Breast reconstruction surgery can help restore a woman’s sense of wholeness and well-being following treatment for breast cancer. One or both breasts are reconstructed, and the appearance of the nipples are restored to provide a balanced, natural-looking appearance.
Immediate or Delayed Reconstruction
Depending on the patient’s desires and the surgeon’s recommendation, either immediate or delayed breast reconstruction can be performed. Immediate breast reconstruction is performed at the same time as the mastectomy (removal of the breast) and has several advantages over delayed reconstruction. However, you and your surgeon may choose to delay reconstruction if you need post-mastectomy radiation therapy or chemotherapy. Delayed reconstruction may also be a more comfortable option if you are concerned that possible recurrence will affect your reconstruction results in the future due to subsequent cancer treatment.
The breast can be reconstructed with a breast implant or flap techniques (autologous fat transfer). With breast implant reconstruction, a temporary tissue expander is placed beneath the skin to make room for the breast implant, which will permanently replace the expander during a second procedure. With autologous fat transfer, a breast mound can be formed using tissue from the woman’s abdomen or back. After either technique for reconstruction is complete, the nipple and areola can be reconstructed to provide a more complete and balanced breast appearance.
Breast Implant Reconstruction
A tissue matrix can be used to support weakened tissue along the lower portion of the breast pocket while the pectoral muscle covers the top of the breast pocket over the implant.
Full Muscle Coverage
The breast implant is covered and supported by the pectoral muscles and sometimes the rectus abdominis muscle.
Partial Muscle Coverage
The pectoral muscle covers only the top of the implant. The bottom of the implant is supported by the breast skin only, which may create a more natural breast appearance.
Autologous Breast Reconstruction
Tissue, including skin, fat, blood vessels, and muscle, is taken from the lower abdominal area to shape the breast.
Latissimus Dorsi Flap
Tissue from the upper back is tunneled beneath the skin to the front of the chest to create the breast mound or to create a pocket for an implant.
Uses tissue from the abdomen like the TRAM Flap, but does not use muscle.
Uses the only the superficial vessels in the abdominal area to support the implant.
If the nipple cannot be conserved during the mastectomy, nipple reconstruction can be performed to complete a natural-looking breast appearance. This is a relatively fast outpatient procedure and is usually performed using local anesthetic. There are many ways to construct the nipple, but most commonly, a flap of skin from the surrounding breast tissue is used. Once healing is complete, areola tattooing can finish the procedure by adding pigment to the area.
Since breast reconstruction is a highly individualized procedure, results and recovery time will vary among patients. You should arrange for someone to care for you at home for the first few days after surgery. Drains and stitches are removed within one to two weeks, and most patients can return to routine physical activities within four weeks.
Breast reconstruction after mastectomy is an option for all women according to the Women’s Health and Cancer Rights Act of 1998. For more information regarding insurance coverage for this procedure, please reference breastreconstructionmatters.com.
If would like to learn more about your options with breast reconstruction surgery, contact board-certified plastic and reconstructive surgeon Dr. Matthew Conrad to schedule a personal, confidential consultation. Please call (316) 681-2227 or fill out ouronline contact formtoday.