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Breast Reconstruction

What Is Breast Reconstruction?

Breast cancer affects hundreds of thousands of women each year. During treatment, a mastectomy may be performed to remove the breast containing the cancerous tissue. Sometimes a prophylactic mastectomy is indicated on the opposite breast as well. This leaves the woman without any breast volume, shape, or symmetry. Many womecn feel less feminine after their mastectomy, saying that they feel as if their sexuality has been taken from them. Breast reconstruction using implants or free tissue transfer can successfully help women regain a level of control over their lives.

The Benefits of Breast Reconstruction

Restores

your feminine curves and silhouette

Creates

symmetry after unilateral mastectomy

Increases

your confidence

Allows

clothing to fit better

Reclaiming your body after cancer can be very empowering

Common Procedures for Breast Reconstruction

Description
An expander is placed in the breast to make room for the permanent implant
The permanent implant can be saline (silicone shell filled with a saltwater solution) or silicone (silicone shell filled with cohesive silicone gel)
Human-derived collagen products (such as Alloderm) are used with the patient’s pectoral muscle to create a well-protected implant pocket
Advantages
An expander allows a patient to finish radiation therapy before having definitive reconstruction
A patient can decide on her final breast size and shape
Reinforcing the pectoral pocket helps to accurately project and position the implant
Recovery period is quicker
No additional body scarring
Disadvantages
Requires multiple surgeries and recovery times
Differences in feel between the breasts may be noticeable in patients undergoing unilateral reconstruction
Implant placement is not recommended in patients undergoing radiation therapy
Description
Utilizes perforator flaps that harvest skin and fat from donor sites and transfer them to the chest
The most common area harvested from is the abdomen (DIEP flap), but other areas that can be used include the buttocks (SGAP flap), inner thigh (TUG flap), and the back (TDAP flap)
The surgeon takes tissue and leaves the muscle intact
Preservation of muscle allows the patient to maintain normal physical and athletic functions
Advantages
It is typically easier to match tissues to create a natural looking and feeling breast, especially for patients who have undergone a unilateral mastectomy
Patients receive the added benefit of a tummy tuck, a butt lift or a lower body lift
When compared to the old TRAM flap technique, patients have a faster recovery time and a much lower risk of developing hernias, bulges, and core weakness
Disadvantages
Generally has a longer and more challenging recovery than implants
Patients will have scars at harvesting sites, which will fade over time
Patients who do not have enough excess fat and skin tissue cannot undergo this treatment
Patients who smoke, are obese, or have diabetes are not ideal candidates for this type of surgery

Important Procedure Considerations

It is important for both the patient and doctor to remember that every person is unique. The method of reconstruction is tailored to each individual's requirements. Factors that may influence procedure choice include the patient’s:

  • Age
  • Goals
  • Extent of surgery desired
  • Type of cancer
  • Overall health condition
  • History of smoking and diabetes
  • Size and shape of the normal breast
  • Active radiotherapy
  • Amount of excess body tissue
  • Recreational activities and sports

Frequently Asked Questions

Can I have my breast reconstruction at the same time as my mastectomy? Most patients can undergo breast reconstruction at the time as their mastectomy (immediate reconstruction). This would be pre-planned with your operating surgeon. In some cases, the need for chemotherapy and radiation requires the postponement of definitive breast reconstruction. Dr. Boyd works with patients who require both immediate and delayed reconstruction.

Is my breast reconstruction covered by insurance? In 1998, it became federal law that insurance companies who cover mastectomies must also cover breast reconstruction. This includes the reconstruction of the removed breast, surgery to the other breast to create symmetry, and external breast prostheses that are needed before or during reconstruction.

Will my breast implant(s) impact my treatment if my cancer returns? It is a common myth that implants will either a) cause cancer to develop or b) prevent its detection. Breast implants will not affect your remission. If your cancer does come back, your implant(s) should not cause a problem with undergoing radiation or chemotherapy. If your cancer does come back, your implant(s) should not cause a problem with undergoing radiation or chemotherapy. However the radiation may cause problems with the implants. If so, Dr. Boyd will advise you on your options.

Will breast reconstruction restore sensitivity to my breast(s)? Breast reconstruction does not restore sensitivity to the breast(s) or nipple(s). Over time, the skin may regain sensitivity, but it won’t feel exactly as it did before.

When can nipple reconstruction be performed? In most cases, nipple reconstruction is performed about four months after the initial surgery, which allows the breasts to have time to heal. It is often performed with other balancing and scar revision procedures to obtain the best aesthetic results possible.

Before & After Photos