What Is Breast Reconstruction?
Breast reconstruction is a plastic surgery that recreates the breast similar to the way it was before cancer. The plastic surgeon may use the patient’s own tissue such as skin, fat, and muscle to approximate the look of the breast.
The process is often helped considerably with the use of a saline or silicone breast implant. When a breast implant is used, less of the woman’s own tissue is needed to build up the breast.
Key Decisions in Breast Reconstruction
The two main decisions that women face when considering breast reconstruction is 1) whether to have reconstructive surgery at all and 2) when to have it. For any of these decisions, there is no wrong answer, just as there is no right answer.
However the decisions regarding breast reconstruction do need to be reached earlier rather than later so that the most options are available. In other words, the sooner that you consider your breast reconstruction options, the more options you will have.
Types of Breast Reconstruction Techniques
There are several types of breast reconstruction surgery techniques, and each option depends on the patient’s anatomy, medical history, and personal preferences.
Common procedures include implant-based reconstruction, where silicone or saline implants are used, and autologous tissue reconstruction (also known as flap procedures), such as the TRAM flap, DIEP flap, or latissimus dorsi flap. Each technique has its own pros and cons regarding appearance, recovery time, and durability.
Women should work closely with a board-certified plastic surgeon experienced in breast reconstruction to determine which technique is best for their needs.
Alternatives to Surgery: Breast Prostheses
Some women decide that when part or most of their breast is removed during mastectomy that there is no need to have further surgery. Either the woman adapts to and thrives in her new profile or she uses breast prosthesis (false breast) to fill out her form.
Breast prostheses are excellent at recreating the shape and volume of the breast under clothes, but are noticeable in bathing suits, bras, or while nude.
Immediate Breast Reconstruction
If a woman opts for reconstructive breast surgery, the choice then becomes when to have it. Many women decide to have the plastic surgery at the same time as the mastectomy. While the duration of that surgery is obviously longer, there are fewer total surgical procedures.
This immediate breast reconstruction, as it is called, may not be an option for every woman. It depends on the extent of the breast cancer and other medical factors.
However, if you are committed to immediate breast reconstruction, you should make your wishes known to your oncologist and breast surgeon early in the process so that every possible accommodation can be made.
Delayed Breast Reconstruction
Some women decide to wait to have their reconstructive breast surgery until some point after the mastectomy. This is called delayed breast reconstruction.
Perhaps a woman that chooses delayed breast reconstruction only wants to endure one breast procedure. Perhaps she is not sure if breast reconstruction is right for her. Whatever the reason, delayed breast reconstruction is a viable option.
Keep in mind, though, that if external radiation treatment is scheduled or could possibly be part of the breast cancer treatment program then reconstructive breast surgery should not be delayed too long.
Preparing for Breast Reconstruction Surgery
Before undergoing breast reconstruction surgery, it’s important to have a thorough consultation that includes imaging studies, a review of your medical history, and a discussion about your personal goals.
Patients are encouraged to ask questions about recovery time, potential risks, scarring, and post-surgical care. Recovery can vary depending on the type of procedure, but most women will need several weeks to heal fully.
Understanding the timeline, potential complications, and post-operative support options ensures that patients are both physically and emotionally prepared for the journey ahead.
Impact of Radiation Therapy on Reconstruction
Radiation treatment can permanently change the skin and tissues of the breast. This means that the skin will not stretch to accommodate the breast implant or breast flap.
In other words, the breast should be reconstructed prior to radiation therapy because it may not look right if it is attempted afterward.
Cost and Insurance Coverage
Fortunately cost is not a factor that most women will need to consider when they are contemplating breast reconstruction. Unlike a purely cosmetic breast surgery, reconstructive breast surgery is almost always covered by health insurance, by law.
Of course you will need to verify this with your own insurance company, but the issue of breast reconstruction cost is not one of the factors that will influence these important decisions.