Breast reconstruction is surgery to restore the appearance of the breast, usually after a mastectomy. The choice of how to proceed after the removal of a breast is a deeply personal one, with some women opting to wear a prosthetic form in a bra, and others choosing to embrace their new breastless form as a reminder of their strength and survival. Those options are perfectly acceptable, but many women feel most comfortable with their missing breast tissue surgically replaced. Breast reconstruction can be part of a patient’s return to normal after experiencing breast cancer.
There are a few different methods used to create the round shape of the breast on the chest. A flap of fat, skin, and muscle can be taken from the side, abdomen or buttock and implanted on the chest to create a breast from the patient’s own tissue. Alternatively, the skin over the chest may be gradually stretched to allow for the placement of an implant. Stretching of the skin is done using expanders, which are similar to breast implants, except they increase in size when saltwater solution is injected into them. Many women also choose to combine the flap procedure with implant placement to achieve their desired result. Once the new breast shape is formed, a nipple can be created and even tattooed to match the other side.
Reconstruction may be done in a single surgery or broken up into multiple procedures:
- Immediate reconstruction rebuilds the breast right after mastectomy. This method is not recommended if additional chemotherapy or radiation is needed after surgery.
- Delayed reconstruction occurs after chemotherapy or radiation has been given. These treatments may decrease the volume or alter the color of the reconstructed breast, so they should be completed before the breast is rebuilt. This type of reconstruction may happen weeks, months, or even years after mastectomy.
- Staged reconstruction splits the reconstructive process into two parts. The first part inserts temporary expanders to stretch the skin and is done immediately after breast removal surgery. The second part replaces the expanders with implants after chemotherapy or radiation treatments have been given.