A diagnosis of breast cancer can be hard to accept, especially in the face of complicated surgical decisions. The good news is, modern plastic surgery offers a wide range of options for physical and emotional well-being.
For women who have lost one or both breasts to cancer or other conditions, reconstruction can dramatically improve self-image, self-confidence, and quality of life.
Breast reconstruction is a series of surgical procedures that restore breasts to nearly normal size, shape, and appearance after a mastectomy. Some procedures can be performed at the same time as the mastectomy, while others occur in stages once the mastectomy has had time to heal. Women who have had only one breast removed sometimes also opt for augmentation, reduction, or a lift to help balance the remaining breast.
Breast reconstruction often involves implants, either silicone gel or saline. If implants can’t be placed at the time of mastectomy, a temporary tissue expander can hold the space. Once the mastectomy begins to heal, the surgeon will inject the expander periodically with fluid. This gradually stretches the skin and surrounding tissue, creating a soft pocket to place a permanent implant later on.
Other procedures use tissue flaps to rebuild the breast ““ that is, skin, fat, and sometimes muscle from other body areas. Tissue flap techniques work well when both breasts need reconstruction. Also, if the tissue source is ample enough to create a solid breast mound, it can help avoid the need for implants. The most common tissue flap procedures are transverse rectus abdominis muscle (TRAM) and lattissimus dorsi, which use tissue from the tummy and upper back. Many surgeons also perform deep inferior epigastric artery perforator (DIEP) reconstruction. This is similar to TRAM, but uses only abdominal skin and fat with no muscle.
Nipple or areola reconstruction adds the finishing touches to the reconstruction process. Skin-sparing mastectomy leaves the nipple or areola in place while breast tissue is removed underneath. Otherwise, nipple reconstruction can be done as part of a latissimus flap process. Nipple tattooing, a non-surgical procedure, can help create a closer color match to the opposite breast.
Reconstruction is a highly individualized procedure – your plastic surgeon can help determine the best and safest progression for you. During the consultation, be candid about your goals, overall health, and lifestyle. Remember that any plastic surgery procedure should be done for yourself, not to meet another person’s expectations or ideal. It’s also important to understand that the physical results of reconstruction will vary between individuals. Reconstructed breasts may not have the same sensation or feel as the breast being replaced. What’s more, radiation treatments can cause transferred tissue to shrink or harden. If radiation is needed, it’s best done before your surgery.