A diagnosis of breast cancer is stressful and frightening. On top of navigating treatment, which often includes mastectomy, most women also have to decide the best way to reconstruct their breasts. Some women skip the reconstruction and have a flat chest, but many feel it’s important to maintain a feminine figure similar to what they had before breast cancer.
Fortunately, there are several options available to help women restore their confidence and sense of femininity and normalcy after a mastectomy. Your plastic surgeon can help you determine the best option for your situation. Here’s what you need to know about mastectomy reconstruction before you meet with your surgeon.
Timing of Reconstruction
The timing of when to have your reconstruction depends on several factors and can be done immediately, after a delay, or it can be staged.
Immediate reconstruction happens at the same time as the mastectomy. The advantages of this approach are that it reduces the number of surgeries you need to undergo, the aesthetic outcome may be improved, and you can avoid some of the psychological trauma of being without breasts. Immediate reconstruction can be done using implants, autologous tissue (flap reconstruction), or with a combined approach.
Delayed reconstruction is performed after the mastectomy has healed, which can take several months. This option is preferred by some women who want to take the time to weigh their options or who have medical issues that need to be resolved before reconstruction.
Staged reconstruction involves a combination of both immediate and delayed reconstruction. Women who require radiation therapy after a mastectomy usually choose this option. In this case, the implant-based reconstruction is delayed until after radiation is completed, while a tissue expander is placed at the time of mastectomy.
Implant reconstruction is the most common method of mastectomy reconstruction. It involves the use of silicone or saline implants to recreate the breast. The implant can be placed under the chest muscle or directly under the skin and fat of the chest wall. This procedure is less invasive than autologous tissue reconstruction and has a shorter recovery time.
However, implants may result in a less natural appearance, especially if there is not enough tissue to cover the implant. Women who choose this option will need to undergo periodic imaging to ensure the implants are functioning properly. Depending on your age, you may need to replace the implants one or more times.
Autologous Tissue (Flap) Reconstruction
Autologous tissue reconstruction involves using tissue from the abdomen, back, buttocks, or thighs to create a new breast. The procedure is more invasive than implant reconstruction and has a longer recovery time.
However, tissue flap reconstruction can provide a more natural look and feel than implants. It also has a lower risk of complications such as infection or implant rupture. The main drawback is that it requires an additional surgical site to harvest the tissue, which can result in scarring and potential complications at the donor site.
Nipple and Areola Reconstruction
Nipple and areola reconstruction can be performed as a separate procedure after the breast has been reconstructed. The nipple can be recreated using skin from the reconstructed breast or from the patient’s own tissue. The areola can be tattooed or created using a skin graft from somewhere on the body.
Mastectomy reconstruction is considered medically necessary and most insurance plans will cover the procedure. This includes both the reconstruction of the breast and the nipple/areola reconstruction. However, insurance coverage can vary depending on the type of reconstruction and the specific insurance plan. It’s important to consult with your insurance provider and plastic surgeon to understand your coverage and out-of-pocket costs.
Partnering with your Plastic Surgeon
Determining what type of reconstruction you’ll want can be daunting, especially with everything else you must manage with a breast cancer diagnosis. Your plastic surgeon is an excellent resource in helping you with your choices. They have a wealth of experience and knowledge to help you understand your best options.
If you have been diagnosed with breast cancer and want to learn more about your reconstruction options, schedule a consultation today!