A Less Painful Approach To Breast Reconstruction

The problem with all the older approaches to restoring breasts is that they are traumatic and painful. Many women wake up from surgery extremely upset by unexpected pain. They become unhappy with their surgeons, they are less likely to comply with the rigorous demands of ongoing treatment, and, while no study finds that older methods of breast reconstruction increase death rates, they certainly do not extend life. But modern reconstruction methods are far less traumatic and far less painful.

It does not use unnatural substances such as silicone, it does not require additional surgery, and it does not have to be performed at the same time as the mastectomy. Also, it can be used to repair damage to the breast caused by lumpectomy. This method is called autologous transplantation of fat-derived stem cells or lipofilling. It uses abdominal fat, which is rich in naturally occurring stem cells, to rebuild the breast.

The breast naturally contains large amounts of strategically distributed fat. This transplant procedure, using the patient's own fat cells, cannot create a new breast, but it can result in a natural-looking, appropriately sized breast. When women do not have enough fat to create a new breast, their fat cells can be multiplied in the laboratory and then injected into the breast. The process of collecting them, through liposuction, is relatively painless and recovery times are fast. And no artificial materials are introduced into the body to rebuild the breast. The procedure isn't successful absolutely every time, but fewer than 1.2% (about 1 in 80) women receiving the procedure have to return to the hospital for treatment of complications. Only about 3% have any complications at all, usually death of fat cells at the injection site.

To take advantage of this procedure, it is important to know that:

• The fat used for lipofilling can be harvested from either the tummy or the thighs.
• Lipofilling requires at least a flap of skin to place the fat under. Extremely tight skin left after total or radical mastectomy may require additional treatments to prepare to accept the fat graft.
• Lipofilling is especially well suited to the complications of lumpectomy that have left the breast too small, missized in comparison to the other breast, or with an inverted nipple.
• Lipofilling usually is done long after the breast is removed. One study found that most women waited 3 years to have the procedure.

In a study conducted in France and Italy involving 534 women who had had the breast reconstruction, women who had lumpectomy and fat filling reconstruction were about 1% more likely to suffer cancer's return. Overall, about 2% of women had recurrence of cancer in the same breast, and about 3% of women had breast cancer to develop in the untreated breast.

See Also: Breast Cancer Prevention: Practical Aspects

It is important to discuss reconstruction options with your doctor before you have your mastectomy. Modern medicine can't give you a new breast, but it often can give you the illusion of a healthy breast, now with minimal pain and minimal risk of cancer recurrence.