What is Breast reconstruction?

Breast reconstruction is a type of surgery for women who have had all or part of a breast removed. The surgery rebuilds the breast mound to match the size and shape of the other breast. The nipple and the darker area around the nipple (areola) can also be added.

Most women who have had a breast removed (mastectomy) are able to have breast reconstruction. Women who have had only the part of the breast around the cancer removed (lumpectomy or breast-conserving surgery) might not need reconstruction, but sometimes they do. Breast reconstruction is done by a plastic surgeon.

For the women who have undergone surgical removal of breasts (mastectomy) because of breast cancer, the long-term prospects of living without breasts or part of the breast is different.

If you’ve had a mastectomy, you may choose to have reconstructive surgery, or you may even skip reconstructive plastic surgery. Having a breast reconstruction surgery is a personal decision, and it’s often not easy to make.

In the recent years, advances in plastic surgery have given superior results than seen previously. You have a choice either to use implants or your tissue for breast reconstruction. This surgery changes your appearance, which has psychological benefits. Outcomes of the surgery can add to a sense of wellness for you and your family.

The amount of breast to be reconstructed will depend on the extent of mastectomy performed, and it also depends on the width, size, and location of the removed tumor.

Breast reconstruction surgery can be performed simultaneously with mastectomy or after complete recovery from mastectomy or any other cancer treatments.

What are the Benefits of breast reconstruction?

Women choose breast reconstruction for many reasons:

• To make their chest look balanced when they are wearing a bra or swimsuit
• To permanently regain their breast shape
• So they don’t have to use a form that fits inside the bra (an external prosthesis)
• To be happier with their bodies and how they feel about themselves

Breast reconstruction often leaves scars that can be seen when you are naked, but they often fade over time. Newer techniques have also reduced the amount of scarring. When you are wearing a bra, the breasts should be alike enough in size and shape to let you feel comfortable about how you look in most types of clothes.

Breast reconstruction after a mastectomy can make you feel better about how you look and renew your self-confidence. But keep in mind that the reconstructed breast will not be a perfect match or substitute for your natural breast. If tissue from your tummy, shoulder, or buttocks will be used as part of the reconstruction, those areas will also look different after surgery

Immediate or delayed breast reconstruction

You may have a choice between having breast reconstruction at the same time as the surgery to treat the cancer (immediate reconstruction) or at a later time (delayed reconstruction).

Immediate breast reconstruction is done, or at least started, at the same time as the surgery to treat the cancer. The benefit of this is that breast skin is often preserved, which can produce better-looking results. Women also do not have to go without the shape of a breast.

While the first step in reconstruction is often the major one, many steps are often needed to get the final shape. If you’re planning to have immediate reconstruction, be sure to ask what will need to be done afterward and how long it will take.

Delayed breast reconstruction means that the rebuilding is started later. This may be a better choice for some women. You might choose to delay breast reconstruction if:

• You don’t want to think about reconstruction while coping with cancer. If this is the case, you might choose to wait until after your breast cancer surgery to decide about reconstruction.
• You have other health problems. Your surgeon may suggest you wait for one reason or another, especially if you smoke or have other health problems. It’s best to quit smoking at least 2 months before reconstructive surgery to allow for better healing.
• You need radiation therapy. Many doctors recommend that women not have immediate reconstruction if they will need radiation treatments after surgery. Radiation can cause problems after surgery such as delayed healing and scarring, and can lower the chances of success. Flap reconstruction surgeries (using other body tissues to create the new breast) are often delayed until after radiation.

Can breast reconstruction hide cancer or make it come back?

Studies show that reconstruction does not make breast cancer come back. If the cancer does come back, reconstructed breasts should not cause problems with chemotherapy or radiation treatment.

If you are thinking about breast reconstruction, either with an implant or flap, you need to know that reconstruction rarely, if ever, hides a return of breast cancer. You should not consider this a big risk when deciding to have breast reconstruction.

What if I choose not to have breast reconstruction?

Many women decide that breast reconstruction is not right for them. Or they might not be able to have more surgery. If you choose not to have breast reconstruction, you can use breast forms or prosthetics that simulate the look and feel of a natural breast. But you can also decide not to use a breast fom.

What are the types of the surgeries?

There are two different techniques by which the breast reconstruction surgery is carried out. After discussing with your surgeon, you can decide upon which type of surgery best suits your needs and expectations. The two types of surgeries include:

• Breast reconstruction using implants: This technique uses breast implants which are prosthetic devices which help to give your breast the perfect shape and size. Saline implants and silicone gel implants are the two types of implants used during breast reconstruction.
• Breast reconstruction using your own tissue: This technique uses your tissue for different sites of your body to replace the lost breast mound. This type of surgery is again sub-divided into two types based on the donor site that is the place from which the tissue is extracted. This includes: using tissue from the abdomen (TRAM transverse rectus abdominis muscle flaps and DIEP deep inferior epigastric perforator flaps) and using tissue from the upper back (Latissimus dorsi flaps)