What is breast reconstruction
and why should I consider this option?
Breast Reconstruction surgery
is performed to recreate a woman’s breast
after a mastectomy. Many women decide to have
reconstructive surgery for a variety of reasons.
Some women find that having reconstruction
improves their body image and self-esteem,
improves their posture and balance, improves
their comfort in clothing, and eliminates their
need to wear breast prosthesis.
women choose not to have reconstruction because
there is additional surgery involved or they
may have conflicting medical problems. It
is a personal choice, but it is helpful to
get the guidance of your whole medical team
(surgeon, oncologist, radiation oncologist,
as well as a plastic surgeon), so that you
can make the decision that is right for you.
Can breast reconstruction
be done at the same time as the mastectomy?
Breast reconstruction is usually
done at the same time as the mastectomy, but it
is important to meet with a plastic surgeon to
discuss this prior to your mastectomy. Some advantages
of having reconstruction at the time of the mastectomy
Having a breast immediately after mastectomy
Fewer operations and less anesthesia
However, breast reconstruction
can be done months or even years after your mastectomy.
Some women choose to wait because they may need
additional treatment for breast cancer, or they
just choose to wait for personal reasons.
Are there different types
of breast reconstruction that can be done?
There are various types and
approaches to breast reconstruction surgery. Your
plastic surgeon will recommend an approach based
on your preferences, body shape, and type of treatment
you may require in the future.
The most common types
of Breast Reconstruction are:
Latissimus Dorsi Muscle Flap
What are some of the advantage
or considerations in choosing a reconstructive
breast surgery procedure?
Implants: Implants are usually the simplest and
most convenient form of breast reconstruction.
Breast reconstruction with an implant is usually
a two-step process. It is usually a one-hour
procedure for the plastic surgeon to place a
tissue expander. The tissue expander is like
a balloon. It requires multiple trips to the
office to instill saline through a port until
the skin is stretched enough to allow the implant
to be inserted. This usually takes several months.
Once the appropriate size is achieved, the surgeon
will remove the expander and replace it with
the implant, filled with either salt water or
silicone gel. Implants sometimes need to be
replaced, since they can shift, move, or break.
Some women experience breast hardness, pain,
or infection, although these are not common occurrences.
TRAM Flap (Transverse Rectus Abdominis Musculocutaneous
Flap): A TRAM Flap is a surgical procedure that
takes about 3 hours for the plastic surgeon to
complete. his procedure can be done at the same
time as a mastectomy or can be delayed. The surgeon
takes excess abdominal tissue which receives its
blood supply from the rectus abdominis muscle
and slides it under the skin to form a breast
mound. Moving muscle and tissue from the lower
abdomen results in a flatter abdomen (tummy tuck).
There are two incisions: an abdominal incision
and a breast incision. The recovery is 4 –
6 weeks, and requires a 2 – 3 day hospital
stay. An advantage of this procedure is that when
all surgery is completed, the breast has a natural
Latissimus Dorsi Muscle Flap: The Latissimus
Dorsi Flap is a surgical procedure that the surgeon
uses to move a muscle from the back to the chest
area to reconstruct the breast. This procedure
is sometimes used with an implant. The surgery
takes 2 – 3 hours. You will be in the hospital
from 2 – 3 days. You will have a back scar,
and recovery will take about 4 – 6 weeks.
Nipple areola reconstruction: This is an
outpatient procedure usually done when a reconstructive
procedure is completed to give a natural appearance
to the reconstructed breast. Skin can be grafted
from the inner thigh (forming an areola). Tattooing
is also done to add more color to the areola.
There will be a small scar on your inner thigh
from where the skin graft was removed.
What if my breasts are
two different sizes after surgery?
In general, the unaffected breast
can be made smaller or larger to match the side
of the reconstructed breast.
What are the risks
of reconstructive surgery?
As with any surgery, there are
risks of bleeding, infection, and poor wound healing.
Fluid or blood can accumulate near the incision
and can require drainage. There may be some numbness
at the incision site. As with other surgeries
there are risks associated with anesthesia.
surgery be covered by my insurance plan?
You should always check with
your insurance company to determine the extent
of coverage. However, in most cases, reconstructive
surgery is covered by insurance after breast cancer
surgery, mandated by state law.
If you have additional questions
or concerns, please call us at 847-797-9000.