Reconstruction of the breast is a valuable option for women who have had a mastectomy, also known as surgical breast removal. The surgery can help reduce the trauma of losing a breast, helping improve the lives of those who face breast cancer.
Breast reconstruction surgery is surgery used to restore the look and feel of the breast after a mastectomy.
There are two methods for reconstruction: using an implant to replace the lost tissue or using tissue from elsewhere in the body (often fat from the abdomen) to replace the lost tissue (autologous).
For patients who are candidates for breast conservation therapy or lumpectomy (partial mastectomy), one alternate type of reconstruction is oncoplastic surgery. Oncoplastic surgery combines the latest plastic surgery techniques with breast surgical oncology.
Women who decline or cannot undergo breast reconstruction surgery can also use a custom-made silicone breast prosthesis for symmetry after their operation.
After a mastectomy, the type of reconstruction most appropriate for you will depend on various factors such as:
- The amount of skin remaining on the chest wall
- The size and shape of the other breast
- The amount of body fat and tissue available elsewhere
- Your general health
- Smoking history (if any)
- Personal preferences
Implant surgeries are often best for women who have not had radiation therapy prior to their mastectomy. In most implant surgery cases, a tissue expander is placed at the time of the mastectomy. Known as a staged procedure, the tissue expander is later switched for an implant at a later date.
For a one stage implant surgery, an implant is placed at the time of the mastectomy procedure. Implants come in different shapes and sizes and are made of saline or silicone. A plastic surgeon will help determine which type of implant is best for you.
Autologous reconstruction (tissue transfer)
For a tissue transfer reconstruction, a breast mound is made from fat and muscle from different parts of the body, such as the abdomen (TRAM), the buttocks or the upper back and chest area.
Once the breast mound is completed, the other breast may be altered (with an implant, a reduction, or a lift) to achieve symmetry. In the final step, a new nipple-areola complex is built if the nipple has been removed, and the area can then be tattooed to have a similar color to the other side.
Because of the varying types of surgical approaches, breast reconstruction surgery does involve various risks. These include:
- Bleeding and/or blood clots
- Fluid build-up in the breast
- Tissue death
- Loss of breast and/or nipple sensation
- Issues with the implant, such as movement, rupture or scar tissue
- Issues with the repurposed tissue, such as swelling, pain and loss of muscle strength