Placing an implant is the method most used by women with breast cancer who have to be subjected to a mastectomy. But transplant with its own fabrics is the most comfortable solution that avoids greater complications throughout life. São José Hospital has been able to get more and more women and without increasing the waiting lists of the national service.
Ana Carolino will record in the body the traces that within 24 hours will serve as guiding lines for a long surgery that will completely remove her left breast. He has been watched since he was 17, after his mammary cysts have been detected.
About three months ago the news came that I hope never to hear. Ana has a tumor of evil origin on the left breast.
In the same operation will make the total mastectomy of the left breast, also the reduction of the right breast and a transplant. When you wake up you will already have the right breast rebuilt with your own fabrics without the need to put any implant
“I just want to be well. I worry a little, yes, because I was never operated on to anything. It’s all new, it’s an adventure,” Ana explains to sic.
The sound column is already on. The surgery goes to the sound of the song and starts at 9:30. The surgery room of the hospital of São José Mal arrives for so many professionals. They are two teams simultaneously. Senoology, led by Maria Inês Morujao, and that of plastic surgery with doctors Luiz Vieira and Luís Ribeiro.
The priority begins by removing the sentinel ganglion. In case of breast cancer is always the first to be affected. The mastectomy follows, still at the hands of the senologist. At the same time the two plastic surgeons work on the abdomen from which the fabric needed to transplant the left breast will come out.
“There are other alternative zones that are not so good but still quite acceptable, which is the inside of the thigh and the latest gluteal region, in the transition of the lumbar zone with the gluteal region. Therefore, these are the most frequently used zones, but with great preference to the abdominal region,” explains Luís Mata Ribeiro, plastic surgeon.
From the interior of the mastectomized breast came almost 1 pound and 200 grams of fabric. Made the bills and after reducing the right breast, it will be necessary around 500 to 600 grams of abdomen to make the transplant.
“In extremely thin patients it can be impossible, in fact, we make a transplant of the abdomen. But I would say this is relatively uncommon. I would say that, in general, thin women have smaller breasts, so the transplant we need to do is also smaller,” says Luís Vieira, plastic surgeon
Mariana had to fatten four pounds
For the gymnastics teacher Mariana Gomes, exercise, more than a profession, is a lifestyle. He gained four pounds to get a 270 -gram transplant. He found that something was wrong because his daughter started rejecting the left breast milk.
He heard from the mouth of a doctor who put a transplant would be faster and would leave doctors more time to operate other sick. Mariana Gomes replied that she would rather live without breast than to have a breast implant.
“To make this option [a reconstrução com os próprios tecidos]the operation can not be as fast as we wanted because there are several teams involved and it is more complicated that we can do the operation as fast as possible, ”says Mariana.
There are hospitals where the possibility of making a transplant is not even debated. Transplanting breast can take more than hours. The long time of surgery weighs on a NHS with long waiting lists. And it can also be a risk and exclusion factor for some women for whom the prosthesis becomes the most viable solution.
“More debilitated, older patients may not be the best option. Therefore, reconstruction with prosthesis there can be a good option. On the other hand, in cases of bilateral reconstruction, especially in cases that there is no neoplasm, there is no tumor, but there is a risk of having tumor, where mastectomy is not so aggressive, prosthesis is a good solution. To decide, ”explains Luis Vieira.
Breast transplantation may take more than 7 hours
The skin was preserved, but the nipple disappeared, will be advised to get a tattoo later. Before that, you will return to a second surgery with local anesthesia to do some touches. When he played back in the breast, Ana Carolino will find a similar touch to what he always felt. The transplanted breast will also grow old at the speed of the rest of the body
“And in the end, what matters is that these patients rebuilt with this method have their lives ahead with much less sequelae, in general, than patients rebuilt with other methods,” says Luis Vieira
“The first three months are very difficult. Before, we have immense liquid retention. It hurts everything. Then, with a lot of drainage, with a lot of physiotherapy, with a lot of motion stimulation, the fabrics start to be malleable. At first we have to learn to mobilize the arm, because it will not ride this way, we bare the arm to the ear, the more it rolls backwards,” Mariana Gomes.
Mariana decided to keep her breast as she was rebuilt to the first. Without nipple, without the symmetry that doctors promised to improve. The sports training you already have now wants to join physical therapy to be able to help women with cancer. Many abandoned by husbands and companions, still in the hospital, when they discover that they will lose a breast.
