Breast reconstructions are a very important part of the rehabilitation of a patient of breast cancer.
It is a major psychological trauma, which the patient undergoes when she loses her breast “ a sign of her femininity “and reconstruction can help alleviate this problem. As the incidence of breast cancer related surgeries is on the rise, so also are the reconstructions.
Breast reconstruction is an important part of the whole rehabilitation process of a woman with breast cancer and she should know about the options and actively seek it out.
The reconstruction is done most commonly using muscle flaps from the back or from the abdomen to form the new breast. The muscle provides the blood supply and bulk. This can be done right at the time of mastectomy (Primary Reconstruction) if the surgeon is happy with the clearance of the disease. If good skin cover is present, silicone implants can be used for reconstructions. The nipple and areola are usually reconstructed at a later date.
The most common flap used for breast reconstruction is a TRAM flap which is a flap which takes skin from the lower abdomen along with the fat and is transferred to the chest to recreate the breast. This gives pretty decent results. In some cases when the opposite breast is large then a simultaneous reduction of the opposite breast is done, to give more symmetry to the breasts.
When a segmental mastectomy is done and in cases where the breast is smaller, flaps from the back like a Latissimus Dorsi based can be taken to reconstruct the breast.
This is a very satisfying and gratifying procedure which helps a patient really feel more confident about herself and more complete after such a major ordeal. But there is still a major lack of awareness about the options for reconstruction of the breast. Problems: Scars are usually present but they are acceptable and efforts are made to minimise them. Sometimes when a bilateral reconstruction of both breasts needs to be performed, then a mesh has to be used to repair the abdominal defect. Healing time is the same as for any other major procedure. Nipple reconstruction is usually done at a second stage after 6-8 months. | 
