Reconstructive Breast Surgery

The diagnosis of breast cancer no longer means a life of disfigurement: Breast reconstruction (surgery to rebuild the shape of a breast) is often an option after mastectomy. When a plastic surgeon is closely involved at the start of the treatment process, excellent results can be attained. For this reason, women considering reconstruction should consult with a plastic surgeon before having a mastectomy.

Reconstruction can be done either at the time of the mastectomy or at a later date. In either case, multiple procedures may be necessary in the months that follow to ensure the best result. Modern treatment includes immediate reconstruction, a multi-stage process using the patient’s own tissue (autologous), and/or implants. It is finished with nipple reconstruction and tattooing for a complete look and feel if the nipple was removed at the time of mastectomy.

There are a variety of breast reconstruction techniques. A temporary implant (expander) can be placed under the skin and muscle at the time of mastectomy, with the size of the expander slowly increased over time. Once the desired size is achieved and treatment is completed, the expander is removed and a permanent silicone or saline implant is placed. The areola is then tattooed and the nipple constructed in a separate procedure. For select patients, an immediate implant can be placed at the time of reconstruction.

Breasts can also be constructed using the patient’s own flap of tissue (muscle, fat, skin) from the abdomen (called a TRAM or DIEP flap). Sometimes, reconstruction utilizes both a flap and an implant (latissimus dorsi flap). We recommend scheduling an appointment with one or more plastic surgeons to discuss your options, as well as talking with women who have had the different procedures you are considering. You may want to know what it feels like to live with the results of the surgery.

Breast reconstruction is not the only option after mastectomy. You may want to talk with your doctor about taking part in a clinical trial (research study of new treatment methods).