Breast reconstruction surgery is used for women who have had all or part of one or both breasts removed during a mastectomy or lumpectomy for the treatment of breast cancer. This surgery is used to rebuild the breast mound, and in the case of a single breast reconstruction, to match the size, shape and overall look of their other breast.
Approximately 80,000 women underwent breast reconstruction following mastectomy in the United States last year, according to the annual statistics from the American Society of Plastic Surgeons. The majority of these women began the reconstructive process immediately at the time of their mastectomies, which has significant technical and psychological advantages.
Good Candidates for Breast Reconstruction
Breast reconstruction can be performed at the same time as a mastectomy or lumpectomy (called an immediate reconstruction) or some time afterwards (called delayed reconstruction). The small percentage of women who are not candidates for immediate reconstruction may be candidates for delayed reconstruction. In general, a good candidate for breast reconstruction:
- Is in good general health
- Is undergoing a type of breast cancer treatment that will not be affected by breast reconstruction surgery
- Wants to restore their sense of well-being and confidence after losing one or both breasts, in whole or in part
- Wants to regain breast symmetry, when only one breast has been altered
Breast Reconstruction Procedure Details
The breast is reconstructed using either breast implants or autogenous tissue (the patient’s own tissue). One method is not necessarily better than the other, and multiple factors are taken into account when making the decision as to which type of reconstruction is better suited to a particular patient.
Currently, approximately two-thirds of all the reconstructions in the United States are implant-based and most of these employ a tissue expander, which is a temporary device that “stretches” the chest tissues in order to create adequate space for a breast implant to fit without tension. The doctor will place the expander beneath the chest muscle, adding saline to it every one or two weeks to gradually expand the skin. Once the skin is adequately expanded, the breast implant is put in its place.
Most of the reconstructions performed using the patient’s own tissues use the lower abdominal tissue that is usually discarded during a “tummy tuck.” This surgery is called a TRAM (for transverse rectus abdominis muscle) flap procedure, and there are several variations, depending on how the abdominal tissue is transferred. Occasionally tissue from the back (latissimus dorsi flap) or tissue from the buttocks area (gluteal flaps) can be used to reconstruct the breast.
Breast Reconstruction Recovery
The patient will likely experience some discomfort for the first few days following surgery. Pain medication that has been prescribed by the doctor can be used to relieve discomfort. A surgical bra will be placed after surgery and worn to support the chest while it heals. Drainage tubes may also be used during this time to remove the buildup of excess fluids. During the first two to three weeks, there will be swelling and bruising in the chest region. The patient may also experience some numbness and tightness. While waiting for the chest to heal, it is important that the patient refrains from lifting objects over the head or putting undue pressure on the chest.
Recovery time for breast reconstruction using the patient’s tissue is longer than when implants are used, since the first technique involves surgery to remove tissue from another part of the body (such as the abdominals), which will be healing at the same time. In general, the patient should be able to return to normal activities within four to six weeks after surgery.
Want to Learn More about Your Options for Breast Reconstruction?
A consultation with one of our board-certified plastic surgeons experienced in breast reconstruction is the best way for a patient to determine which procedure is best in their case. A patient’s age, health status, body type, quality and quantity of available tissue for the reconstruction, planned radiation therapy, aesthetic goals for the reconstruction and personal preference are among the many factors that play a role in the decision-making process. Your one-on-one consultation will allow you to ask questions about the different reconstruction procedures. At this time, the doctor will also give you a more complete picture of your surgery options so that you can best determine one that will meet your expectations and work well with any treatment you may be receiving. To schedule your consultation, please contact us today at (305) 479-2991.