In breast reconstruction, a plastic surgeon rebuilds all or part of a breast that has been removed surgically for the treatment of cancer. Breast reconstruction is performed either with breast implants, a patient’s own tissue or a combination of the two. The surgeon and patient discuss the goal of reconstruction so the surgeon can best produce the desired results.
When is Breast Reconstruction Performed?
Breast reconstruction can be performed either at the time of mastectomy (immediate reconstruction) or later (delayed reconstruction). Most reconstructions can be performed immediately. However, some reconstructions are delayed due to advanced cancer stage, the need for additional breast cancer treatments, other medical conditions or personal preference.
Who is a Candidate for Breast Reconstruction?
Women are candidates for breast reconstruction if they've had or are planning to have all or part of their breast removed due to cancer or if they are having a prophylactic (preventive) mastectomy to reduce the risk of cancer with a strong family history or genetic mutation.
Breast Reconstruction with Implants
Breast reconstruction using implants provides acceptable aesthetic results without taking tissue from other parts of your body. Implants are filled with either saline or silicone, and either type of implant is safe.
The appearance of breast implants after mastectomy can be further improved with additional techniques, such as fat grafting and collagen layering.
Perceived advantages of implant reconstruction include:
- A shorter surgery than other type of reconstruction
- The avoidance of scars on other parts of the body
Potential disadvantages include:
- Difficulty with symmetry with the larger natural breast in unilateral reconstructions
- Two stage procedure which requires removal of the expander and placement of the permanent implant
Breast Reconstruction Using a Patient’s Own Tissue
Breast reconstruction using a patient’s own tissue provides the most natural result for breast reconstruction. Skin and soft tissue from another part of the body (referred to as a flap) is used to replace the skin and soft tissue of the breast. Abdomen tissue is most commonly used for this procedure, but other locations include the buttock or inner thigh.
Perceived advantages of using a patient’s own tissue include:
- The natural feel and behavior of the reconstructed breast
Perceived disadvantages of using a patient’s own tissue include:
- A scar at the site where the tissue was removed
- Longer hospitalization and recovery
Breast Reconstruction Using the Latissimus Flap and an Implant
A flap harvested from the back, called a latissimus dorsi flap, provides soft tissue covering to a tissue expander or immediate breast implant. The skin and soft tissue provided by the reconstruction can produce a very natural breast contour and can support a pleasing nipple reconstruction. This method of reconstruction is most commonly used in slender women to help camouflage an implant-based reconstruction or for patients who have had radiation and don't have other areas on the body for flap-only reconstruction.
After your breast reconstruction has healed, you may wish to have a nipple reconstruction. Your reconstructed nipple will be designed to have the projection of your original nipple but will not respond to touch. Nipple reconstruction is performed with local skin from your reconstructed breast.
Tattooing of the skin to recreate the areola portion of the nipple as well as the nipple itself can also be done, either as an alternative or in addition to nipple reconstruction. Three dimensional tattooing is an art form and can give the illusion of a nipple without the need for further surgery. With surgical reconstruction of the nipple, tattooing of color to the skin can give the finishing touch to a complete breast reconstruction. Tattooing can be done either before or after the nipple reconstruction.
Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.