Breast Reconstruction after Malignancy Ablation Surgery

Surgery can be horrifying to some people. However, some particular situations such as early stage breast malignancy, has to undergo surgery as its treatment of choice. Breast malignancy is one of the most common types of malignancy among women, second only to cervical malignancy. It is a pity that most patients with breast malignancy in Indonesia seek medical help after the malignancy has grown into late stage. In this situation, treatment is done by chemotherapy and radiotherapy. If the malignancy responds to treatment and becomes operable, the surgery will be carried out. This article shall focus on patient rehabilitation after ablation surgery (the removal of breast).

A plastic surgeon can perform a breast reconstruction either directly after an ablation surgery or at a later period (delayed reconstruction). This procedure will restore the physiologic form of the breast after ablation by using an autologous material, implant, or a combination of both. The method of reconstruction depends on the plastic surgeon’s judgement after discussing the subject with the patient. After the reconstructive surgery, a nipple restoration can ensue if it is also removed during the ablation.

An autologous material is taken from the patient’s own body. After a minimal ablation surgery, only a part of the breast is removed. Therefore, the reconstruction of the breast can utilize the remaining breast tissue or muscle and skin tissue from the back of the patients. In the occasion of total breast tissue removal, another autologous material can be used: fat and muscle from the lower abdomen. In a relatively overweight patient, this method can be done simultaneously with a tummy tuck procedure to improve the abdominal shape.

An implant, on the other hand, is a material made from silicone, similar to the one commonly utilized in breast augmentation, nose lift, etc. This material is relatively inert (not reactive to other chemical substances), therefore safe for the body.

Numerous Indonesian patients who have undergone ablation surgery don’t go through reconstructive surgery. This is caused by several factors, one of which is the social economical circumstance of the patient. Many of the patients have a difficulty in funding the chemotherapy and radiotherapy, let alone the reconstructive procedure. Another factor is the unawareness of the patient that such procedure is available. This is usually caused by the lack of explanation from the healthcare staff, who often focuses the curative aspect and overlooks the postoperative quality of life. The third factor is the lack of plastic surgeon compared to the number of Indonesian population, which reaches more than 200 million.