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Breast Reconstruction Options

October 17 represents an important day for many patients who have undergone the harrowing journey of a breast cancer diagnosis, tumor surgery and reconstruction. It’s National Breast Cancer Reconstruction Awareness Day. For many patients, the month of October also represents a month-long reminder that breast cancer remains an integral piece of so many lives. 

Breast reconstruction is a vital part of my practice. It represents a labor of love and is a way to help my patients with breast cancer feel “whole and feminine” again. Despite the misconception that breast reconstruction is a single surgery, it is actually a variety of different types of surgeries that are designed to help patients feel as good as possible after their breast cancer surgery. 

A variety of techniques and surgical procedures are available for women with breast cancer. Most importantly, we must remember that all women diagnosed with this condition are treated uniquely based on their particular cancer biology, tumor location within the breast, their body and current breast type. In addition, the possible need for radiation is an important consideration for your plastic surgeon. Thus, what might work well for a friend or family member may not work as well for you.

Women who have already had breast cancer surgery and have not had reconstruction, or those who have had reconstruction and desire a revision or improvement may also be candidates for breast reconstruction surgery. Importantly, this criterion includes women who may have had breast conservation therapy (as described below) on one side and have uneven breasts due to volume differences. 

For women undergoing breast conservation therapy, also known as lumpectomy with radiation, your plastic surgeon should work with your breast surgeon to attempt to minimize the breast deformity resulting from the lumpectomy (removal of cancerous tissue). Options may include a breast lift or breast reduction, if excess tissue is indicated, at the time of the lumpectomy.

Another option may be to rearrange internal breast tissue to “fill in” the space created by the lumpectomy. This process is called oncoplastic surgery, which simply means that we combine the cancer portion of the surgery with the plastic/reconstructive portion to achieve an optimal outcome. Ideally, this type of reconstruction takes place before radiation as the effects of radiation can be quite significant on the skin and underlying breast tissue. These effects make molding, lifting and healing the tissue after surgery extremely difficult and oftentimes disappointing. Thus, it is important to discuss oncoplastic surgery with your breast surgeon at your initial consultation. It is always a good idea to request a consultation with a board-certified plastic surgeon when trying to determine your options regarding your breast cancer care. 

Women undergoing one-sided or double mastectomy have two main types of reconstruction options. The first option is an implant-based reconstruction that can be performed at the time of the mastectomy (removal of the breast) or be delayed (sometime after the removal of the breast). The second option is autologous tissue reconstruction (taking your own tissue to make a breast). Back and abdominal tissues are often used for this procedure. Depending on your goals, body type, medical issues and need for radiation, your plastic surgeon will help guide you through the different options to help you determine what is best for you. 

If you would like to schedule an appointment with me, please feel free to contact us.

ASAPS

FACS

SESPRS

American Society of Plastic Surgeons

ABMS

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