Autologous Breast Reconstruction Q&A

  Breast cancer, a killer of women, has recently become younger and according to statistics in the United States, 1/4 of women who have had their breasts removed due to breast cancer have had suicidal thoughts. The following are some of the concerns of post-breast cancer patients about breast reconstruction with autologous tissues.  1.What kind of people need breast reconstruction? What are the methods of breast reconstruction?  After mastectomy, breast reconstruction can be used to restore the beauty of female breasts. Breast reconstruction is divided into simple breast implant reconstruction, partial autologous tissue plus breast implant reconstruction and simple autologous tissue reconstruction. Simple autologous breast reconstruction is to use the patient’s own skin, subcutaneous tissue, adipose tissue and muscle, etc., transplanted, free grafted or transferred from other parts of the breast to the breast on the side of the defective breast, and then shaped to create a breast that is basically the same shape as the opposite breast.  2.How to perform breast reconstruction? Is there any effect on the abdomen when autologous tissue is transplanted through the abdomen?  In order to perform breast reconstruction, we must first find out how much of the breast is missing and then choose the part of the body to be taken, such as the abdomen. The current breast reconstruction technique carries only the blood vessels when removing the skin and subcutaneous tissue without destroying the muscles, thus protecting the integrity of the abdominal muscles. The excised tissue is transplanted to the defective breast for vascular anastomosis, then shaped according to the contralateral breast, and finally the abdominal wall is closed. This method is called DIEP and it has the advantage of reducing the incidence of postoperative abdominal wall hernias. Middle-aged women often have flabby abdomens, and choosing the abdomen for breast reconstruction not only reconstructs the breast, but also shapes the abdominal wall. This surgery does not remove the abdominal wall muscles, which ensures the integrity of the abdominal wall, leaving only incision marks on the abdomen after surgery, and has no effect on function.  3.Does the reconstructed breast have nipple areola?  Nipple areola can also be reconstructed, but not at the same time as breast reconstruction. Nipple and areola reconstruction can be done 3 months to 6 months after the 1st surgery and after the wound has healed. The nipple can be reconstructed with a local scar, while the areola should be tattooed with color after the nipple wound has healed, which can be done using local anesthesia.  4.When is the right time for breast reconstruction?  If there is no contraindication to surgery, breast reconstruction can be performed about 3 months after the end of chemotherapy after mastectomy. Nowadays, immediate breast reconstruction can also be performed, that is, breast reconstruction can be performed at the same time of mastectomy. This kind of surgery is suitable for patients with stage 1-3, that is, patients without distal metastasis, and requires close cooperation between oncologists and plastic surgeons during the surgery, and patients can solve the problem in 1 operation, which not only saves costs, but also does not bring the shadow of losing breast to patients’ psychology.  5.What patients can undergo breast reconstruction? Does the reconstructed breast have the function of breastfeeding?  Breast reconstruction can be performed as long as the patient has a request for reconstruction and there are no contraindications to surgery, such as high blood pressure, diabetes, and distant metastases. The reconstructed breast has no breast gland but only fat and therefore has no lactation function.