Pink October: breast reconstruction can restore self-confidence

Between 2020 and 2022, it is estimated that over 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 disease staging (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 self-esteem and female confidence, contributing significantly even to strengthening the fight against the disease.

First and foremost, the proposed oncological treatment must be analyzed, as silicone implant breast reconstruction may not always be immediately feasible, especially in cases where a lot of skin is removed or a complementary radiotherapy treatment 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 placed during the mastectomy surgery beneath the pectoral muscle. After the surgery has healed, it is filled with saline solution during outpatient follow-ups until the desired volume is achieved. This process allows the skin to gain elasticity so that a surgery can then be performed to exchange the expander for a silicone implant.

Mastectomy Result – Unlike aesthetic surgery, a reconstructed breast has distinct characteristics. Nipples, for example, often need to be recreated. 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 of the opposite breast for symmetrization and harmonization. Reconstruction, whether immediate or delayed, must 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 available reconstruction options and to trust the team caring for 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 regularly.

*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).