Before breast reconstruction, a thorough assessment of the cancer diagnosis is essential, including the histological type, tumor size and location, and its relationship to the total breast volume. Imaging tests such as mammography, MRI, and ultrasound aid in surgical planning. It is also important to quit smoking weeks before surgery and undergo laboratory and cardiological tests as clinically indicated.

In some cases, the contralateral breast can be adjusted during the same surgical procedure as the reconstruction to achieve symmetry. However, if the patient undergoes radiation therapy, we may wait a few months after the end of radiation therapy to perform symmetry adjustment, as the operated breast may undergo changes in volume and texture that affect the aesthetic result.

Breast reconstruction combined with quadrantectomy is usually performed under general anesthesia. The type of anesthesia may vary depending on the extent of the surgery and the patient's clinical condition. For minor procedures, sedation with local anesthesia may be considered, but general anesthesia is most common to ensure comfort and safety.

The scar pattern varies depending on the size and location of the tumor, the type of incision used for the quadrantectomy, and the reconstructive technique chosen. In small tumors, primary closure can be achieved with limited scarring. In larger surgeries, we use designs similar to those used in reduction mammoplasty, with "L," inverted "T," or periareolar scars, always seeking the best balance between aesthetics and oncological safety.

The choice of technique depends on the tumor size and breast volume. For small tumors in large breasts, local glandular flaps can be used, redistributing the breast tissue itself. For larger tumors and those with ptosis, mastopexy can be performed. For larger tumors or small breasts, more complex techniques may be necessary, such as local flaps (e.g., lateral thoracic flap) or distant flaps (such as the latissimus dorsi flap), always respecting oncological principles. Symmetrization of the contralateral breast can be performed simultaneously or in a secondary surgery, especially if radiation therapy is required.

Recovery involves moderate rest, use of a surgical bra, and rigorous monitoring of healing. In many cases, radiation therapy is indicated and should begin between 30 and 45 days after surgery. Minor symmetry adjustments or cosmetic touch-ups may be indicated after radiation therapy, usually between 6 and 12 months later, when the tissues have stabilized.