What is Breast Reconstruction Surgery ?
Breast reconstruction is a surgical procedure performed to recreate breasts after a mastectomy or lumpectomy, which involves the removal of breast tissue. This process may require multiple surgeries and can be done using various techniques. Some methods involve the use of silicone or saline breast implants, while others utilize tissue from different parts of the body, such as the lower belly.
This reconstructive surgery can be done immediately after breast cancer surgery (immediate reconstruction) or can be scheduled for months or even years later (delayed reconstruction). Depending on the individual case, patients may opt for reconstruction of both breasts, or their healthcare provider might replace one breast and reshape it to match the other. The reconstruction process might involve several surgeries carried out in stages, as recommended by the healthcare provider.
It’s important to note that the decision to undergo breast reconstruction is highly personal. While some individuals choose to have the procedure after a mastectomy, many others do not. The choice is ultimately made by the patient based on their preferences and circumstances.
Types of Breast Reconstruction Surgery
There are two primary types of breast reconstruction surgery following mastectomies:
1. Flap Reconstruction:
In flap reconstruction, the surgeon uses tissue from your own body (known as autologous tissue) to create a new breast. Typically, this tissue is taken from the lower abdomen (belly), although it can also be sourced from your thigh, back, or buttocks. The surgeon removes fat, skin, blood vessels, and muscle from these areas to form a flap, which serves as the foundation for the new breast.
There are two methods within flap reconstruction:
- Pedicled Flap: In this approach, the flap is moved through your body while retaining its own blood supply. The surgeon carefully repositions it to form the breast.
- Free Flap: Alternatively, in a free flap reconstruction, the flap is detached from its original blood supply and then attached to blood vessels in your chest to establish a new blood flow, allowing the tissue to survive and form the breast shape.
2. Implant Reconstruction:
In implant reconstruction, surgeons utilize either saline or silicone implants to recreate breast tissue. This approach involves the use of artificial implants to restore the shape and volume of the breast. In some cases, surgeons may combine implants with tissue sourced from your own body for a more natural look and feel. Implant reconstruction can occur simultaneously with a mastectomy, where the implants are placed during the same surgical procedure. Alternatively, you have the option to undergo this procedure sometime after the mastectomy, allowing for flexibility in the timing of the reconstruction process.
Types of Implant Reconstruction:
- Under the Chest Muscle: Implant placed beneath chest muscle for natural appearance.
- Above the Chest Muscle: Implant positioned on top of chest muscle; quicker recovery as muscle remains in place.
- Implant with Tissue Expander: Tissue expander placed under skin and filled with saline over time. Skin stretches gradually, and the implant replaces the expander once expansion is sufficient
What type of breast reconstruction surgery should you get?
- Your Age, Health, and Lifestyle: Consideration of your overall health, age, and lifestyle helps in determining the most suitable reconstruction option tailored to your individual circumstances.
- Type of Mastectomy or Lumpectomy: The extent of your previous mastectomy or lumpectomy and the amount of remaining tissue influence the reconstruction technique.
- Need for Additional Treatments: If you require additional treatments like chemotherapy or radiation, it impacts the timing and type of reconstruction that may be recommended.
- Prior Surgeries and Medical History: Past surgeries, especially abdominal procedures, can affect the feasibility of using tissue from specific areas like the belly for reconstruction.
- Your Goals and Desired Appearance: Your preferences and the appearance you desire post-reconstruction play a significant role. Discussing your goals with your provider helps them tailor the approach to meet your expectations effectively.
By considering these factors, your Breast cancer doctor can recommend the most appropriate and personalized breast reconstruction technique for your specific situation.
Risk of Breast Reconstruction Surgery
- Infection and Bleeding: Infections and bleeding are common risks associated with any surgery, including breast reconstruction.
- Altered Sensation: After the surgery, it’s common to experience reduced or no sensation in the newly reconstructed breasts. Over time, some sensation might return, although it won’t be the same as before.
- Blood Clots: Certain flap reconstruction surgeries may increase the risk of blood clots forming.
- Asymmetry and Firmness: Reconstructed breasts might differ in size or shape, and one breast might feel firmer than the other. Nipples and areolas may not be perfectly symmetrical.
- Bruising and Scarring: Bruising and scarring are natural outcomes of any breast reconstruction surgery. Scars may fade over time.
- Fat Necrosis: In flap surgeries, there’s a risk of fat necrosis, which is the death of transplanted tissue.
- Implant Issues (for Implant Reconstruction): Problems with implants can occur, including wrinkling, rippling, and ruptures in the implant.
- Donor Site Complications (for Flap Reconstruction): If tissue is taken from the lower belly, thigh, back, or bottom, complications at the donor site such as weakness, pain, or sensitivity can occur.
It’s important to discuss these potential risks and complications thoroughly with your Breast Cancer Surgeon before making a decision about breast reconstruction surgery. They can provide detailed information about the specific risks associated with the chosen procedure, considering your individual health and circumstances.