BREAST RECONSTRUCTION SURGERY in Dubai, UAE

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Breast reconstruction in Dubai quick facts

Breast reconstruction for breast cancer patients

Breast cancer is the most prevalent cancer among women, affecting one in every eight. It’s a daunting reality. Fortunately, with the help of advanced diagnostic techniques, we can now detect it at an early stage, and 3D technologies are set to revolutionize how doctors identify cancers.

However, the removal of breasts can take a toll on a woman’s emotional well-being, often leading to feelings of inadequacy and depression. Breast reconstruction aims to surgically restore a woman’s breast and body image after undergoing treatment for breast cancer.

The primary approach to treating breast cancer is surgery, which may involve either partial or complete removal of the breast. Depending on the stage of the cancer, additional treatments like radiotherapy, chemotherapy, or hormonal therapy might also be necessary.

What is breast reconstruction?

Breast cancer can be one of the most devastating psychological challenges a woman might face in her lifetime. The shock of being diagnosed with such an unexpected illness can leave her feeling shattered, especially with the loss of a body part that represents her femininity. Many women may start to see themselves as less than, unattractive, or even morbid.

Fortunately, with today’s advanced diagnostic technology, early detection and treatment are more accessible than ever. The success rates for surgeries have improved significantly alongside the evolution of surgical techniques. These positive outcomes offer hope to women and help ease their fears.

What should you expect from breast reconstruction?

Breast reconstruction can really help restore your body image after a mastectomy. But it’s important to keep your expectations in check. The new breast won’t be an exact replica of your original, natural breast after the procedure.

A reconstructed breast won’t function like a natural one. Since it won’t have glandular tissue, you won’t be able to produce milk.

Additionally, the sensation and sensitivity of the new breast will differ from what you experienced before.

You’ll also have permanent surgical scars on both the breast and the area where tissue was taken from.

Getting the shape and size of the new breast to perfectly match the other one is nearly impossible. So, it’s essential to be okay with having asymmetrical breasts in terms of shape and size.

If you want to have a positive experience after surgery, it’s crucial to prepare yourself mentally and consider all the facts beforehand.

Are you a good candidate?

When it comes to immediate breast reconstruction, it’s crucial for both an oncology specialist and a general surgeon to understand the risks of recurrence. For delayed breast reconstruction, having good overall health is key, especially being free from systemic issues like heart disease. Additionally, your medical history is an important factor that needs to be taken into account.

What is ideal timing for breast reconstruction?

According to guideline of American Society of Plastic Surgeons, there are two options for breast reconstruction after mastectomy:

Immediate (primary) breast reconstruction

Breast reconstruction can actually be done during the same surgery as the primary cancer operation. After the general surgeon removes the cancer, the plastic surgeon steps in to start the reconstruction process. This means that both the removal of the cancer and the reconstruction happen in one go.

For women diagnosed at an early stage who don’t require additional treatments like radiotherapy or chemotherapy, immediate reconstruction is a viable option, especially if there’s no risk of recurrence.

One of the biggest benefits of immediate reconstruction is that it helps ease the emotional distress that can come with losing a breast. Since the reconstruction happens right away, the woman doesn’t have to face the reality of her breast being removed. Plus, this approach means she won’t have to go through another surgery later on.

That said, it’s important to remember that immediate reconstruction is only suitable for certain patients.

Delayed (secondary) breast reconstruction

If a woman requires extra therapy after her mastectomy, or if the surgeon thinks there’s a chance of recurrence, the breast reconstruction will be put on hold. Once the additional treatments are finished and there’s no longer a risk of recurrence, then they can move forward with planning the reconstruction.

Advanced methods of breast reconstruction in Dubai, UAE

When it comes to breast reconstruction, there are a few different approaches to consider. Essentially, the options boil down to using either the patient’s own tissue or silicone implants. The surgeon plays a crucial role in deciding which method is best, based on specific criteria.

Here are some key factors that guide the surgeon in making this choice:

• Whether the pectoral muscle, which is located beneath the breast, was removed during the initial breast cancer surgery.
• The patient’s smoking history.
• The availability of sufficient expandable soft tissue.
• Any history of abdominal surgeries.
• The presence of any vascular disorders.
• The patient’s age and overall health condition.

Breast reconstruction with implants

Placing a breast implant after a mastectomy is generally considered a simpler approach compared to other methods. Its straightforwardness often makes it the preferred choice among various options.

However, this method isn’t suitable for everyone. It’s essential to have enough soft tissue to adequately cover the implant. If the surgeon has removed all of the breast tissue and the pectoral muscle during the initial cancer surgery, using a silicone implant may not be an option. On the other hand, if the pectoral muscle is still intact but there’s insufficient expandable tissue, tissue expanders can serve as an alternative.

Get information about breast augmentation

What is tissue expander?

A tissue expander is essentially a balloon that a surgeon places beneath the skin. This balloon can be inflated and comes with a port for easy inflation. The surgeon gradually fills it with a saline solution about 1 to 3 times a week. As the balloon expands, it gently stretches the surrounding tissue.

This inflation process typically lasts around two months. Once the tissue has expanded enough to accommodate a permanent implant, the surgeon will remove the tissue expander and replace it with a silicone implant.

If the surgeon had to remove the pectoral muscle during the mastectomy and there isn’t enough soft tissue to properly cover the implant, the next best option would be to use autologous tissue transfer.

TRAM flap (Transvers rectus abdominis muscle flap)

The rectus abdominis muscle is a long, column-shaped muscle that makes up the front wall of the abdomen, situated on both the left and right sides of the midline. The skin and fat tissue below the belly button are positioned over the rectus abdominis muscle to help form a new breast.

The TRAM flap is often a go-to choice for patients who don’t have enough soft tissue in their breasts for implants. Fortunately, there’s usually enough tissue below the belly button to create a new breast.

Plus, removing the fat and skin from that area can give you a tummy tuck effect as well.

That said, if you’ve had previous abdominal surgeries, this option might not be available to you.

Latissimus dorsi flap

The latissimus dorsi is the largest muscle in your back. If breast implants and the TRAM flap aren’t options, the latissimus dorsi flap serves as a solid third choice.

Free flap technique

When it comes to breast reconstruction, both the latissimus dorsi and rectus abdominis flaps (also known as TRAM flaps) are options for the free flap technique.

This technique involves taking skin, fat, and muscle from one part of the body and moving it to another. It requires establishing a new blood supply at the site where the tissue is being transferred, which is where microsurgery comes into play.

While this method can lead to better aesthetic outcomes, it does come with some downsides. For one, the microsurgery can extend the length of the operation and introduce risks that aren’t entirely within the surgeon’s control. Issues like vascular kinking or occlusion at the connection point can occur, with complications ranging from 5% to 40%. These problems can disrupt blood flow to the tissue, potentially resulting in partial or complete loss of the transferred tissue. This not only wastes valuable tissue but may also necessitate further surgeries to repair the situation.

For these reasons, I tend to shy away from free flap techniques for a safer approach.

Comparison table of breast reconstruction methods

Nipple areola reconstruction

Nipple areola reconstruction is the final step in the breast reconstruction process.

There are a few different methods available for nipple areola reconstruction.

One of the simplest options, which doesn’t require surgery, is using permanent makeup or a tattoo to darken the skin color for the areola.

Interestingly, the darker skin from the inner labia can also be a great choice for creating the areola. If a patient has prominent, dark-colored labia minora, it can be a smart option to transfer that skin to the breast area.

For creating nipple prominence, techniques like cartilage filling and skin reshaping are available.

How is the recovery after breast reconstruction?

As I mentioned earlier, there isn’t a one-size-fits-all approach to breast reconstruction. Because of this, the recovery time can vary depending on the surgical method chosen.

All surgeries require general anesthesia. Among the various options, the easiest one is breast implant placement. If you go this route, you might be able to head home the very next day after your surgery.

On the other hand, if you opt for TRAM or latissimus dorsi flap surgery, you’ll need to stay in the hospital for about 3 to 5 days so the medical team can monitor the flap’s survival.

No matter which technique you choose, taking your medications at home is essential. Pain relievers will help ease any discomfort during your recovery, and it’s also wise to take antibiotics to lower the risk of post-operative infections.

Following post-operative instructions not only helps you feel better but also minimizes the chances of complications during your recovery.

What are the risks and complications of breast reconstruction surgery?

Patient safety is our top priority. It’s important for you to be aware of the risks and potential complications associated with the procedure.

The risks involved in breast reconstruction can vary depending on the method you choose. According to the one-year outcomes from the Mastectomy Reconstruction Outcomes Consortium (MROC) study, each technique comes with its own set of risks.

Generally speaking, breast implant placement is considered the least risky option since it’s the simplest procedure. As a rule of thumb, the more complex the method, the greater the chance of complications.

During our consultation, I’ll go over all the risks associated with each method in detail.

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Reference links:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5904787/

https://www.fda.gov/consumers/consumer-updates/3d-technologies-poised-change-how-doctors-diagnose-cancers

https://www.cancer.gov/types/breast/reconstruction-fact-sheet

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