Breast reconstruction

What is breast reconstruction?

 

Breast reconstruction is a surgery that some people opt to get after undergoing a mastectomy or lumpectomy. Reconstruction might take several surgeries and there are multiple techniques. For some patients, a doctor may decide to use:

  • Silicone implants
  • Saline implants
  • A flap of tissue from your body (i.e.: the lower belly)

 

The timeline for breast reconstruction surgery differs between patients. Some people decide to get immediate reconstruction after breast cancer surgery. Others select delayed reconstruction months or years after the initial surgery. Surgery may include:

  • Reconstruction of both breasts
  • Replacing one breast and reshaping it to match the other one
  • Multiple surgeries over several stages

 

The decision whether or not to seek breast reconstruction is a personal preference. While some choose to have breast reconstruction after a mastectomy, many choose not to undergo another procedure.

What are the types of breast reconstruction surgery?

Back to top

The two main types of breast reconstruction surgery after a mastectomy:

Flap Reconstruction

Your surgeon will take tissue from your body and use it to form a breast. The tissue may come from your:

  • Lower abdomen (most common)
  • Thigh
  • Back
  • Bottom

 

There are different types of flap reconstruction with some more common than others.

  • DIEP flap: Skin, fat, and blood vessels are taken from the lower belly
  • TRAM flap: Skin, fat, blood vessels, and muscle are taken from the lower belly
  • Latissimus dorsi (LD) flap: Tissue and muscle are taken from the back
  • IGAP flap: Tissue (but not muscle) is taken from your bottom
  • SGAP flap: Tissue (but not muscle) is also taken from your bottom while using a different group of blood vessels
  • PAP flap: Tissue is taken from the inner and back of the thigh (no muscle)
  • TUG flap: Tissue and muscle are taken from the the thigh
  • SIEA flap (or SIEP flap): Like a DIEP flap, but it is a rare technique that uses other blood vessels

 

Implant Reconstruction

Surgeons use saline or silicone implants to create breast tissue for implant reconstruction. The types of implant reconstruction involve:

  • Lifting up the chest muscle and placing the implant underneath it
  • Placing an implant on top of the chest muscle (less recovery time)
  • Placing a tissue expander under the skin that is filled weekly with saline (the implant is placed once your skin has expanded enough to cover it)

 

Oncoplastic reconstruction is another option for people who are candidates for a lumpectomy. The best path forward is speaking with an oncologic breast surgeon to discuss your options after receiving radiation as a lumpectomy is performed.

How do I choose the right breast reconstruction surgery?

Back to top

Speak with a provider to help you to determine the appropriate breast reconstruction technique. Your provider can better determine your next steps by taking into consideration your:

  • Age
  • Overall health and lifestyle
  • Type of mastectomy or lumpectomy
  • Remaining tissue after a mastectomy or lumpectomy
  • Future need for breast cancer treatments (chemotherapy, radiation)
  • Past surgeries (abdominal surgery) that would make it hard to take a flap from your belly
  • Goals and/or desired appearance

What does breast reconstruction treat?

Back to top

Breast reconstruction surgery is most commonly used after surgeries done to treat or prevent breast cancer. It can also be performed to restore the symmetry of breasts or to reconstruct breast tissue from congenital abnormalities (birth defects).

It is completely understandable if, after a mastectomy, you want to manage the strong emotions and move forward by getting reconstructive surgery. Speaking with your doctor is the way to do that while ensuring that you make a choice that is in your health’s best interest.

What happens before breast reconstruction surgery?

Back to top

People who have breast cancer may need to undergo chemotherapy or radiation before getting breast reconstruction surgery. Prior to any additional surgery, your surgeon will:

  • Conduct a comprehensive examination
  • Measure and take photographs of your breasts
  • Ask about your health, any medications, and past surgeries
  • Ask you to stop taking some medications before your procedure

What is the recovery process after breast reconstruction surgery?

Back to top

People who have breast reconstruction surgery may stay in the hospital for up to a week. Your team of doctors will provide you with more insight and monitor your healing process. You may wear a surgical bra to support your breasts as they heal to help with reducing any swelling.

Your provider should discuss in detail how to take care of yourself and manage any pain when it is time to return home. Closely follow the instructions for taking prescriptions or over-the-counter pain medication.

What are the risks or complications of breast reconstruction surgery?

Back to top

Surgical procedures always have certain associated risks. The results will differ based on the specific type of procedure. How much tissue remained after a breast cancer surgery and the radiation are factors in any results. Some risks of breast reconstruction also include:

  • Infection
  • Bleeding

 

You will most likely feel little or no sensation in your newly reconstructed breasts after surgery. Some sensation in the skin may return over time. Complications to stay vigilant for include:

  • Blood clots (common after flap reconstruction surgeries)
  • Weakness, pain, or sensitivity at the donor site (flap reconstruction surgeries)
  • Bruising or scarring
  • Fat necrosis (death of transplanted tissue common with flap surgery)
  • Wrinkling, rippling, and ruptures (tears) in implants
  • Different sized or shaped breasts (i.e.: one breast feels more firm)
  • Asymmetrical nipples and/or areolas

 

If you notice these or unusual complications, it is important to speak to your doctor right away. Prompt medical treatment will help prevent minor complications from becoming more serious.

What is the outlook for breast reconstruction surgery?

Back to top

How you recover from breast reconstruction surgery will depend on your personal and medical history. Make sure to avoid:

  • Lifting
  • Exercising
  • Doing strenuous activities while you heal

 

It is also important to note that cancer can return after breast reconstruction surgery. Getting regular checkups with your provider is essential. Make sure that you also schedule a regular mammogram if you only had one of your breasts reconstructed.

Categories

Archives