When a woman is diagnosed with breast cancer, it may be necessary to treat the disease by completely removing the cancerous tissue. Depending on how advanced the cancer is, oncologists may recommend a lumpectomy (removal of part of the breast tissue) or a mastectomy (removal of the entire breast) with or without radiation therapy, chemotherapy, hormone therapy, or other therapy modalities.
For many women, the thought of losing breast tissue is demoralizing. It can alter your curvy figure and perhaps even your sense of self. The good news is that, through reconstructive surgery, the breast can be rebuilt to optimize a woman’s appearance and tailored to each person individually.
What is Breast Reconstruction?
Breast reconstruction is the term used for any surgery that helps to rebuild and reshape the breasts following a mastectomy or lumpectomy. As we will soon see, there are multiple types of breast reconstruction surgery.
It is crucial to note the distinction between breast reconstruction and breast augmentation. The latter refers to the use of implants or fat grafts to add volume to existing breasts. While this is a perfectly good and even useful procedure, its aims are primarily cosmetic. Breast reconstruction, on the other hand, is restorative, helping to repair the body as closely to normal as possible following a surgical procedure.
What are the Types of Breast Reconstruction Surgery?
The best way to learn more about the different types of breast reconstruction is to schedule a consultation with a reconstructive surgeon. Generally speaking, the primary options include reconstruction with implants or reconstruction using a flap. Fat grafting can be performed to smooth the breast contour and provide more fullness of the cleavage. The nipple and areola can also be reconstructed. Each of these options comes with its own benefits.
Breast Reconstruction Using Implants
The first option is to have your breasts rebuilt using implants. Breast implants are flexible silicone shells that may be filled with either saline or silicone gel. The implants may be placed either over or under the pectoralis major (chest) muscle and are used to fill the void of tissue that is removed during the removal of the breast tissue. In short, these implants help restore the shape and volume of the breast.
This is the most common type of breast reconstruction and maybe the best option if:
- You have enough healthy skin and tissue to support the implants.
- You wish to avoid incisions elsewhere on your body.
- You wish to avoid the longer recovery time that is typically associated with the “flap” method.
- You do not need radiation therapy. (Note that radiation therapy often leads to complications with breast implants.)
Breast Reconstruction Using a Flap
Another option is to restore your breast shape and volume using tissue harvested from elsewhere on your body. This tissue, which is often called a “flap,” can come from anywhere, but it usually comes from the back, belly, buttocks, or inner thighs.
Sometimes, this flap is removed from its blood supply, picked up, and grafted to your chest which is called a “free flap.” In other cases, it remains connected to its blood supply and is moved underneath the skin up to your chest area which is known as a “pedicled flap.”
This type of breast reconstruction tends to take longer, and often has a more demanding recovery. Also, it involves surgical incisions and scarring at the site where the tissue is harvested. With all of that said, some patients prefer this method because it generally lasts a lifetime, whereas implants may need to be replaced, typically within 10 to 20 years.
Reconstruction with Fat Grafting
Often the skin flaps left behind after breast tissue is removed are thin and uneven which can result in contour deformities and unnatural feel and appearance of the reconstructed breast. Fat grafting can be performed to provide thickness to the skin flaps, fill in contour deformities, and provide more breast cleavage. Fat grafting is performed by using liposuction to obtain fat from other parts of the body (commonly the abdomen or thighs) and injecting the fat into the breast area.
Reconstruction of the Nipple and Areola
A final option worth knowing about is the reconstruction of the nipple and areola. Frequently, the nipple and areola are removed during the mastectomy, and most plastic surgeons will advise against having the nipple restored at the same time as the breast reconstruction. The reason for this is simple: Combining the two procedures can result in poor positioning of the nipple.
A few months after your reconstructed breasts heal, you may decide to have the nipples surgically reconstructed or even tattooed onto your breasts.
Which Type of Breast Reconstruction is Right for You?
To determine which type of breast reconstruction surgery is best for you, we recommend meeting with a plastic surgeon to discuss the different options. Generally speaking, your doctor will advise you based on the following factors:
- Your overall physical health
- The size and location of your cancer
- Your breast size
- Whether you require a mastectomy or a lumpectomy
- The treatments you need following surgery, such as radiation therapy, chemotherapy, hormone therapy, etc.
- The amount of tissue available for breast reconstruction
To learn more about the different options of breast reconstruction available to you, we invite you to schedule a consultation with the experienced reconstructive surgeons at Thrive Reconstructive Surgery.