Breast Reconstruction

What is Breast Reconstruction?

Breast Reconstruction is most commonly done after breast cancer, to restore form after a mastectomy.  It can be a tremendously rewarding experience for a woman to feel whole again after her mastectomy, however  many women have misconceptions about breast reconstruction and what is involved in the process.  Sometimes they have a mastectomy and  do not realize that reconstruction is an option.

What are the types of reconstruction and what are the surgeries?

Broadly we divide reconstruction into implant based and autologous (using one’s own tissue).  There is no right answer but depending on your body type you may be a better candidate for one or another.

With implant based reconstruction the doctor places a tissue expander into the breast pocket under the muscle.  After this first surgery the expander is inflated with saline solution until your breast regains an acceptable size.  Then in a second surgery the expander is switched to an implant.  In a third surgery a nipple can be created.  The entire process takes 6-9 months total on average.  Using autologous reconstruction we borrow tissue from either the back muscle (latissimus) or the abdomen to reshape the breast.  This reconstruction can look more natural but is typically a longer surgery.  Other operations to create the nipple can be done.  If the reconstruction is only one sided, we sometimes do a breast lift (mastopexy) on the non-cancer side.

When is the plastic surgeon involved in the process?

Ideally before you even have your mastectomy.  This is because often we do reconstruction at the same time as the mastectomy (immediate reconstruction).  There are also important decisions to consider when deciding on reconstruction, like radiation and where we place scars.

If they cover the mastectomy they should cover procedures related to reconstruction such as tissue expander, implants, nipple reconstruction, and breast lift.  Please ask about your options for coverage regarding reconstruction, and do not assume your insurance will not cover.

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