Breast Reconstruction Surgery (Post-Mastectomy)

About This Procedure

Breast reconstruction surgery is most often conducted to reconstruct breasts after mastectomy. Best results often require two separate surgical procedures. The first to install a tissue expander - a special implant placed beneath skin and muscle - to help the body replace tissue lost during the mastectomy. Later, the tissue expander is replaced with a permanent implant, and nipples and areola are reconstructed.

Thanks to the latest advances in plastic surgery, breast reconstruction after mastectomy or lumpectomy due to breast cancer is very possible. The procedure is designed to rebuild the breast mound. Combining skill and experience, plastic and reconstructive surgeons are able to recreate all or part of the breast that has been surgically removed. Following breast reconstruction, many patients report a boost in emotional wellbeing and overall quality of life.

Ideal breast reconstruction candidates:

• Are in good general health
• Are undergoing a type of breast cancer treatment that will not be affected by breast reconstruction surgery
• Want to restore their sense of well-being and confidence after losing one or both breasts, in whole or in part
• Want to restore a normal breast appearance in size and shape, following a mastectomy or lumpectomy
• Want to regain breast symmetry, when only one breast has been altered

Breast reconstruction options

Breast reconstruction is a highly individualized procedure that will depend on each patient's anatomical needs and preferences. Women have the choice to begin the reconstructive process during their mastectomy (immediate reconstruction) or sometime afterwards (delayed reconstruction).

There are several options for breast reconstruction. Some women choose to reconstruct the breasts using saline or silicone implants. Today's breast implants are natural-looking and designed to last for many years. Each type of implant has benefits and limitations, which the plastic surgeon will go over during the initial consultation. Before placing the breast implants, the breast surgeon will place a device called a tissue expander to create space (or a "pocket") in the tissue to accommodate the implants. The saline or silicone implant will be placed within the pocket and closed with sutures.

Other women may choose to reconstruct the breast mound using tissue harvested from another body area, such as the abdomen or back. Reconstruction surgery that utilizes lower abdominal tissue is known as transverse rectus abdominis muscle (TRAM) flap surgery. Breast reconstruction that uses tissue from the back is known as latissimus dorsi flap surgery, while reconstruction that uses tissue from the buttocks area is known as gluteal flap surgery. In some cases, breast implants can be combined with a flap technique to recreate the breast.

In many cases, the nipple and areola reconstruction is the final step in breast reconstruction surgery. Nipple reconstruction can be completed using a variety of techniques, including skin grafts and tattooing.

Reconstructive breast surgeons work closely with each patient and their oncology team to design a safe treatment plan that achieves the best outcome. Several factors, including the patient's health status, body type, quality and quantity of tissue available, and aesthetic goals will be taken into consideration when designing a breast reconstruction treatment plan.