Breast Reconstruction
What Is Breast Reconstruction?
Breast Reconstruction Services at Continuum
What is Breast Reconstruction?
Reconstructive surgery may begin immediately after a mastectomy is performed, months or years afterward, or
not at all. In some cases your surgeon may recommend that you wait a period of time before beginning reconstruction,
but in most cases the timing is up to you. If you do have a mastectomy, and you choose reconstruction, several
very successful procedures are available for you to choose from. All of these procedures have inherent advantages,
and you should weigh the particular merits of each as you consider breast reconstruction.
Making a Decision
There is absolutely no urgency for making a decision about breast reconstruction. From a medical standpoint
it does not matter when you do it, or even if you do it. Many women do not want to contend with additional procedures
of any kind immediately following a mastectomy. Others feel that additional surgery to reconstruct the breast will
help them psychologically.
In any case, your surgeon can refer you to several plastic surgeons who will advise you regarding the types of
reconstructive surgery available, and, perhaps, make specific recommendations based on your particular size, shape,
and desired look. Reconstructive surgery is always performed by a plastic surgeon, and many specialize in breast
reconstruction. The hospital stay is usually about five to seven days.
If you're undecided, you may want to try wearing an external prosthesis for a while
and make up your mind at a later date.
Surgical Implants
The most common method of breast reconstruction involves a surgical implant, just like the ones used for cosmetic
breast augmentation. The results are very much the same. Although complications from the use of silicone
implants have eliminated their use for cosmetic surgery at the present time, they are still available for breast
reconstruction. Saline (salt water) implants are thought to be less controversial,
however, and are frequently used for both cosmetic and reconstructive surgery.
If you choose breast reconstruction immediately following your mastectomy, your plastic surgeon, working with your
breast surgeon, will more than likely start the process by inserting a tissue expander
before the mastectomy incision is closed. This is a saline implant with a silicone covering that allows the normal
tissue surrounding your breast to expand gradually over a period of 8 to 10 weeks before a permanent implant is
put in place. This will not affect your recovery period. In this case, a permanent implant that matches the size
and shape of the unaffected breast can be positioned as soon as the surrounding tissue has sufficiently expanded,
usually as an outpatient procedure. Some women use this as an opportunity to expand or decrease the size of both
breasts and elect cosmetic surgery of the other breast to achieve symmetry.
Flap Reconstruction
This is somewhat more complicated reconstructive surgery, also called a myocutaneous
flap, involves the relocation of muscle, fat, and skin tissue taken from another part of your body. This tissue
can be taken from the abdomen, back, or buttocks, and is molded into the shape of a breast. Some women prefer this
method of reconstruction because it eliminates the use of foreign material in the body. Others may prefer not to
have an additional surgical procedure performed elsewhere on the body that will have its own healing process to
go through. The reconstructive procedure makes the recovery process somewhat longer than that which follows mastectomy
alone.
The results of this surgery are often very good but it is considerably more expensive than a surgical implant.
Like the implant procedure, this procedure can begin immediately following mastectomy or it can be delayed.
Nipple Reconstruction
Whether you choose a surgical implant or a flap, you may also have the nipple and areola
(area around the nipple) reconstructed some months later, using skin from elsewhere on your body. This is a relatively
simple procedure but some women elect not to have it done, feeling that the reconstructed breast alone is sufficient.
If elected, the skin that is used, usually from the inner thigh, is tattooed to match the coloration of the nipple
on the other breast. The results of this procedure are also quite good.
After reconstruction you should have regular breast follow-up. A breast cancer recurrence should be relatively
easy to detect after reconstruction because cancer most often recurs in the skin and not the reconstructed tissue.
Reconstruction does not impede the physician's ability to detect recurrence as was once thought.