Breast Reconstruction Surgery

About Breast Reconstruction

One of the most gratifying and redeeming conclusions to breast cancer treatment is breast reconstruction. Breast reconstruction can play an important role in rebuilding a patient’s self-esteem and confidence after breast loss due to a lumpectomy or mastectomy.

Breast reconstruction can help a patient’s breasts appear natural with clothing on or off. In addition, breast reconstruction can eliminate the need for wearing an external prosthesis or concealing clothing.

When performed by skilled and experienced reconstructive plastic surgeons like Dr. Stephanie Cohen and Dr. Rick Winters, there are many viable options for breast reconstruction surgery. The ultimate goal is to help patients feel complete after breast cancer, provide increased self-esteem and confidence and aid in the process of moving on after diagnosis.

Breast Reconstruction After Cancer

There are several reconstructive options that can restore the breast after a mastectomy. These options include implants, body tissue techniques and fat grafting, which are utilized to rebuild the breast mound. The nipple and areola can also be recreated by using tissue grafts to recreate the texture and projection of the nipple as well as tattooing to match the nipple and areola coloring, Breast reconstruction may be completed immediately after removal of the breasts or later after the original surgery site has healed.

Sometimes patients who are having lumpectomy or partial mastectomy will also require reconstruction. Usually this entails rearranging the available breast tissue or reducing the breasts to reduce contour abnormalities. This type of reconstruction may also be performed immediately or after the original surgery has healed.

Breast Reconstruction Options

There are basically two categories of breast reconstruction; those that use implants to recreate the breast and those that use body tissue. There may be several options within each category and some that encompass both types.

• Breast Implants: Breast reconstruction is most frequently completed using breast implants. Usually, a natural and stable implant reconstruction will require two stages utilizing a tissue expander first to create a pocket for the implant. Later the expander is removed, and the permanent implant placed. Occasionally an implant procedure can be accomplished in one stage without the expander. Implant procedures are generally considered easier because the surgery and recovery is shorter.
• Body Tissue Flaps: A one-stage breast reconstruction may be performed by moving tissue from the abdomen or the back. The resulting breast will have a natural look and feel. These procedures are more complicated than the implant options and require incisions in other parts of the body, but can be completed at the time of the mastectomy.
• Combination Implant and Flap: Some patients are good candidates for a one-stage body tissue procedure, but there is not enough tissue to match the breast size. An implant may be added without using an expander to obtain almost any sized breast.
• Fat Grafting: Fat grafting is another breast reconstruction technique that relies on the patient’s own tissues to rebuild the breast. During fat grafting, fat is liposuctioned, purified and then carefully injected into the breast to shape and refill the contours. This is most frequently done for partial mastectomy but currently research is looking into its advantages for more extensive reconstruction.
• Nipple Reconstruction: Sometimes a mastectomy may be performed without removing the nipples, however if this is necessary, the nipple reconstruction is a relatively simple procedure. Small local skin flaps and grafts are used. The nipple reconstruction is almost always completed separately from the breast reconstruction to allow settling and final contours to be appreciated before applying the nipple.

Dr. Cohen and Dr. Winters will help each patient understand the best reconstructive options based on goals and circumstances. The “right” reconstruction for any individual will depend on many factors: Age, health status, body shape/size and type of disease, to name a few. Often times it comes down simply to personal choice. Sometimes choosing the ideal one may be difficult. Dr. Cohen and Winters will educate and support every patient while making this decision since this undoubtedly is a stressful time.