Breast reconstruction may be an option for women who have had a mastectomy as part of their breast cancer treatment. Breast and plastic surgeons work together to decide on the best treatment plan and will advise if it is possible and whether the reconstruction can be done at the same time as the mastectomy or if it should be done later.
Some women who are not candidates or who decide against reconstruction may use a breast prosthesis to help them feel more comfortable and confident with their appearance after their mastectomy. In contrast, other women don’t choose either option.
For women who are candidates for breast reconstruction, there is no right or wrong answer; it is a personal choice. The decision should be made after careful discussion with their surgeon and after they fully understand the potential benefits and risks.
Types of Breast Reconstruction
There are different types of reconstruction surgery to rebuild the breast:
Implant Reconstruction
One type uses a fluid-filled implant placed under the chest muscle. This procedure is done at the same time as a mastectomy.
Sometimes a two-step reconstruction will be advised. First, a tissue expander stretches a patient’s skin and muscles, and an implant is placed with a second surgery. A tissue expander is an empty implant shell that your surgeon will periodically inject with fluid, typically every 1 to 2 weeks. With each fluid injection done through a port placed under the skin, the muscle and skin are stretched. Your surgeon will determine when the muscle and skin are stretched enough to replace the expander with an actual implant.
While there have been vast improvements with breast implants, there are still risks that include:
Infection
Bleeding
Implant replacement needed
Breast hardening
Flap Reconstruction
A breast cancer surgeon or plastic surgeon can perform a flap reconstruction using your existing tissue to form the shape of a breast.
TRAM Flap
A TRAM Flap procedure uses the existing fat, muscle, and skin. A flap of skin with one of the abdominal muscles and fat is surgically removed from the lower abdomen. If this procedure is used, your surgeon will explain how the flap is repositioned to form the shape of a breast and what scars will be visible after surgery.
LD Procedure
This type of reconstruction uses both back muscles and fat and is often combined with an implant. If you are a candidate for this surgery, your surgeon will discuss the specific details of the surgery and the results you can expect, including any scarring you will have.
With both procedures, a nipple and areola may be created either during or after surgery.
Your surgeon will thoroughly explain the entire process of your reconstruction surgery and what you can expect with recovery time. You will also know before surgery any side effects and / or limitations you may have both during your recovery and long-term.
With Flap Reconstruction surgery, as with any surgery, there are certain risks to be aware of, including:
Infection
Bleeding
Muscle weakness
Breakdown of tissue
Lumps that may form in the rebuilt breast are caused by fat tissue.
