❌ Scars in the area where tissue is taken (e.g., abdomen or back).

WHEN SHOULD BREAST RECONSTRUCTION BE DONE?

Breast reconstruction can be performed immediately after mastectomy or delayed until after cancer treatment.

✔ Immediate Reconstruction – Done at the same time as the mastectomy.

• Benefits: Fewer surgeries, emotional relief, and better cosmetic results.
• Considerations: Not suitable for women who need radiation therapy.

✔ Delayed Reconstruction – Performed months or years after mastectomy.

• Benefits: Allows time for cancer treatments to finish before surgery.
• Considerations: May require extra procedures to prepare the skin and chest area.

The best timing depends on the patient’s health, cancer treatment plan, and personal preference.

BENEFITS OF BREAST RECONSTRUCTION SURGERY

Breast reconstruction is more than just aesthetic surgery—it has powerful physical and emotional benefits:

✔ Restores a Feminine Body Shape – Helps women feel whole and balanced.
✔ Boosts Self-Esteem and Confidence – Reduces emotional distress and improves mental well-being.
✔ Eliminates the Need for External Prosthetics – Many women prefer permanent reconstruction instead of wearing breast prosthetics.
✔ Enhances Clothing Fit – Makes it easier to wear fitted clothes and bras comfortably.

Many women who undergo breast reconstruction report higher levels of happiness and body confidence, improving their overall quality of life.

POTENTIAL RISKS AND COMPLICATIONS

Like any surgery, breast reconstruction carries some risks, including:

✔ Infection – Can be treated with antibiotics or additional surgery.
✔ Scar Formation – Most scars fade over time but remain visible.
✔ Implant Complications – Implants may leak, shift, or require future replacement.
✔ Tissue Loss (Flap Necrosis) – In flap procedures, some transferred tissue may not survive, requiring revision surgery.

Patients should discuss all risks and benefits with a board-certified plastic surgeon before deciding on reconstruction.

CHOOSING THE RIGHT SURGEON FOR BREAST RECONSTRUCTION

Breast reconstruction is a highly specialized procedure that requires the expertise of a board-certified plastic surgeon. When choosing a surgeon, look for:

✔ Experience in breast reconstruction surgeries.
✔ Before-and-after photos of previous patients.
✔ Accreditation by national or international plastic surgery boards.
✔ A clear explanation of surgical options and expected results.

CONCLUSION: A TRANSFORMATIVE PROCEDURE FOR BREAST CANCER SURVIVORS

Breast reconstruction is not just about restoring physical appearance—it is about empowering women to regain confidence and emotional well-being after surviving breast cancer.

For women considering breast reconstruction, consulting a qualified plastic surgeon can help determine the best option for their body and lifestyle.

With advancements in reconstructive surgery, breast cancer survivors can now embrace life with confidence, strength, and a renewed sense of self.

Dr. Aranmolate Rasheed Ayobami is a board-certified plastic surgeon and the founder of Grandville Medical & Laser. For consultations, visit www.gml.com.ng or visit any of our branches:

• Lekki: Plot 106 Taju Okoya Close, Eleganza Garden Estate, Opposite VGC, Lekki, Lagos. Tel: 0817 153 0599.
• Surulere: 76 Femi Ayantuga Street, Surulere, Lagos. Tel: 0816 454 8279, 0812 020 8868.
• Abuja: 5b Lephalala Close, Off Ganges, Maitama. Tel: 0817 323 3025.