Pink October: breast reconstruction can restore self-confidence

Between 2020 and 2022, it is estimated that more than 66,000 new cases of breast cancer will be diagnosed in Brazil, according to data from the National Cancer Institute (INCA). This represents a risk of approximately 61.61 cases per 100,000 women.

Depending on the staging of the disease (determined by lesion size, location, lymph node involvement, and presence of metastasis), mastectomy (breast removal) may be indicated, and it is at this moment that breast reconstruction can make a difference in restoring female self-esteem and confidence, greatly contributing to strengthening the battle against the disease.

First of all, the proposed oncological treatment needs to be analyzed, as silicone implant breast reconstruction cannot always be performed immediately, especially in cases where a lot of skin is removed or a complementary treatment with radiotherapy precedes it.

If a larger amount of skin needs to be removed during mastectomy, the patient must use a breast expander, a type of silicone balloon that is placed under the pectoral muscle during mastectomy surgery so that, after the surgery has healed, it can be filled with saline solution during outpatient follow-up visits until the desired volume is reached. This process allows the skin to gain elasticity so that a surgery can then be performed to replace the expander with a silicone implant.

Result of Mastectomy – Unlike aesthetic surgery, the reconstructed breast has distinct characteristics. The nipples, for example, often need to be reconstructed. The reconstructed breast will not have the same appearance as the healthy breast, as it may have scars and be harder.

I always advise my patients to come accompanied to the consultation to discuss breast reconstruction. Another recommendation I give is to seek psychological support to understand the moment. The news and treatment of the disease often leave the person with certain blocks in understanding the techniques that can be used in surgery.

It is a woman's right to have her breast reconstructed by the Unified Health System (SUS) and by health plans in Brazil, as well as plastic surgery on the opposite breast for symmetrization and harmonization. Reconstruction, immediate or delayed, should be individualized, respecting both the patient's wishes and the clinical conditions and treatment she will undergo.

Dr. Priscila Beatriz Oliveros dos Santos, a mastologist on my team and a member of the Brazilian Society of Mastology, advises patients to learn about all the reconstruction options that can be performed and to trust the team that is taking care of the patient's health. And it is always good to emphasize that mammography is essential for early diagnosis. Therefore, do not fail to perform it, as this examination can reduce mortality by up to 30% when done periodically.

*Dr. Fernando Amato is a plastic surgeon, a full member of the Brazilian Society of Plastic Surgery, a member of the International Society of Aesthetic Plastic Surgery (ISAPS), and the American Society of Plastic Surgeons (ASPS).