The center explains that reconstructing the breast after a mastectomy is much more than an aesthetic issue, since the loss of a breast can cause emotional, psychological or even physical problems, such as a greater susceptibility to suffering back injuries. Currently there are different techniques capable of restoring its anatomy and functionality. And all this without resorting to a breast prosthesis.
He points out that the DIEP (Deep Inferior Epigastric Perforator) reconstruction technique is the one that offers the best results, such as “greater naturalness and better long-term evolution”. It is characterized by taking tissue from the patient’s abdomen to reconstruct the breast and the “only” difficulty is its great complexity.
Ruber Internacional Hospital has the human and technical team necessary to perform this type of surgical procedure. Indicates that breast reconstruction returns the functional and cosmetic anatomy that the patient has lost after undergoing a mastectomy. “Either due to breast cancer (one in ten women in Spain will be affected by it) and to a lesser extent due to trauma or infection. Reconstructing a breast implies restoring both the skin, the areola and the nipple as well as the mammary gland, “he explains.
According to César Casado, specialist in plastic, aesthetic and restorative surgery at the Ruber International Hospital, it is often only necessary to reconstruct one of these parts or tissues because there are others that remain intact in oncological surgery. The plastic surgeon reports that “this depends on the tumor and the type of mastectomy, which can be total by removing all the tissues, or partial, where you only remove a segment of the breast.”
RECONSTRUCTION SURGERIES
Ruber International Hospital performs about 150 breast reconstruction surgeries each year. Operations that aim to restore the physical and emotional integrity of the patient. “If the patient is mutilated, she will always remember the disease,” emphasizes Dr. César Casado, who points out that losing a breast can condition daily life in multiple ways, starting with the patient’s self-esteem.
Currently, breast reconstruction is considered both immediate (reconstruction while the breast is removed) and delayed. That is, after having finished all cancer treatments, such as cancer surgery, chemotherapy and radiation therapy. Either immediately or deferred, this procedure can be done using prostheses-prosthetic techniques-or with autologous tissue, from the patient herself.
The health center details that the characteristics of the patient are key to determining the most suitable technique. Obesity or smoking are contraindications for some procedures. As well as the type of treatment. “Radiation therapy is a treatment that saves many lives, but is less compatible with some reconstructive techniques,” emphasizes Dr. César Casado.
He explains that within reconstructive techniques, the use of the patient’s own tissue is considered the best alternative, since it provides stable and lasting results over time.
More specifically, the DIEP (Deep Inferior Epigastric Perforator) flap breast reconstruction technique is the most sophisticated and advanced of its kind. According to Dr. César Casado, it consists of extracting fat and skin from the patient’s abdomen. “The DIEP technique can be applied as long as there is tissue in the abdomen, below the navel, which is very similar to the breast,” he says.
According to the doctor, being a candidate for this surgery is not a matter of being more or less thin, but of the laxity of the tissue. As he indicates, “if it is very loose, you can close the abdomen and leave a tolerable scar.”
However, it is also the most complex technique. Since, according to the doctor, it requires “taking blood vessels that are very fine from the abdomen, locating blood vessels located under the ribs and joining them to those of the abdomen through microsurgery.” In this way, it is a procedure that requires a lot of experience and technical demand, but that lasts forever. This does not happen with breast implants. “I can never discharge a patient with a prosthesis, the prosthesis can always break,” says the specialist in plastic surgery. Besides that it remains unchanged over the years. Instead, the DIEP technique rebuilds a breast that thins, fattens and ages just like the patient will, he adds.
To achieve this, the Ruber International Hospital has sophisticated equipment. Among the different tools, Dr. César Casado highlights the qualities of the Kinevo 900 surgical microscope. According to him, “it allows you to analyze the viability of the tissues at the moment instead of waiting until the postoperative period to check if it has worked. It is one more tool that facilitates the viability of vascular microsutures ”.
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