General Information
Plastic Surgery and Breast Cancer

The diagnosis of breast cancer can be a devastating event. There are the obvious concerns about survival, the trauma of surgery, and the potential effects of chemotherapy and/or radiation therapy. Patients can also be concerned about the potential change in body image. Plastic surgeons can offer invaluable information so the patient may make decisions about what surgical procedure is best for them; including procedures to the unaffected breast. It is important to know that federal law mandates that insurance companies must cover not only the reconstruction after a mastectomy, but also the procedures to the unaffected breast to restore symmetry. This is not only referring to reconstruction after a mastectomy, but also in the decision between a lumpectomy or mastectomy and then, a single or a bilateral mastectomy. The plastic surgeon can also help restore symmetry between the breasts by offering procedures such as a lift or a reduction.

Breast Reconstruction can be broken down into three categories:

• Using a breast implant
• Tissue transfer from another part of the body
• Oncoplastic procedures

Breast reconstruction using a breast implant is generally performed as a multi-step process, starting with an inflatable implant to create space for the permanent implant to be placed at a later stage. Breast reconstruction using your own skin and fat is a complex operation in which skin and fat are transferred from other parts of the body to the chest. The blood supply of the skin and fat comes from underlying muscles. To transfer skin and fat, the blood vessels must also be moved to supply blood flow to the tissue being transferred. The most common area to harvest the tissue is from the lower abdominal (called a tram flap) or from the back (called a latissimus dorsi flap). This can also provide an outstanding result but is a significantly more complicated procedure. Oncoplasty is a relatively new field of reconstruction. This procedure allows the breast surgeon to remove the tumor from the breast through incisions that allow the plastic surgeon to either lift or reduce the breast giving a more youthful appearing breast.

© 2013 Stephen A. Madry, MD. All Rights Reserved.