Breast Reconstruction is plastic surgery aimed at patients who have had a mastectomy, that is, who have undergone surgery to remove the breast, usually due to breast cancer. In this sense, the main objective of this surgery is to reconstruct the breast in order to improve the woman’s self-esteem and confidence and give her a better quality of life.

In addition to these cases, breast reconstruction may also be indicated in cases where there is some type of breast deformation, whether due to genetic reasons, accidents, or even the consequences of previous breast surgery that may have gone wrong.

At Clínica Baptista Fernandes, before Breast Reconstruction, there is a whole preparation and planning that are fundamental for the definition of the surgical plan. This process is divided into 4 steps and they are:

1 – Assessment consultation
The first step consists of a consultation during which Dr. João Baptista Fernandes or Dr. Fátima Baptista Fernandes will gather all the patient’s information to understand her motivation and goals. In addition, measurements and photographs are taken to define the surgical plan.

2 – Choice of prostheses
There are several types of breast implants and to define which will be the most suitable for each case, it is necessary to take into account at least four elements: size, weight, shape and type of coating. These elements will directly influence the results of the breast reconstruction and, therefore, taking into account the patient’s wishes, the doctor will advise which type of prosthesis is most suitable.

Size: Breast implants can range from 100 to 1000 cc. Therefore, advice on the ideal size, by the doctor, is essential to obtain the desired results.

Weight: Depending on the size, the weight of the implant will vary. However, there are conventional prostheses and B-lite prostheses. B-lite prostheses are 30% lighter and, in some cases, are more recommended, especially when the patient wants greater projection.

Format: Breast implants can be round, anatomical or conical. Each format promotes a different end result. For example, when the objective is a more natural result, as a rule, anatomical prostheses are used. For those who want more breast projection in the upper part (neckline) as a rule, round prostheses are used. However, each case must be evaluated individually for the right choice of format.

Type of coating: There are several types of coating for implants. There are implants with a smooth surface, textured, microtextured and with polyurethane coating and the choice will depend on what the doctor thinks is most advisable.

3 – 3D Simulation
The third step involves the 3D simulation of the intended results. After all the information gathered, a 3D simulation is performed using the Crisalix software. In this simulation, the patient will receive at least three demonstrations of results with different types of prostheses. From these simulations you can choose the option you want.

4 – Exams and doubts
The last step is to carry out tests to find out if you are fit to perform the surgery. After that, you can make a new appointment to present the test results and to clarify questions you may have regarding the procedure. From there, it proceeds to surgery.

Breast reconstruction, in the first phase, consists of placing an expander under the skin and muscle. This expander is a kind of empty balloon that the doctor will fill, week after week, with saline solution. This technique is used to promote skin expansion in a progressive and non-harmful way. Upon reaching the ideal volume, a new surgical intervention is performed to remove the expander and place the breast implants.

Regarding the nipples, in cases where they have not been preserved after the mastectomy, it is possible to reconstruct them with skin flaps from the breast itself. In these cases, the preserved nipple is used as a reference to obtain the dimensions and shape of the nipple to be reconstructed.

Breast reconstruction is performed under general anesthesia or sedation and takes approximately 3 hours. The surgery does not require hospitalization, but you will be under observation for about 8 hours after it, the time necessary to perform analgesia. After this period, you will leave the clinic with an elastic bra over compresses. You will have to go to the clinic for a few weeks to fill the expander with saline and perform drains. After reaching the intended volume, a new surgery will be performed to change the expander for the definitive prosthesis and reconstruct the nipple, if necessary. After the second intervention, you will leave the clinic with a compressive bra and, in some cases, with drains, depending on the type of surgery performed. The next day, he returns to the clinic for the first drainage and to remove the drains, if he has them. The stitches will be removed between the 8th and 10th day, and the post-surgical bra will have to be used for one month, and the use of underwired bras will have to be avoided in the three months after the surgery.

You cannot sunbathe during the first month or use a sauna during the first 3 months. During the first month you should not do violent exercises, lift your arms or lift weights. The return to work activity normally occurs after 10 days, but this period depends on the type of work you do.

The scars, in addition to being treated by the therapist during the lymphatic drainage, require certain subsequent care to become imperceptible, such as moisturizing the breast skin well, applying healing cream and silicone or polyurethane tapes for some time after the surgery.

Finally, as in all interventions, prior medical examinations are mandatory to detect problems that may prevent the surgery from being performed. It is mandatory to perform a breast ultrasound and a mammogram to have a record before the breast architecture is modified. Women who are smokers and wish to undergo this surgery must refrain from smoking for 2 weeks before and 2 weeks after the procedure because tobacco can impair the healing process.

The final result is only definitive after 4 months, and the scars only stabilize after 6 months.

At Clínica Baptista Fernandes, all drainage sessions are included in the cost of the surgery, as the recovery process is essential for the success of Breast Reconstruction. That’s why we have a team of therapists specially trained to carry out the drainage and, if necessary, ultrasound sessions and LED light therapy for a quick and healthy recovery. In addition, each patient receives direct contact from the doctor who performed the surgery so that they can contact him to clarify any doubts.