Breast Reconstruction Surgery

What Is Breast Reconstruction?

Breast reconstruction is surgery to restore one or both breasts after a mastectomy or lumpectomy. The shape, appearance, size, and symmetry of the breasts are restored as much as possible during the surgery.
Reconstruction is typically a process performed in stages. It can start with the mastectomy or be delayed. It generally requires several appointments to include time to prepare the tissues of your chest for reconstruction and to perform nipple reconstruction after the initial surgery.

Types Of Reconstruction

In general, there are two types of breast reconstruction. The type used depends on several factors:

• Body type
• Mastectomy type
• Cancer treatments

Implant-Based Reconstruction

Implant-based reconstruction uses standard breast implants to create a new breast shape.

The first step is the placement of an implant or a tissue expander, either during your mastectomy or during a later procedure.

A tissue expander stretches your chest’s skin and soft tissue over time to make space for the implant. It may go over or under your pectoral muscle. It may take several months and multiple appointments to achieve the size you need.

Your surgeon will replace the expander with a permanent saline (salt-water) or silicone gel implant when the tissue expansion is complete.

Flap Reconstruction

Also known as autologous, flap reconstruction involves forming a breast using tissue from another part of the patient’s body. Flap surgery is a complex process. You may need separate surgeries to place an expander, reconstruct the tissue, and then perform nipple reconstruction.

The tissue used to reconstruct your breast comes from your abdomen, back, or buttocks. Your body type and medical history influence which donor location your surgeon will use. In addition, there are different locations on your abdomen, buttocks, back, and inner thigh.

Your surgeon will discuss the various options with you.

A critical component of flap reconstruction is maintaining an adequate blood supply to the transplanted tissue. If you have diabetes, vascular disease, a connective tissue disorder, or are a smoker, flap reconstruction may not be the best option for you, as those conditions may affect the blood flow to your tissues.

Reconstruction Surgery Risks

Major surgery always carries a risk of complications. Both flap and implant-based reconstruction carry additional risks along with the standard complications.

Risks with Flap Reconstruction Surgery

• Abdominal wall weakness or hernia
• Bleeding
• Changes in sensation
• Complications at the site of tissue retrieval
• Extended healing and recovery time
• Fluid buildup (seroma)
• Infection
• Risks associated with anesthesia
• Tissue death of the graft
• Wound healing complications

Risks with Implant-Based Reconstruction Surgery

• Asymmetry
• Bleeding
• Breast pain
• Changes in sensation
• Implant deflation or rupture
• Increased risk of rare cancer called anaplastic large cell lymphoma (ALCL)
• Infection
• Need for future surgery to replace or remove the implant
• Poor healing of incisions
• Risks associated with anesthesia

In addition, your doctor may recommend you delay reconstruction surgery until after completing radiation therapies that deliver radiation to the skin and chest wall. That type of therapy may complicate healing if given after reconstruction.

Recovery

You may need pain medication after reconstruction and may be sore and tired for weeks after surgery. It may take a year or two before you feel fully healed.

With implant surgery, you may initially go home with drainage tubes to remove fluids that collect in the site and may need to wear a surgical support bra for some time after surgery.

Your surgeon will discuss instructions for your recovery with you, including restrictions to your activities and movement and any post-operative instructions. It is critical to carefully follow your post-operative instructions to ensure your best outcome, as with any surgery.

Paying For Breast Reconstruction

The Women’s Health and Cancer Rights Act of 1998 (WHCRA) mandates that group and individual health plans cover:

• All stages of reconstruction on the affected breast(s)
• Reconstruction of an unaffected breast to attain symmetry
• Prostheses
• Treatment of all physical complications of all stages of mastectomy

Breast reconstruction surgery can provide shape and symmetry to your body and help you feel more like your pre-surgery self. It’s an important milestone in recovery for many women.

To learn more about breast reconstruction, schedule a consultation appointment today.