Advancements in Breast Reconstruction - Understanding Your Options

If you are planning to have a mastectomy you may also be considering breast reconstruction surgery to rebuild the shape and look of the breast(s). It’s important to keep in mind that this is not a one-size-fits-all procedure. Some techniques use your own tissue, some use artificial implants and some can use a combination of both. Deciding which option is right for you can be difficult. Before having the initial surgery to remove the tumor or breast, talk with your doctor about reconstruction surgery options. This will allow your care team to plan the best treatment for you, even if you decide to wait and have reconstructive surgery later.

Major advancements have been made in breast reconstruction following mastectomy surgery, making long, jagged scars a thing of the past. Plastic surgeons now have access to advance techniques that have provided them with the tools to rebuild a patient’s breast in such a way that her silhouette is once again whole.

There are two main considerations when considering breast reconstructive surgery: when to have surgery and what type of surgery to have.

When to Have Breast Reconstruction Surgery

Simultaneous breast reconstruction - Occurs at the same time as the mastectomy. This is a reasonable option for patients who do not need breast irradiation.

Staged breast reconstruction - Patients who require radiation therapy are advised to have staged breast reconstruction surgery instead of simultaneous. Radiation that is performed on a newly reconstructed breast may alter its cosmetic appearance over time, causing the implant to become painful, deformed, contracted or even exposed.

In order to keep the breast skin that was saved during the skin sparing mastectomy procedure stretched and supple in preparation for the final reconstruction, a tissue expander will be inserted after the mastectomy. This is done several months after radiation is complete.

Delayed breast reconstruction - When struggling with a cancer diagnosis, you may not feel comfortable weighing all the options at once and choose to wait until after all the recommended treatment to treat the cancer is completed. Your doctor may also advise you to wait if you have high blood pressure, are overweight or smoke.

Types of Breast Reconstruction

Implants - Can be inserted during or after a mastectomy. They are made out of silicone, saline or a combination of both. As in the case of breast augmentation, the implants are placed underneath the chest muscle versus on top of it.

Flaps - Also called autologous breast reconstruction, this procedure is done by plastic and reconstructive surgeons. A breast is created using tissue taken from other parts of the body like the abdomen, back, buttocks or thighs. It is then transplanted to the chest/breast area to build a new and more natural feeling breast.