What is Breast Reconstruction?
What is breast reconstruction? All your questions answered.
Introduction: Understanding Breast Reconstruction
Statistics from the American Society of Plastic Surgeons show that approximately 140,000 breast reconstruction procedures are carried out every year in the US. Breast reconstruction is a procedure which restores the natural aesthetics, size and symmetry of the breasts. In most cases, breast reconstruction takes place after a breast cancer diagnosis, but some people choose to have surgery as a preventive measure if they have a high risk of developing breast cancer. Breast reconstruction is commonly performed after a mastectomy. It can be used to restore the shape and natural look of one or both breasts.
If you have been diagnosed with breast cancer, or you’re considering undergoing a mastectomy due to a family history of breast cancer, it’s important to understand the ins and outs of breast reconstruction surgery to help you make a well-informed decision. This guide has all the answers you need if you’re wondering what breast reconstruction surgery is and how it could benefit you.
Implant Reconstruction vs. Flap Reconstruction
There are two methods used in breast reconstruction surgery. These include implant and flap reconstruction.
- Implant reconstruction
Implant reconstruction is a two-step procedure, which involves using an implant to recreate the natural look, size and shape of the breast. During the first procedure, your surgeon will place a tissue expander to create space for the implant. During the second session, the implant will be positioned. In some cases, it may be possible to fit an implant immediately after a mastectomy, but some people prefer to wait and have the implant fitted at a later date. Your surgeon will discuss the options with you. Implants can produce very lifelike results, but the tissue will feel different to natural breast tissue. It will be slightly firmer and cooler to the touch.
- Flap reconstruction
Flap reconstruction uses natural tissue from another part of the body to reconstruct the breast or breasts. Most commonly, tissue from the back or the lower abdomen is used to rebuild the breast after a mastectomy. It may also be possible to take fat and skin from fleshy areas such as the buttocks and the thighs. Flap reconstruction offers an alternative to implants for people who would rather not have implants, as well as those who don’t have sufficient tissue in the chest wall to support implants following a mastectomy or radiation therapy.
How to Choose Which Type is Best for You
If you’re undergoing breast reconstruction, it’s understandable to want to make the right decision about which type of procedure is best for you. You will be able to ask questions and your surgeon and medical team will be able to help and offer advice, but here are some factors to consider:
- Recovery time: Recovery times vary according to the individual. If you choose to have an implant, you may need two procedures, which are usually 2-3 months apart, and you’ll need to factor in recovery time after the second surgery. With flap reconstruction, most people recover after 4-6 weeks. With flap reconstruction, you will have two areas of healing – the breasts and the site from which the tissue was taken.
- Your personal preferences: People have different preferences when it comes to breast reconstruction surgery. Some people would rather not have implants while others would prefer implants. It’s also important to think about what you want in terms of the appearance of the breasts. Flap reconstruction uses your own body tissue so the breasts may look and feel more like natural breasts.
- Your body type: Consider your body type and size when choosing the type of breast reconstruction procedure. In some cases, one type may be recommended over another depending on how much donor tissue is available and whether there is sufficient tissue in the chest wall.
- The stage of breast cancer and your treatment plan: Sometimes, there are additional risks to consider based on your treatment plan. If you want to have implants, for example, but you’re due to undergo radiation therapy, this type of treatment can increase the risk of complications. This is one more reason that patients may go through a “staged” reconstruction, meaning the mastectomy and reconstruction are done at different times. It allows the other necessary cancer treatment to be started prior to reconstruction.
Breast Reconstruction Procedure
Breast reconstruction can take place either immediately after a mastectomy or later. The procedure will vary depending on whether you have a flap or implant reconstruction.
Implant reconstruction
If you choose to have implants fitted, you may need to have two procedures. The first involves fitting an expander, which creates more space for the implants. Typically, this process takes 2-3 months. The second surgery involves placing the implant or implants. Reconstruction using tissue expanders and implants usually takes around three hours and it can be done under general anesthesia.
Flap reconstruction
Flap reconstruction is a more complex surgical procedure, which involves taking tissue from other parts of the body to rebuild and reshape the breast or breasts. This procedure can take up to ten hours depending on where the donor tissue comes from and whether reconstruction is required for one or both breasts. Treatment can be carried out under general anesthesia. Most commonly, tissue is taken from the lower abdomen or the back. Your surgeon will remove donor tissue, which may include parts of the muscle, skin, fat and blood vessels. In some cases, just the skin and fat are taken. This is sometimes called a free flap procedure. The donor tissue is connected to large blood vessels within the chest. It’s important to note that not all women are candidates for flap reconstruction.
Recovery Tips
Recovery from breast reconstruction can take several weeks. It’s important to follow guidelines and give yourself time to heal to ensure you make a full recovery. Here are some tips:
- Get plenty of rest
- Seek expert advice if you have any concerns or you’re worried about side effects or slow healing
- Avoid strenuous activities and exercise until you get the green light from your medical team
- Start light exercise as soon as your medical team advises
- Take good care of yourself: Stay hydrated, eat well and take as much time as you need to heal
- Keep your wounds clean
- Make sure you attend follow-up appointments
The Psychological Benefits of Breast Reconstruction
Breast reconstruction can offer significant psychological benefits for individuals. Going through cancer treatment and surgery can be physically demanding and emotionally challenging. Some people may not feel ready to have surgery straight after a mastectomy but others may want to go through the procedure as soon as possible. The main psychological benefits include:
- Enhanced body image and self-esteem
- Feeling more like yourself again
- Feeling less self-conscious about your body
- Reduced anxiety about how you look, especially in social settings or during intimate moments
Conclusion
Breast reconstruction is a surgical procedure, which rebuilds the breasts after a mastectomy. If you have breast cancer, or there’s a high risk of developing breast cancer, you may be advised to consider breast reconstruction. There are two main types of surgery, including implant and flap reconstruction. Recovery can take several weeks, but many people find that they feel more confident and less body-conscious after treatment. Experienced breast surgeons can carry out reconstruction surgery immediately after a mastectomy or later depending on the individual’s needs and preferences.