Breast reconstruction: everything you need to know about restoring the breast

KEIT Day Hospital has 3 operating theatres, 2 inpatient wards with 10 rooms and 20 beds, an in-house laboratory, and a postoperative resuscitation room, allowing the surgical process to be organised within the same facility for procedures compatible with its care capabilities.
The operating theatres are equipped with ventilation systems featuring HEPA filters, laminar airflow above the operating table, and positive air pressure. These technologies help control air quality and reduce the risk of contamination in the surgical environment. The facilities also include electric operating tables, Surgiris LED surgical lighting systems, Karl Storz surgical instruments, and modern equipment for monitoring patients' vital signs.
The inpatient rooms are also designed to support patient safety and care during recovery. In addition to centralised oxygen supply and medical suction systems, they feature three alarm systems: a bedside device, a portable wrist-worn device, and intelligent sensors integrated into the bed and room environment. These systems alert healthcare staff when a patient requires assistance or when a situation requiring assessment is detected.

KEIT Day Hospital works with an international team of approximately 30 surgeons, including 27 Italian surgeons, specialising in plastic surgery, otolaryngology, and oral and maxillofacial surgery. A distinguishing feature of the clinic's organisation is the selection of surgeons according to their specialisation and experience in the specific procedure. For particularly complex operations, surgical teams consisting of two or more surgeons may be assembled.
For breast reconstruction, the surgeon assesses the quantity and quality of available tissue, mastectomy scars, any previous radiotherapy, and the characteristics of the opposite breast. These factors help determine whether implant-based reconstruction, potentially preceded by the use of a tissue expander, or reconstruction using autologous tissue is appropriate and available. The objective is to restore breast shape and volume while aiming for harmonious proportions and symmetry compatible with the patient's anatomical characteristics.
The choice of technique must also take into account the complexity of the procedure and the availability of the necessary expertise and resources. In particular, free-flap reconstruction requires microsurgical expertise, specialised flap monitoring, and an appropriate care infrastructure.
The surgeons at KEIT Day Hospital regularly attend international congresses, training courses, and conferences to update their professional knowledge and stay informed about scientific developments and surgical techniques within their respective specialities.

At KEIT Day Hospital, preparation for breast reconstruction involves a structured medical assessment process. According to the clinic's protocol, every patient undergoes at least two consultations with the surgeon, an anaesthesiology assessment, a cardiology assessment, blood and urine tests, and an electrocardiogram (ECG). These examinations are coordinated within the facility, which has an in-house laboratory for preoperative testing.
These assessments allow the medical team to evaluate the patient's overall health, identify potential risk factors, and determine their suitability for surgery and anaesthesia. For breast reconstruction, particular attention is paid to the patient's oncological history, the type of mastectomy performed or planned, any previous chemotherapy or radiotherapy, and the condition of the skin and chest wall tissues. Diagnostic imaging and additional specialist assessments may also be required.
Planning requires coordination with the breast care and oncology team responsible for the patient's treatment to determine the most appropriate timing for reconstruction and ensure that surgery does not interfere with any necessary oncological treatments.
This approach allows a personalised reconstructive treatment plan to be developed, taking into account not only aesthetic goals but also the patient's medical history, therapeutic needs, and safety.

KEIT Day Hospital follows infection control protocols developed in collaboration with specialists in infectious diseases and microbiology, with organised inspections of clinical environments and sterilisation processes. Air filtration systems undergo regular maintenance and replacement, while operating theatres are cleaned and disinfected after every procedure.
During surgery, sterile single-use surgical kits and fluid-resistant materials are used to help maintain a sterile operating field. Disposable materials carry identification labels containing information about manufacturing, expiry dates, and traceability, which is recorded in the patient's medical documentation.
Surgical instruments are cleaned and sterilised after each use, following documented procedures supported by records from the equipment used. This system enables sterilisation processes to be verified and traced. The clinic also conducts periodic microbiological testing of its environments and follows antibiotic prophylaxis protocols when indicated by the medical assessment.
Together, these measures, from the management of sterile materials to sterilisation traceability and microbiological monitoring, form an essential part of the procedures adopted by KEIT Day Hospital to reduce the risk of surgical infections.

At KEIT Day Hospital, surgical procedures requiring general anaesthesia are performed, according to the clinic's protocol, using TIVA (Total Intravenous Anaesthesia), a technique based on the intravenous administration of anaesthetic medications. This technique may support recovery from anaesthesia and help reduce postoperative nausea and vomiting, depending on the patient's characteristics and the anaesthetic protocol used. Breast reconstruction is generally performed under general anaesthesia, with an anaesthetic plan tailored to the reconstructive technique, the expected duration of surgery, and the patient's individual medical condition.
During surgery, the anaesthesia team continuously monitors the patient's vital signs using General Electric equipment available in all three operating theatres. The facility also has centralised systems for oxygen distribution, compressed air, and medical suction, as well as equipment for difficult airway management, cardiac defibrillators, emergency medications, and backup power and medical gas supply systems.
To manage potential emergencies, KEIT Day Hospital has a postoperative resuscitation room equipped with a ventilator, multiparameter monitors, a defibrillator, intravenous infusion pumps, and other equipment for supporting vital functions. According to the clinic's reported history, this room has not yet been used to treat major complications, but it remains equipped and ready for use in the event of unforeseen circumstances.
For more complex reconstructive procedures, the suitability of the facility must also be assessed in relation to the need for intensive postoperative monitoring, microsurgical care, and the ability to perform prompt reoperation when necessary.

At KEIT Day Hospital, patient care continues after the surgical procedure has been completed. Patients undergoing procedures compatible with the day hospital setting generally spend one night at the facility, during which they are monitored and cared for by healthcare staff. However, breast reconstruction may require a longer hospital stay, particularly when autologous tissue is used or complex procedures are necessary. In these cases, the length of hospitalisation and the care setting must be adapted to the patient's clinical needs.
After discharge, each patient is supported by four professionals: a coordinator, a nurse responsible for dressings and wound care, a doctor, and the operating surgeon. Follow-up appointments are generally scheduled at 1, 3, 6, and 12 months after surgery, allowing the medical team to monitor healing, identify potential problems, and assess how the surgical result develops over time. Breast reconstruction may also require more frequent appointments, particularly during the first few weeks and any stages of tissue expansion.
For breast reconstruction, follow-up care includes assessing surgical incisions, swelling, tissue viability, and the possible presence of seromas or other complications. The surgeon also monitors implant position and settling, when an implant is used, or healing of the donor site and reconstructed breast in autologous procedures. Patients receive instructions on managing dressings, any surgical drains, and gradually resuming daily activities. For international patients, care may continue after they return to their home country through communication with the medical team and follow-up appointments arranged according to individual needs.
Surgical follow-up does not replace the breast care and oncology appointments included in the patient's treatment plan, which must continue according to the recommendations of the specialists responsible for their care. KEIT Day Hospital also provides patients with an emergency contact number, available 24 hours a day, 7 days a week, to request assistance if needed after surgery.

One of the defining features of the services provided at KEIT Day Hospital is the emphasis on transparency and documentation throughout the surgical process. A complete medical record is prepared for every procedure, documenting preoperative assessments, the operation performed, the surgical techniques used, and information relating to postoperative recovery.
The clinic also uses photographic documentation taken before and after surgery to monitor the development of surgical results, in accordance with personal data protection requirements and medical confidentiality. Each patient receives a service contract, an official invoice, and an informed consent form, which is sent before surgery to allow sufficient time to review information about the procedure, potential risks, benefits, and alternative treatment options.
KEIT Day Hospital also provides an Official Guarantee Certificate, which defines the clinic's responsibilities and the conditions under which expenses may be covered in the event of complications during or after surgery, as specified in the document. The specific guarantee conditions are communicated to the patient before the operation, allowing them to understand the applicable terms and limitations of coverage in advance.