When is it the right time for breast reconstruction after mastectomy?

Breast reconstruction can be done immediately or at a later time.

Immediate reconstruction takes place in the same operating stage with the mastectomy. The advantage here is that the patient who undergoes mastectomy “wakes up” from this amputative operation having a new breast on the operated side. In cases of immediate reconstruction, the alternative methods the Plastic Surgeon can use often vary and the final result is possibly more natural, as more skin is often preserved in order to cover the new breast; in addition, the quality of this skin is better, without scars, fibrosis or other problems. Another very significant advantage is the lower psychological burden of the patient who does not experience the sight of an amputated breast. Immediate reconstruction can follow both total and partial excision of the breast. In order to have immediate breast reconstruction, the Plastic Surgeon must examine the patient before the mastectomy operation, so as to discuss the surgical options and determine the overall plan of the operation.

Delayed reconstruction is the operation performed months or even years after mastectomy. This operation gives women who suffered the extremely unpleasant experience of having their breast amputated the chance to have it reconstructed. In these cases, as well, a thorough discussion between the patient and the Plastic Surgeon precedes the operation in order to examine the various alternative reconstructive solutions. Opting for a delayed reconstruction helps to avoid a long initial operation, although, two separate - but shorter - medical operations are eventually needed. The advantage of this method is for some the fact that the woman can discuss and decide concerning reconstructive operation calmly and having completed the rest of the necessary treatment for her disease.

Until what age can a woman have breast reconstruction?

There is no age limit to the patients who wish to have breast reconstruction after mastectomy. Every woman who has undergone or is going to undergo mastectomy has the right to obtain a new breast. Depending, certainly, on the patient’s age, overall condition and wishes, the proper reconstructive surgical technique is selected and applied. Even in advanced forms of the disease, breast can be reconstructed after mastectomy so that the patient does not suffer the psychological burden of losing her breast.

Is reconstruction operation possible after partial mastectomy as well?

Partial mastectomy is a less amputative operation than total mastectomy; however, a defect in the breast area can still - and not rarely - be created, which can lead to a larger or smaller deformity. In any case, it is possible to correct this deformity in order to achieve a satisfying shape and symmetry with the other breast. As a rule, the cosmetic result is better when the correction is performed immediately, that is, at the same time with the partial mastectomy operation.

Is there a contraindication in having chemotherapy or radiation after breast reconstruction?

Extensive research has proven that when one of the latest reconstruction techniques is used (tissue taken from the abdomen, the buttocks or the back combined with an implant) it is not dangerous to have chemotherapy and/or radiation. Rarely, radiation can cause a slight shrinkage in part of the new breast. The various studies assure that with these reconstruction methods there is no contraindication neither for breast reconstruction, nor for the subsequent radio- or chemotherapy.

Can a reconstructive operation obstruct the monitoring of the breast or hide a potential cancer relapse?

All current studies agree that no breast reconstruction method can either obstruct or affect the monitoring of the breast and the diagnosis of a potential tumor relapse. All diagnostic examinations performed for the monitoring of the breast, for example mammography, ultrasound, CT scan, MRI, scintigram etc. take place regularly and can very accurately depict a possible relapse.

Is it always necessary to have a corrective operation on the healthy breast?

As mentioned above, corrective operation on the contralateral healthy breast is performed in the cases where it is predicted to have severe asymmetry after a reconstructive operation, for example when the healthy breast is too big or ptotic. In the cases where tissue from the abdomen or the buttocks is used, it is more likely to achieve symmetry without operating on the healthy breast, as a larger amount of fat is taken from the donor area (abdomen, buttocks).

Do social security organizations cover these kinds of operations?

Both state and private social security institutions in Greece do cover the cost of breast reconstruction operations after mastectomy. The operation takes place either in specialized plastic surgery clinics of state hospitals, provided that they perform reconstructive surgeries, or in private hospitals, also affiliated to social security organizations, by specialized plastic surgeons.

Reconstructive operations are performed with general anesthesia and the patient stays in the clinic for a few days so that her post-operative course is closely monitored. Our objective is to assure that the pain is minimal and that the patient is mobilized very quickly after the operation. The patient can gradually return to most of her activities after about three weeks.