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Breast reconstruction has helped numerous women feel “whole” again after a mastectomy on one or both breasts. When breast cancer causes a woman to undergo a mastectomy, she may feel less “like a woman” and/or experience a reduction in self-confidence. However, studies have shown that women who undergo breast reconstruction immediately after losing their breasts benefit psychologically. Breast reconstruction can give back what was taken. Other patients decide to wait months, or even years after a mastectomy, which is referred to as delayed reconstruction. Nevertheless, there are various types of breast reconstruction procedures that can be performed after breast cancer treatment.

Breast Reconstruction Procedures

Breast reconstruction is performed using implants, the patient’s own tissue or a combination of both. Nipple and areola reconstruction is often necessary if the nipple region cannot be spared during the mastectomy. However, nipple reconstruction is usually delayed until the breast tissue has healed from reconstruction surgery.

• Implant reconstruction usually involves 2 surgeries with several office visits in-between. In some cases, the implants can be placed immediately and only one surgery is needed. In most cases, a tissue expander is needed to stretch the existing tissue and to make room for the implant. The tissue expander is placed under the muscle in the breast cavity. During the next few months, the doctor will gradually increase the expander by injecting saline into the balloon-like device. Then, a second surgery will be needed to replace the expander with the implant.
• Autologous tissue reconstruction is also known as flap reconstruction. There is only one surgery needed for this procedure since the breast is reconstructed by using body fat from the abdomen, buttocks, back or thighs. Patients should understand that the flap procedure will have two surgical sites which are the donor site and the recipient site. This can make recovery a little longer than implant reconstruction. A flap of tissue can remain connected to the original blood supply and is tunneled up from the abdomen to the chest or it can be completely detached and then reconnected to a blood supply. However, the patient must have enough fat on the body to build a breast mound.
• Nipple and areola reconstruction is usually performed by folding over the skin from the breast tissue and suturing it into place to create a nipple. Once it is healed, the patient is sent to a special tattoo artist who will darken the area to create a more realistic looking nipple and areola. Alternatively, a prosthetic nipple can be created and glued onto the tattooed areola. However, the glue is temporary and will need to be reapplied on a regular basis.

Researching the Options

It is important for patients to learn about each procedure, as well as any risks, so they can choose the best option. There are additional risks for implants and either method can be altered with weight fluctuation or the natural signs of aging. However, the flap method allows the breast to age more naturally.

Breast reconstruction can improve the shape and size of the breast but it is important to understand that the new breast will never have the same sensations as the natural breast. Furthermore, there will be visible scars from either the mastectomy or the breast reconstruction surgery. The flap procedure will also leave scars on the donor site. However, the surgeon will always try to hide the scars within the natural creases of the body or below the bikini line whenever possible.