Reconstruction R8
Sequelae and symmetrisation
Correcting a quadrant defect and a distorted areola after lumpectomy and radiotherapy, and rebalancing the chest with a procedure on the opposite breast.
- Anaesthesia
- General
- Lipomodelling sessions
- 2 as a rule
- Symmetrisation
- Same operation as reconstruction
- Decision
- Multidisciplinary board
Figures confirmed by the surgeon; they vary from case to case and are specified in consultation.
The essentials
The four questions that come up
- What are sequelae of conservative treatment?
- Breast-conserving treatments — removal of the tumour and radiotherapy — can leave aesthetic sequelae: a defect in one quadrant of the breast and a distortion of the areola. These breasts have generally been irradiated.
- How are they corrected?
- Fat grafting is the option most often chosen: it fills the defect and reshapes the distorted area. Two sessions are generally needed. Recourse to a latissimus dorsi flap or to implants remains possible.
- Why operate on the opposite breast?
- Because it is often too small, too large or ptotic. Augmentation, reduction and mastopexy techniques are then used, sometimes fat grafting in place of a small implant.
- When is that procedure carried out?
- During the same operation as the breast reconstruction whenever possible. The decision is always validated by a multidisciplinary breast board.
What conservative treatment can leave behind
Today’s breast-conserving treatments are far less deforming than they once were. We are nonetheless confronted with their sequelae.
They take the form of a defect in one quadrant of the breast and a distortion of the areola. These breasts have generally been irradiated, which governs the choice of corrective technique.
How they are corrected
Fat grafting is the option most often chosen in this indication. It fills the defect and reshapes the distorted area of the breast, without foreign material and without the weight of flap surgery.
Two sessions are generally needed. Recourse to a latissimus dorsi flap or to implants remains possible depending on the case.
These procedures must be carried out in a multidisciplinary setting, with reliable, regular and thorough clinical and radiological monitoring of the breasts. Cancer follow-up does not stop because an aesthetic correction is undertaken.
The most marked cases
Where the deformity is severe, local correction may no longer suffice.
Completing the mastectomy, with immediate reconstruction by implant or by flap, is then to be discussed. That decision is taken by the board, and it changes the nature of the project.
Symmetrisation of the opposite breast
It is common to need a procedure on the opposite breast, which may be too small, too large or ptotic. A successful reconstruction on one side does not make a balanced chest.
Augmentation, reduction and mastopexy techniques are used. Sometimes, additional fat grafting can be considered in place of a small implant.
When it is carried out
This procedure is carried out during the same operation as the breast reconstruction whenever possible. It is one of the alternatives discussed at the reconstruction consultation, since the decision to augment the opposite breast can also be an opportunity to improve the chest and, in that case, to increase the volume of the reconstruction.
Ptosis will need correcting, since implant reconstruction gives a stable, rejuvenated breast. Management of the opposite breast may finally prompt a discussion about considering instead a prophylactic mastectomy with immediate reconstruction, in the light of the patient’s history, age and genetic risk factors.
That decision is always validated by a multidisciplinary breast board.
Frequently asked questions
What patients ask
These answers reflect the content written and validated by the surgeon. Each one is written to stand alone, question by question.
How many sessions to correct sequelae?
Can an irradiated breast be operated on?
What if the deformity is severe?
Is a procedure on the opposite breast compulsory?
Meet us
Consultation
A first consultation is there to understand your request and tell you what is possible — including when the answer is that it is better to do nothing.
Clinique Esthétique Ferrère
16 ter rue Ferrère
33000 Bordeaux
In cosmetic surgery, French law requires a detailed written quote and a cooling-off period of at least fifteen days between the consultation and the operation. No deposit may be requested during that period. Two consultations are required before any operation.