The sense of freedom that explodes when, clothes off, you strip away the fatigue of a year’s work and your skin lights up in contact with the sun and the wind. A joy dulled only by the thought of not appearing as perfect as you would like. The bane and delight of every beginning of summer, the costume fitting It has a slightly different bittersweet taste for women returning to the beach after a breast reconstruction surgery for breast cancer. No taboos, no complexes and fears: revealing yourself and facing the mirror and the gaze of others head on is possible and necessary. Word of the experts of Beautiful After Breast Cancer (Babc) Italia Onlus, who on the occasion of the World Bikini Day scheduled for July 5th, they reassure and advise those who are preparing to wear it after surgery.
“When you wear a bikini again after breast reconstruction, there is a fear that any irregularity or difference between the breasts might be noticed,” explains Marzia Salgarello, a reconstructive plastic surgeon at the Fondazione Policlinico Università Agostino Gemelli Irccs in Rome and president of Babc Italia Onlus. “In reality – she specifies – with the new techniques of prepectoral prosthetic breast reconstruction, I feel like reassuring women. These techniques, in fact, make the more natural reconstructionbecause the prosthesis is positioned in front of the muscle and therefore behaves similarly to the breast before the mastectomy”. Not theory, but reality: “At this time of year – says the specialist – my team and I receive numerous photos of patients proudly showing off their bathing suits. In those images there is first of all the joy of having overcome a difficult period, but also that of finding one’s body again, in some cases even more beautiful than before. This is especially the case for patients who have received bilateral reconstruction after a bilateral mastectomy, in which, therefore, the two breasts are very similar, since the same prosthesis was positioned on both sides”.
But also “in all other cases, that is when the mastectomy and subsequent breast reconstruction were unilateral, that is, they involved only one breast – Salgarello reassures – the reconstruction with the prepectoral prosthesis still guarantees an appearance and mobility that makes it resemble the other breast”.
“If the patient has undergone reconstruction with flaps, that is, with her own tissue and not with the prosthesis”, continues Liliana Barone Adesi, medical director of the UOC of Plastic Surgery of the Fondazione Policlinico Gemelli and vice president of Babc Italia Onlus, the breast “will certainly have an even more natural appearance which will also guarantee, in the immediate future, greater symmetry compared to the other breast. Furthermore, the results of reconstruction with flaps are more stable over time: the reconstructed breast will follow the physiological changes of the body, gaining weight if the patient gains weight and aging with her. It will be subject to the force of gravity, as the original breast does. This type of surgery, however, requires ‘drawing’ tissue mainly from the abdomen, and therefore is not recommended for particularly thin patients. Patients who have a slightly more pronounced belly can reconstruct the breast by taking tissue from that area. The incision will be made in an area that falls under the underwear and will therefore be invisible even in a swimsuit, similarly to what is usually done in the US. It happens for a cosmetic abdominoplasty”.
“What patients fear most about wearing the costume – Salgarello reports – is that in the lying position, if the reconstruction was with a unilateral prosthesis, the breast with the prosthesis will remain harder and more static, while the other non-reconstructed one will change shape because it is softer. In reality, thanks to the new techniques of prepectoral reconstruction, the mobility of the breast is very similar to the original one and also with the use of ad hoc costumes this problem can be reduced to a minimum. Thanks to modern prostheses it is possible to obtain a natural result that makes the reconstructed breast uniform to the healthy one”, reiterates the expert.
Someone good habits can help. “We advise patients to use a sun protection 50+ even under the swimsuitapplied several times a day, and to expose yourself to the sun only during the coolest hours, thus avoiding the central hours of the day”, recommends Barone. “No problem – he adds – for swimming in the sea. The advice, however, is to take a fresh water shower immediately after, to avoid skin irritation that saline water can cause. Another useful precaution in case of autologous reconstruction is to use the silicone patches on the scar. This way you will get complete protection of the scars, almost as if it were a total sunscreen applied permanently, and it also promotes better healing of the skin.”
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