Our Summary

This study looked at the safety and patient satisfaction of different types of breast reconstruction after mastectomy, specifically comparing silicone breast implants and a procedure called tertiary reconstruction. Tertiary reconstruction is a third-stage procedure that often uses tissue from another part of the body, like the abdomen, to create a new breast.

The researchers looked at the medical histories of 23 patients who had undergone both types of procedures and asked them to fill out a questionnaire about their experiences.

They found that patients who had tertiary reconstruction because of a second breast cancer diagnosis usually had this surgery sooner after their initial silicone implantation than those who chose the surgery electively.

In terms of complications after tertiary reconstruction, they found instances of partial flap loss (where some of the tissue used to create the new breast doesn’t survive), seroma (a pocket of clear bodily fluid), hematoma (a collection of blood outside blood vessels), and infection. However, there were no cases of total necrosis (death of all tissue used to create the new breast).

When it came to patient satisfaction, the surgery using abdominal tissue scored higher than silicone implants. However, when asked if they could go back and choose their initial reconstruction method again, over half of the patients said they would still choose silicone implants.

The researchers concluded that tertiary reconstruction can be beneficial in reducing symptoms and improving appearance, particularly for patients with a second breast cancer diagnosis. However, they also noted the appeal of silicone implants, which involve less invasive surgery and typically have shorter hospital stays.

FAQs

  1. What is tertiary reconstruction and how does it compare to silicone breast implants?
  2. What are the potential complications after tertiary reconstruction surgery?
  3. Based on the study, which type of breast reconstruction had higher patient satisfaction rates?

Doctor’s Tip

A helpful tip a doctor might tell a patient about breast reconstruction is to carefully consider all of the options available and discuss them thoroughly with their healthcare team. It’s important to weigh the potential risks and benefits of each type of reconstruction and think about what is most important to them in terms of appearance, recovery time, and long-term outcomes. Additionally, it’s important for patients to have realistic expectations about the results of the surgery and to be prepared for the emotional aspect of undergoing such a significant procedure. Ultimately, the decision should be based on what is best for the individual patient and their unique circumstances.

Suitable For

Overall, patients who are typically recommended for breast reconstruction include those who have undergone a mastectomy due to breast cancer, those who have a genetic predisposition to breast cancer (such as BRCA gene mutations), and those who have experienced trauma or injury resulting in the loss of one or both breasts. Additionally, patients who are dissatisfied with their current breast appearance or who experience physical or emotional discomfort due to their breast appearance may also be recommended for breast reconstruction. Ultimately, the decision to undergo breast reconstruction is a personal one that should be made in consultation with a medical professional.

Timeline

Overall, the timeline for a patient undergoing breast reconstruction typically involves the initial mastectomy followed by a period of healing before reconstruction surgery. After the reconstruction procedure, patients may experience complications such as partial flap loss, seroma, hematoma, or infection, which may require additional treatment. Despite these potential complications, many patients report high levels of satisfaction with their reconstruction outcomes. The decision between silicone implants and tertiary reconstruction often depends on individual preferences and medical considerations.

What to Ask Your Doctor

Here are some questions a patient should ask their doctor about breast reconstruction:

  1. What are the different options for breast reconstruction after mastectomy, and which one would be most suitable for me?
  2. What are the risks and potential complications associated with each type of reconstruction?
  3. How long is the recovery period for each type of reconstruction?
  4. Will I need additional surgeries or procedures in the future after reconstruction?
  5. What are the expected outcomes in terms of appearance and symmetry with each type of reconstruction?
  6. How will the reconstruction affect sensation in the breast area?
  7. Will I need to undergo radiation therapy or chemotherapy after reconstruction, and if so, how will that affect the results?
  8. What are the costs associated with each type of reconstruction, and will my insurance cover it?
  9. What is the long-term outlook for patients who undergo different types of breast reconstruction?
  10. Can you provide me with before and after photos of patients who have undergone the type of reconstruction you are recommending?

Reference

Authors: de Kerckhove M, Matsunaga N, Tomita S, Fujii M, Terao Y. Journal: J Plast Reconstr Aesthet Surg. 2023 Apr;79:47-54. doi: 10.1016/j.bjps.2023.01.016. Epub 2023 Feb 7. PMID: 36868171