5 Common Questions about Breast Reconstruction after Mastectomy
According to BreastCancer.org, every year 296,000 American women are diagnosed with breast cancer. Although in many cases the patient is able to have a lumpectomy, or segmental mastectomy (where just part of the breast tissue is removed) in some women a mastectomy may be recommended. In these cases, the patient may wish to undergo further surgery in order to reconstruct the look and shape of the breast.
With National Breast Cancer Awareness Month coming to a close I wanted to address the top 5 most common questions regarding breast reconstruction surgery:
1. How is Breast Reconstruction Performed?
During surgery the breast is reconstructed using either implants, or the patient’s own tissues.
When implants are used a tissue expander is usually placed to help gently stretch the covering tissue. The expander is then removed and the implant inserted.
The second option for breast reconstruction is to use autologous tissue, which is tissue taken from elsewhere on the patient’s body, usually the back or abdomen. This harvested tissue is sculpted into the correct shape, and used to reconstruct the patient’s breast.
2. Should I Choose Implants or Natural Tissue for my Breast Reconstruction?
Whether a reconstructive surgery should make use of implants or natural tissues will differ from patient to patient. There are a number of factors we need to consider:
- Appearance: Reconstructions using natural tissues tend to be more successful at replicating the look and feel of natural breasts.
- Impact of Surgery: Implants require less extensive surgery than autologous techniques. Because the natural tissues are harvested from elsewhere on the body, the patient has two surgical sites.
- Recovery: A reconstruction using Implants usually requires a 2-3 week recovery period with few resulting scars. Surgery using natural tissue techniques can require 3-6 weeks of recovery time, and result in more scarring.
- Risk of Complications: Both techniques carry the risk of surgical complications. The amount of risk will be unique to your case, so please consult your surgeon on this topic.
3. Should I Undergo Reconstruction at the Same Time as My Mastectomy?
The main benefit of immediate breast reconstruction is it allows surgeons to use the patient’s own skin and fresh incision site, which means less surgery for the patient, and often better results. Delayed reconstruction is necessary in patients who require additional radiation therapy to the chest area after the mastectomy.
4. How is Nipple Reconstruction Performed?
Nipples are commonly reconstructed using skin from the new breast once it’s fully healed. The areola (the area surrounding the nipple) can be tattooed on, or created from grafted skin. Both nipple and areola reconstruction help to hide scarring and make the breast more realistic looking. Some patients may be able to use the nipple saving mastectomy option currently in trials; be sure to consult with your plastic surgeon for more information.
5. What Are the Potential Drawbacks of Reconstruction?
Results from reconstructive surgeries are highly variable and patients may not be happy with the final outcome. The reconstructed breast will not experience the same level of sensitivity as it did before cancer surgery and there will be scarring visible both on the breast and from where any natural tissue was harvested (if autologous techniques are used). There may be a degree of asymmetry following reconstructive surgery, although this may be corrected using breast augmentation, breast reduction, or breast lift procedures.