2023-07-02 16:00:26
Several cases of third-degree burns in women who had breast reconstruction by prosthesis alerted doctors. Each time the women wore a dark swimsuit…
“I was on the beach, went to take a shower and saw a huge burn 10 centimeters wide and 4 centimeters high on my breast. I didn’t realize it until I looked in the mirror when anyone would have noticed it long before.” Like Marie*, the fight of women who have overcome the hardship of cancer continues… in the sun. After having undergone the removal of one breast, or even both, followed by complete reconstruction with prostheses, these patients are in fact more vulnerable to the risk of serious burns in the event of prolonged exposure. “Since this is a risk that we did not know about a few years ago, the specialists did not warn the patients, who rightly blame us for it, explains Dr. Isabelle Sarfati, plastic surgeon specializing in breast surgery. . Today, we know it and it is important to talk about it! »
After a mastectomy, that is to say a complete removal of the diseased breast, many women ask for reconstruction. Several methods are offered to them, including the fitting of breast prostheses. Nevertheless, although it is a frequent operation and there is no contraindication to exposing oneself to the sun with prostheses, there is a circumstance where the sun can become a danger: the wearing a dark swimsuit coupled with prolonged exposure.
Unlike light shades, dark colors strongly attract heat. However, the prostheses are placed just under the skin and the pectoral muscle, which due to a long sunbath with a black, dark blue or even brown swimsuit, can concentrate the heat at the level of the reconstructed breast and therefore potentiate the risk. of burning. “There is a very small thickness, less than a centimeter, between the prosthesis and the skin. In the event of an exhibition with a dark jersey, it is then sandwiched by the heat concentrated at the level of the chest and the prosthesis which heats up”, explains Isabelle Sarfati. The problem is that during a mastectomy the skin is detached from the mammary gland, and is thus rendered insensitive. Result ? Women exposing themselves to the sun do not feel the burn. Very often, they only realize it after the fact, when they take off their swimsuits.
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“A new scar that is added to the others”
Apparently this risk would therefore only concern reconstructions after breast cancer and not women who had recourse to the fitting of prostheses for aesthetic reasons. “In France, about fifteen cases are recorded every year. For the moment, none concerned cosmetic surgery,” confirms Dr. Sarfati. A study published in 2021 in the scientific journal Aesthetic Surgery Journal and carried out in collaboration with the hospitals of Paris (AP-HP) reported 28 cases of severe burns in French women and all of them had actually undergone breast reconstruction after cancer. In the specific case of cosmetic surgery, the burn would be avoided by the fact that the natural breast better protects the prosthesis located below and that the sensitivity of the skin is not entirely lost. But these are only guesses, according to the doctors.
Marie was devastated at the idea of facing a new ordeal after seeing the damage to her skin on returning from the beach: “It took 5 operations for a complete reconstruction and finally turning the page on cancer. I didn’t need another bad news. His first instinct was to call his surgeon who offered him an emergency consultation. After examination, she was followed until the burn stood out on the skin, dried and scabbed over, which usually takes a week. Once delimited, the part of burned skin was removed and then the breast was stitched up during an operation under local anesthesia.
Healing is long and requires care for several weeks or even months. These include applying a hydrocellular dressing, a sort of artificial second skin, to the wound and changing it regularly to speed up healing. “I had surgery in May and the wound is still oozing, it should finish healing by the start of the next school year. I’m reassured since the healing is going well, but it’s still a new scar added to the others,” laments Marie*.
Be aware of the risk to better protect yourself
If the reconstruction of Marie* could be saved, other women were not so lucky. “Sometimes we can’t close the burn so well that there’s no choice but to remove the prosthesis,” says Dr. Sarfati. Indeed, if the burn is complete, that is to say it affects the entire thickness of the skin up to the prosthesis, the latter may become infected and require removal. “It’s terrible because after a long fight against cancer, a more or less laborious reconstruction, the woman loses her breast again just for having had the misfortune to stay two hours in the sun”, continues the surgeon, aware of the suffering. what it might represent.
This does not mean that the women concerned must absolutely avoid the sun. The surgeons want to be reassuring: being aware of the risk is already a good start because it allows you to put in place the right actions. Among other things, doctors advise avoiding dark swimsuits in direct sunlight and replacing them with light shades. When exposed to the sun, it is also recommended to place a cloth at chest level and, if possible, to moisten it regularly. “Put more sunscreen on the other hand has no impact because it protects against UV and not heat,” warns Isabelle Sarfati.
*The patient’s name has been changed.
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