Tokuda Hospital Sofia


Breast Reconstruction

What circumstances lead to breast reconstruction procedures?

Numerous diseases or traumas often cause defects to the breast tissues, which are treated with plastic surgery methodologies in the form of breast reconstruction procedures. Numerous tumor related diseases treatments involve removing parts or the whole breast, and breast reconstruction procedures have been developed to resolve these post treatment effects.

Breast reconstruction after oncology breast operations

Due to the developments of modern medicine, it is fully possible to restore the volume and form of the breasts after oncology surgeries, and as an added benefit to perform aesthetic corrections to the unaffected breast during the procedure. Additionally, it is clinically proven that a large percentage of patients view the breast reconstruction procedure as powerful motivational factor to  agree to undergo a mastectomy as well as continue with supplemental cancer treatments.  

The procedure has numerous patient benefits including:

 - Restorative psychological and body personality integration

 - External prosthetics become unneeded

 - Restores freedom of movement and freedom in clothing choices

 - Improves sexual life and intimate relationships

In short the procedure aims to return women back to their normal way of life  

Many research studies have proved that the breast reconstruction procedure doesn’t have a negative effect on oncology therapies or long term survival rates.

The breast reconstruction process

Restoring the breast can be achieved in three methods:

 - Relocating the patient’s own tissues

 - Using implants  

 - Using a combination of the above two methods

Most often the tissues used for the tissue relocation procedures contain parts of the transverse or straight abdominal muscles, but there are also other complex surgical techniques using other more distant from the breast tissues to secure blood supply to the new breast structure. Recently, the practice of reconstructing the breast using fat tissue combined with growth factors and implantation of various cell populations has been more routinely implemented to achieve the desired results.

Types of breast reconstruction according to their stages of implementation

In terms of implementation, we make the distinction of single stage and multiple stage reconstruction.

Single stage reconstruction

For the single stage reconstruction during the oncology surgery the tumor or entire affected tissue mass is removed and the breast is restored. The resulting tissue defect frequently doesn’t allow the possibility for a long term implant to be implanted.  Because of this, a tissue expander is implanted and its volume is increased over time to the desired size, after which a breast implant replaces the expander.  Modern implants are covered by a silicone elastomer shell filled with a cohesive silicone gel that even when ruptured are designed not to leak. The main advantages of single stage reconstruction are psychological, cosmetic, and financial. However, sometimes the surgery is supplemented by radiotherapy, hormone therapy, or chemotherapy. The single stage breast reconstruction must not delay or hinder the supplemental oncology treatments.

Multiple stage reconstruction

The multiple stage reconstruction is performed after a determined period of time after the tumor removal intervention. Typically, the final breast shaping is completed over a series of stages. Staged breast reconstruction is recommended and implemented dependent upon the type and stage of the breast disease, and the necessity to complete supplemental oncology therapies (chemotherapy or radiotherapy) which are all taken into account during the process.

In summary, the procedures interventions involve creating bust symmetry, building the areola-mammary structures, and others.

The choice to use this method depends on the size and degree of sag of the other unaffected breast, the age and body shape of the patient, the patient’s physical and emotion state, and the skill of the surgeon.

Our approach is based upon team work meaning the patients have full access to our plastic surgeons to finalize the tumor removal decision as well plan together the post operative period procedures, the reconstruction treatment schedule, and the associated medical costs.

To make an appointment please call: +359 02/ 403 4911

You can also email your requests to our clinic chief Associate Professor Dr. Dimitar Evstatiev at


Plastic, Reconstructive a…


Breast Enlargement

Breast Lifting

Breast Reconstruction

Abdominoplasty Tummy Tuck



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Patient's stories

Hospital location

51B "Nikola I. Vaptsarov" blvd. (if you drive, the entrance is from "At. Dukov" str.), "Hladilnika" distr., 1407 "Lozenets".

The hospital has a parking lot. The first 30 min. are free of charge, then a fee of 3 bgn/hours applies.

Public transport:
Buses: №88, 120
Shuttle bus: 32

Subway: Getting off at "James Bourchier" station, after that walking through "Lozenets" distr., or tram №10, taking off at "Nikola I. Vaptsarov" stop. or a bus №88, taking ff at "Tokuda Hospital" stop.


From the Central Railway Station

Bus line №305 getting off at "Romanian embassy" stop
From "Romanian embassy" stop – Bus line №120 getting off at "Tokuda Hospital" stop.
(after the traffic lights at "Atanas Dukov" str.

With a subway, from "Central Railway Station" station, getting off at "James Bourchier" station, after that walking through "Lozenets" distr., or tram №10, taking off at "Nikola I. Vaptsarov" stop. or a bus №88, taking ff at "Tokuda Hospital" stop.