14 Rue Petrarque
75116 Paris
Phone: 01 47 20 48 70

Surgical treatment for breast cancer by mastectomy involves amputation of the entire breast and areola, leaving a transverse scar in the middle of the chest instead.

Reconstruction of an amputated breast is an essential step in healing.

To rebuild a breast is to respond positively to the injustice that this disease is.

Breast reconstruction must meet a very legitimate requirement of patients.

It is a long road, sometimes difficult, but which allows each patient to find femininity and well-being after this terrible ordeal.

Why  ?

The objective of reconstruction is to restore shape, volume and above all harmony to the chest and décolleté, following the partial or total removal of a breast. Breast reconstruction makes it possible to alleviate the psychological suffering of this amputation, to restore social, personal and intimate serenity to each patient.

The consultation with the restorative surgeon can allow a patient, who has just been announced that the mastectomy was necessary, to plan for the future, to consider a reconstruction even before the cancer treatment begins.

How? 'Or' What  ?

Reconstruction of a breast requires at least two operations and is spread over a period of six months to a year.

In some cases, immediate reconstruction (RMI), at the same time as the mastectomy, is possible but will however require a second stage for the areola.

This RMI is possible when radiotherapy is not planned following the intervention.

Reconstruction processes depend on "  local conditions  », Ie the quality and quantity of residual skin, whether or not radiotherapy has been carried out, the appearance of the contralateral breast, the patient's morphology and naturally her desire.

Depending on the case, and sometimes in combination, a breast prosthesis, a latissimus dorsi or abdominal flap (DIEP) (when skin is missing) and fat reinjection (lipofilling) are used.

Reconstruction of the areola and nipple is the last step in breast reconstruction. The most common use is a skin graft taken from the inguinal fold, reconstruction of the nipple by graft or flap, and tattooing.

In more than 75  % of cases, an intervention on the other breast is justified to obtain the best possible symmetry. Depending on the case, a reduction, a correction of the ptosis or an increase by prosthesis is then carried out.

Suites and result.

When reconstruction uses a flap, it is a rather heavy intervention requiring on average one week of hospitalization.

After a breast prosthesis, three to four nights of hospitalization are then necessary.

Lipofilling as well as areola and nipple reconstruction are performed on an outpatient basis.

The result of each intervention is evaluated between three and four months, and their validation allows the passage to the next stage.

It is sometimes necessary to pay attention to the course of an immediate breast reconstruction so that the patient is not disappointed, that she does not imagine herself with the same breast as before.

Indeed, the period of mourning, after a mastectomy, is an often necessary step and makes it possible to appreciate the reconstruction of the breast more calmly.

From the first step and as the interventions progress, the patient will gradually regain a sense of well-being in her daily actions and in her privacy.

The end of the reconstruction allows everyone to put an end to this period of her life that is breast cancer and to start a new one.

Risks.

In addition to those related to general anesthesia, the risks associated with implants on irradiated skin should be emphasized. Skin fragility can cause the scar to open and the prosthesis to be exposed, which will then need to be removed.

Problems with healing after a latissimus dorsi or abdominal flap (necrosis, disunity) may occur, which justifies the contraindication of tobacco during breast reconstruction.

The other risks, as well as the technical details of each reconstruction process, are explained in the corresponding SoFCPRE information sheets.