Breast Reconstruction Following Mastectomy

Breast augmentation is not always a purely cosmetic procedure. However, for breast cancer patients, it can make a world of difference. Cancer patients often undergo mastectomies in order to preserve their overall health—but, as a result, many feel less “whole” after the procedure. Breast reconstruction can play a key part in returning normalcy to the patient’s life.

WHAT IS BREAST RECONSTRUCTION?

Breast reconstruction restores the breast after it has been damaged or removed. The breast could be removed for a variety of reasons, including prophylactically for patients who test positive for the BRCA gene (a genetic predisposition for breast cancer). The reconstruction process involves rebuilding the breast, typically immediately following the mastectomy. This can include free tissue transfer (in which tissue is moved from abdomen or buttock to the breast area via microscope), flat surgery, and/or implants. Today, with general surgeons doing “skin-sparing mastectomies,” which work to save all of the skin and nipple, reconstruction is mostly done with implants.

The implants themselves could be a two-stage procedure, where a tissue expander is used temporarily to stretch the tissue; the expander is then replaced with an implant. Additionally, doctors often opt for adjustable implants (which are a combination of tissue expanders and breast implants), in order to avoid placing too much pressure on the skin flaps.

One of the newest innovations in breast reconstruction (apart from adjustable implants) is fat grafting to the breast. After the surgeon reconstructs the breasts, irregularities and asymmetries can be filled with fat injections. The fat can be taken from the abdomen or thigh, and, once injected, will behave just like it would in any other part of the body.

RISKS

The risks vary from patient to patient, and will depend heavily on the patient’s health. If she is unhealthy—a smoker, or diabetic, or overweight—she stands the risk of the wound breaking down or healing poorly. If the tissue is affected, the implant may need to be removed. The risk, of course, increases if the patient is having an extensive mastectomy, because the remaining skin can’t always be saved in its entirety. Additionally, the risk increases if the patient has undergone radiation therapy.

CHOOSING A SURGEON

Patients should be sure to choose a general surgeon who works closely with a plastic surgeon, and who is familiar with reconstruction. The plastic surgeon should be board certified, and should do a lot of breast reconstruction procedures. Patients should be sure to take a look at the plastic surgeon’s previous work, and should be able to communicate comfortably and clearly with both the plastic and general surgeons.

CONCLUSION

Though options used to be limited for patients looking for a breast reconstruction after a mastectomy, modern medicine has allowed for a multitude of great choices. Patients who are planning to reconstruct their breast (or breasts) should be sure to find the right surgical team. This will increase the likelihood that the patient will be happy with her treatment, and will improve her overall quality of life following the procedure.

Written by Cosmetic Town Editorial Team through exclusive interview provided by Dr. Hilton Becker of Becker Plastic Surgery in Boca Raton, FL.