In these groups, all cases of breast cancer are discussed individually and each specialist brings their expertise to optimize the treatment. The role of the plastic surgeon consists on the one hand of contributing to the development of a therapeutic plan that prevents or minimizes the sequelae of surgery or puts the patient in the best conditions for subsequent reconstruction. On the other hand, a possible reconstruction is offered to all patients with sequelae of mastectomy or lumpectomy.
Breast reconstruction surgery (and associated operations) are reimbursed by social security.
Breast reconstruction is a process that requires several interventions (between 2 to 4 depending on the complexity of the case). The objective is to rebuild a chest that allows the patient to be able to mourn her illness and the loss of her breast and to come to terms with her body image.
It is a surgery that aims to improve the quality of life.
Different techniques are available to the plastic surgeon: breast remodeling, prostheses, skin, muscle or fat flaps, micro-surgical flaps and fat injection. These different techniques can be used alone or combined to achieve the desired result.
The reconstructive surgeon chooses among his various options according to his skills and the indications or contraindications specific to each patient.
Reconstruction of the breast using only the patient's tissues is generally done using the free flap or microsurgical transfer technique.
The most frequently used technique is called DIEP. In this operation, excess fat and skin from the lower abdomen are used to reconstruct the breast. This has the advantage of reconstructing the breast without foreign body and by clean tissues very similar to the lost breast. This is the technique that most often gives the best results. The breast is completely natural and evolves over time (weight gain, weight loss and aging) like a normal breast. The belly is reduced and flatter, similar to the result of an abdominoplasty.
However, the free flap techniques are also the most difficult: only 50 surgeons in Belgium perform these procedures on a regular basis.
Our service at CHU Ambroise Paré has extensive experience of this type of intervention.
An operation of this type lasts an average of four hours (two and a half to five hours). Patients are hospitalized for three to five days. A postoperative visit to intensive care is not necessary. Our team and that of the anesthesiology department carefully monitor the optimization of the treatment of post-operative pain. In most cases, it is possible to treat postoperative pain without intravenous drugs, from the second day after the operation.
Wearing a sheath is recommended for the first 4 weeks.
The recovery time is comparable to that of an abdominoplasty (4 weeks). It takes 6 to 8 weeks for the resumption of intense physical activity.
Optimal reconstruction also depends on good breast symmetry. If remodeling of the contralateral breast is necessary, this is an integral part of the treatment plan. This type of intervention is also reimbursed by social security.
For more detailed explanations of the different techniques, you can consult the explanatory sheets of the French Society of Plastic Surgery:
Breast reconstruction by prosthesis
Latissimus dorsi breast reconstruction
Rectus abdominis breast reconstruction
Breast reconstruction by DIEP
Reconstruction of the nipple-areola plate
Fat transfer for breast reconstruction after total mastectomy
Fat transfer for the correction of sequelae of conservative treatment of breast cancer
Prophylactic mastectomies for high breast risk
Bilateral mastectomies in the context of gender reassignment or dysphoria
It is with pleasure that I will see you at my consultation to give you personalized explanations.