Breast Reconstruction

Women who consider breast reconstruction surgery tend to be either breast cancer survivors who have had single or double mastectomies or women who have had their breast tissue removed as a way of reducing the risk of breast cancer due to a significant family history of the disease.

Women who have had lumpectomy procedures do not need reconstructive surgery.

Breast reconstruction is a surgical procedure, performed by a plastic surgeon that restores the appearance of a breast by rebuilding the breast contour. Women can also opt to reconstruct the nipple and darker area around the nipple called the aureole. Reconstruction will not restore the normal feel and sensation of your breast.

Breast reconstruction can be done at the same time as your mastectomy. The main benefit of immediate reconstruction is one less surgical procedure to endure. Delayed reconstruction may be appropriate if radiation is prescribed following the mastectomy. Radiation can increase complications after surgery.

Deciding to have breast reconstruction is a matter of individual choice and should be thoroughly researched and discussed with your doctor, plastic surgeon, support group, family and those you trust. Try not to rush your decision making process. It is important for you to make a decision that you are comfortable with based on thoroughly researched and understood information.

Reconstruction will not give you back your breast. Although the reconstructed breast will not have natural sensation, the surgery can give you a result that looks like a breast. If you are thinking about reconstruction you should talk with a plastic surgeon before your mastectomy. Ask your surgeon for a referral to an experienced plastic surgeon. Some women begin reconstruction at the same time as the mastectomy is done; others wait several months or even years.

Breast Implants

A plastic surgeon is able to form a breast mound by using an implant or by using tissues from another part of your body. Breast implants are silicone sacs filled with saline (salt water) or silicone gel. The sacs are placed under your skin behind your chest muscle. Your body type, age and cancer treatment will determine which type of reconstruction will give you the best result.

Saline and Silicone Breast Implants

Saline-filled breast implants are available for anyone who wants them.

Some scientists are concerned about possible short-term and long-term health problems associated with silicone gel-filled breast implants. The Food and Drug Administration (FDA) has decided that breast implants filled with silicone gel may be used only in an FDA-approved clinical trial. Your surgeon can determine if you are eligible and can make arrangements for you to join the study.

Possible Implant Problems: As with any surgery you may have some pain, swelling, bruising and tenderness. These problems should disappear as you recover. Scars will fade over time. You should let your doctor know immediately about any fever, infection, or bleeding.

Side effects that could appear later include rupture, leakage, deflation or shifting of the implant or interference with mammography readings. Breast implants age over time and may need to be replaced.

Reconstruction with Tissue Flaps

A flap (section) of skin, muscle and fat can be moved from another part of the body to the chest area where it is formed to create a breast shape. This tissue can be taken from the lower abdomen, back, or buttocks.

Tissue Flap Reconstruction: This flap of skin, muscle, and fat is moved while still connected to its blood supply. It is then shaped to form a new breast mound. Choose a plastic surgeon that has been trained in this procedure and has performed it successfully on many women. Of course, you will need to have regularly scheduled follow up care and mammograms.

Possible Problems

Tissue flap reconstruction is a major operation resulting in large surgical wounds. If there is a poor blood supply to the flap tissue part or all of the tissue in the breast area may not survive the transplant. Infection and poor wound healing are possible problems.

What You Should Know

Most women who have breast reconstruction are happy with their decision. A woman starting this process, however, should know that breast reconstruction requires more than one surgery. Extra steps may include:

Adding a nipple.

  • Changing the shape or size of the reconstructed breast.
  • Surgery on the opposite breast to create a good match.

With most of these extra surgeries you can go home the same day as the operation.

Source: National Cancer Institute

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