Breast reconstruction after breast cancer

Brustwiederaufbau nach Brustkrebs

Breast cancer is a widely spread disease among women. Breasts do not always have to be removed, but a reconstruction of the breast (or both breasts) is almost always possible after amputation (mastectomy). However, this procedure should be performed as early as possible.

In the most favourable case, this will be done in connection with the initial operation or immediately after subsequent treatment (radiation or chemotherapy).

The selection of the procedure that is most suitable for breast reconstruction depends on different conditions: Age, health status, skin condition, existence of sufficient autologous tissue, size and shape of the healthy breast, individual decision in favour of more sophisticated or simple procedures and, in connection with this, a shorter or longer incapacity for work. Generally speaking, the following procedures are available among others:

  • Breast reconstruction using an expander / implants
  • Breast reconstruction using a skin- / muscle flap from the back
  • Breast reconstruction using a skin- / fat flap from the abdomen (TRAM, Diep),
  • Breast reconstruction using relocation of skin flap from the torso
  • Breast reconstruction using autologous fat grafting

In rare cases, a breast is not properly developed for hereditary reasons. More often, injuries (burns in particular) are accountable for the absence of one breast, but in most cases, surgical interventions have produced this outcome.

Only very few women resign themselves to the loss of a breast that is sometimes inevitable to get cured. Prostheses to be used in pocketed lingerie are a common means, but they only affect the appearance in clothing. Often, there is a constant worry that the prosthesis might shift and be noticed by others.

Please do not hesitate to contact us for a personal consultation. Our surgeons will review, explain in detail, and discuss your options regarding »breast reconstruction« at Park-Klinik Birkenwerder/Berlin.

Is there a risk that cancer will reappear once a surgical intervention is performed in the area of the old scar?

Numerous scientific studies have shown that there is no reason for this widespread fear.

Is breast reconstruction with autologous fat carried out in several steps?

Yes, reconstruction with autologous fat usually consists of several sub-steps. It also depends on the size of the breast to be reconstructed. If necessary, 2 to 3 partial steps are then sufficient. In the case of extensive radiation in the medical history, there can also be up to 10 partial steps.

Does health insurance pay for the build-up with autologous fat?

The private health insurance companies usually pay the costs for reconstruction with autologous fat after examining an application for reimbursement. Unfortunately, this does not apply to the statutory health insurance companies. Unfortunately, detailed educational work and information on scientific findings have not yet led to the statutory health insurance companies covering the costs.

What are the complications that can occur in breast reconstruction?

In all relocations of larger skin areas, there is the general risk of ischemia and of tissue necrosis. The back muscle is much safer in this than the abdominal skin. A complete necrosis of a tissue flap is rare to see, but individual parts of an abdominal skin flap (TRAM) have to be removed more frequently due to ischemia. As excess tissue is planned in advance, this has only rarely a negative impact on the final result.

How is the fat removed?

We use water jet associated liposuction, WAL liposuction for short. It enables us to gently harvest the fatty tissue in small "ready-to-use" particles so that they can be used directly for transplantation. The aesthetic results at the donor sites and in the recipient area are excellent. The complaints after suction are minor.

What do you have to pay attention to after a breast reconstruction?

It is important that the transplanted fat can heal in peace. Physical exertion, especially excessive movements and shearing/compressive forces in the thoracic area, should be avoided for 2 to 3 weeks.

What experiences have the patients had?

Video interview on the subject of "breast augmentation with autologous fat"

Video interview with the topic "Advantages and disadvantages of autologous fat transplantation"

The Park-Klinik is a little oasis, I have always understood and felt cared for.

Dagmar M.

A beautiful décolleté – so that you can move freely without complexes. It is perfectly clear that one cannot survive such an illness without scars. I am very happy to be able to wear a dress with a neckline again without feeling pursued by eyes.

Petra P.

… I was diagnosed with breast cancer 3 years ago and required a complete mammary gland removal with nipple preservation. Since a silicone implant was out of the question for me and I am too slim for a reconstruction with autologous fat using a DIEP flap, I decided on a reconstruction using fatty tissue augmentation using the BEAULI method.

I had great reservations about this method and found it difficult to imagine the result. After removing the mammary gland, an expander was first inserted. I was lucky and my private health insurance covered all the costs for the surgical procedures. So far, a total of 6 operations have been performed under twilight anesthesia over a period of 2 years. The fat was gradually harvested from the thighs for breast reconstruction, with the nice side effect that I no longer have saddlebags.

After each op some volume was drained from the expander and during the last op the expander could be completely removed. Now all that is actually required is a final operation to adjust the other breast. I'm still waiting for a confirmation from my health insurance company. Overall I am very happy with the result. It was definitely the right decision.

… Not correct! After three months they came back and after six months the cancer had no place in my body. Everything was good. In 2015, a new cancer diagnosis turned my life upside down. I was prepared this time, I thought. The attending doctor should have known that a silicone implant is hardly possible after radiation.

Still, I beat cancer, but paid a heavy price for it. No one prepared me for how to live without a breast. So what were my alternatives? Abdominal flap plastic or back muscle? Huge operations with an uncertain outcome. There had to be another way for me - and I found it. In the Park Clinic Birkenwerder. *** .

Very competent and friendly doctors have allowed my breasts to grow again very slowly by treating their own fat. All the staff at the clinic accompanied me through the long treatment with friendliness and a great deal of patience. I would wish that many women in a similar situation would find the same help in this clinic as I do. THANKS. Thank you Mrs. Dr. *** for your great advice, the encouragement and your commitment to patients who do not just want cosmetic surgery, but need medically necessary (even if not paid for by health insurance) treatment.

Park-Klinik Fachärzte Team Park-Klinik Fachärzte Team

Dr. med. Ursula Tanzella and her team will be happy to advise you personally.

Make an appointment.