Breast reconstruction is an alternative for almost every woman who has undergone or is about to undergo mastectomy, and for some who have undergone a lumpectomy. Woman choose to have breast reconstruction for a number of different reasons – some no longer feel whole or as feminine, while others simply don’t want to wear a breast prosthesis every day. Breast reconstruction surgery allows a woman to feel good about herself and to make a fresh start.
Although breast reconstruction can be performed anytime after a mastectomy, most reconstructive options offer superior results when they are done at the same time as initial cancer surgery.
A number of reconstructive options exist, from the insert of a breast implant to reconstruction using a woman’s own tissue. Additionally, different reconstructive techniques yield different types of breasts. Our goal is to make you aware of all of your options, so that you can make a truly informed decision.
There are two main categories of reconstructive options:
Reconstruction Using Your Own Tissue (Autologous)
Many tissues from the body can be used to rebuild a breast after a mastectomy. The preferred location (or donor site) depends on your body type. The best choice provides sufficient tissue to replace the missing fat and skin and lessen scarring at both the donor site and mastectomy site.
The lower abdomen is the first choice for most women. This site provides the needed fat and skin while placing the scar in a spot that is less visible. It also flattens the stomach giving a tummy tuck. While this is the preferred donor site, it may not be available to be used in all patients. Other choices include the back, hips or buttock areas. READ MORE
Implant reconstruction uses a temporary expander to stretch the skin and muscle. Approximately three to six months after the placement and expansion of the expander a permanent implant replaces the expander to give the final breast a mound-like shape.
The permanent implant is a silicone bag filled with saline (salt water) or gelled silicon. All permanent implant shells are made of silicon. In other words, both saline and silicone implants have a silicon shell – the only difference is what is inside the shell. Saline implants are filled with salt water (saline) and silicone implants are filled with gelled silicone. There are four main steps of implant reconstruction: READ MORE
Breast Reconstruction Timing
The timing of breast reconstruction is described in two ways:
- Immediate Reconstruction
- Delayed Reconstruction
Breast reconstruction can be done at any time after a mastectomy, however superior results are often obtained if reconstruction is done at the time of the mastectomy. This is called “immediate reconstruction.” At the time of mastectomy there is usually no scar tissue, no fibrosis, and no radiation damage to the tissue that can affect healing and the ultimate outcome of the reconstruction. Additionally, when done at the time of the mastectomy, the plastic surgeon will work with the cancer surgeon to make incisions that will be less visible and heal better.
Delayed reconstruction is done months or even years even after a mastectomy. Delayed reconstruction options are generally the same as immediate reconstruction options. Women who have had radiation treatment may have limited options, due to tissue damage caused by radiation therapy.
The goal of both immediate and delayed breast reconstruction is to replace the missing breast volume and any missing skin. Shape and symmetry are of prime importance. The longevity of the reconstruction and the mobidity of the operation are also important factors.
The information provided here is intended to support the consultation patients have with their plastic surgeon, to assist them in making a well-informed choice. The information found here does not provide all options, risks, complications or possible outcomes.