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Breast reconstruction: regaining one's femininity after breast cancer

Mastectomy is sometimes necessary to overcome breast cancer. This operation leaves women a difficult body to accept. In this case, breast reconstruction is a solution to avoid giving away everything to the disease and find a body that suits you. Practiced by an expert surgeon in the field, this surgery can rebuild your chest, sometimes without scars.

The basics of breast reconstruction surgery

Breast reconstruction can be done according to different methods, the choice depending on the patient and its specific characteristics. We will expose them below. In general, breast reconstruction requires several operations to be complete. These correspond to: the construction of the breast, the symmetry of the breast and the construction of the nipple and the areola.

If mastectomy is the last stage of cancer treatment, reconstruction can potentially begin at that time. Indeed, other treatments such as radiotherapy can prevent the smooth progress of the reconstruction. It is also possible that the surgeon asks to wait a few months after the end of all treatments before starting the process.

For what result?

The breast plastic surgery will give you in all cases a firmer breast and less mobile than a natural breast. In addition, you will notice a lower sensitivity of this part of the body. Despite this, our patients are very happy to find a silhouette in which they recognize themselves and this helps them to recover morally from the disease.

1. The first step: breast reconstruction

The different techniques

Breast reconstruction can be done on the basis of prosthesis or autologous tissue (tissue of your own body). The first solution is possible only in the case where the skin is supple and not damaged (radiotherapy, skin diseases, …), as well as if the pectoralis major muscle is intact.

The surgeon then performs a detachment of the tissues below the pectoral muscle. The prosthesis is slipped into this pocket and the incision is closed. The method is simple and without additional scar. However, the breast is often frozen, has a low volume, is less sensitive and symmetrization is difficult if the other breast suffers of ptosis.

Breast reconstruction with the skin of the back

   A. With muscle

This method is possible with prostheses or by taking the muscle with the fat tissue from the back of the patient. In this case, the surgeon uses a musculo-cutaneous paddle taken from the back of the patient and uses the prosthesis or fat injection to add volume to the breast. At the level of the area where the skin was removed, the residual scar will usually be horizontal, and hidden by the strap of the bra.

 Illustration of the paddle used in Dr. Abboud’s technique (in red)

The technique is usable for almost all patients, but is especially applicable in cases where the skin of the thorax has been damaged by the rays.

This procedure lasts approximately 2 to 3 hours under general anesthesia. The cicatrization is obtained quickly enough and the discomfort in the shoulder disappears in 2 or 3 weeks. There is no reason to fear a disability in the function of the arm.

The remodeling of the other breast can be done at the same time as the reconstruction if the patient wishes.

Dr. Abboud adapted this technique several years ago. Indeed the principle of transferring dorsal tissue to the breast level had already been described. In his technique he uses a larger paddle of tissue, to bring a considerable volume to the breast reconstruction. This technique was published in 2013 and presented at many international conferences.

   B. Without muscle

Recently, Dr. Abboud has developed a new surgical technique that significantly reduces complications, reduces the operating time and leads to better results. In this operation, the surgeon uses the tissue located at the same place as in the previous technique, but leaving the muscle intact. A cutaneo-fatty paddle is thus transferred to the reconstruction site. Threads are then used, forming internal loops in the new breast as to recruit more peri-mammary tissue and bring a beautiful shape to the reconstructed breast. Finally, the injection of fat will bring the remaining volume.

This technique is being published, and Dr. Abboud continues to be invited to various international congresses (from the International Society of Plastic Surgery in Miami, French Society of Plastic Surgery, Belgian Society of Plastic Surgery, …) to expose his innovation. From this sharing of knowledge, he receives many foreign plastic surgeons who have come to Belgium to learn his new technique.

Breast reconstruction from the skin and fat tissue of the abdomen

This technique allows to reconstruct a breast of large volume and is particularly indicated in the case where the patient has an excess of fat and skin in the lower abdomen.

The surgery will leave you with a natural-looking breast and a low scar, which will fade over time and be located under the bar of the pants.

The remodeling of the other breast can be done simultaneously, which will save you one more operation. The intervention lasts between 3 and 4 hours. After the operation, you will need a little more time to recover, but you can leave the hospital after one week. Respiratory physiotherapy sessions will be prescribed.

Scarless breast reconstruction using loops and lipofilling

Dr. Marwan Abboud, world renowned in the use of threads and fat injection in multiple areas of the body (face, neck, arm, abdomen, buttocks) also uses this method for breast surgery. Whether it is breast reduction, augmentation or reconstruction, he has developed his mini-invasive surgery philosophy optimally to leave a minimum or even no scar on the patient.

In his technique, Dr. Abboud begins by detaching the mammary and peri-mammary region through infiltration and tunneling with his cannula. This will facilitate the recruitment of the peri-mammary tissue through an inner thread placed in the form of a loop. Finally, an extra volume will be added by injection of fat taken from the patient.

However, this surgery is indicated only in patients with sufficient fat reserves, the fat being liposucted from the patient.

The principle of detachment-liposuction-lipofilling by a power assisted cannula called “Power Assisted Liposuction and Lipofilling (PALL)” has been widely introduced by Dr. Abboud at many international congresses since 2011, as well as his scarless breast reconstruction technique using loops and lipofilling.
He also published his principle in the Aesthetic Surgery Journal, and frequently receives foreign plastic surgeons who come to learn his technique.

2. Second stage: The symmetry of the breasts

Breast reconstruction may include a step of symmetry. Indeed, the reconstructed breast may be rounder and firmer than the remaining breast. Therefore, it may be necessary to perform a procedure on the natural breast to obtain a harmonious result.

This step takes place three months after the first operation. The intervention is much less invasive (it will last 2 hours and the recovery will be faster) and is usually refunded by the mutual.

3. Step Three: The Areola and Nipple

The last stage of breast reconstruction, the operation can be performed under local anesthesia. There are several ways to rebuild these parts of the breast: either by taking skin on the areola of the other breast or in the upper thigh, or by tattooing. The skin graft will naturally take on a darker color. If you choose the tattoo, you will have the advantage of being able to choose the color.

In all cases, these are simple, non-painful methods. They give a fairly similar image of the nipple and areola whose presence is important to give a “completed” appearance to the reconstructed breast.

As the obtain the optimal symmetry while tattooing, Dr. Abboud developped a method using a plastic cover to reproduce the same areola on the reconstructed breast. This technique was published in The Breast Journal.

Choosing your surgeon

Rebuilding your chest can help you recover from the disease. The process will make you a figure in which you will feel better. In this case, it is important that the result is professional and up to your expectations. For that, turning to the right doctor is essential.

Dr. Abboud is an expert in breast reconstruction and greatly satisfies his patients. For more information or to make an appointment with him, fill out the contact form below.

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