After mastectomy, many women want to have breast reconstruction to help their bodies feel and look more like before surgery. If you have insurance, federal law requires that it cover breast reconstruction after mastectomy, though you may still have considerable out-of-pocket expenses.
Breast reconstruction can be done in combination with your mastectomy, as a single operation, or at a later date. If you decide to have the nipple and aureola reconstructed too, that procedure is done separately after your breast reconstruction, to allow the new tissues to heal and settle into place first. It’s important to know about your options in breast reconstruction, and the advantages and disadvantages of each. There are two types, the implant method and the flap method.
The implant method uses soft sacs filled with liquid or gel to replace breast tissue. The sacs, or breast implants, are surgically placed under the chest muscle and skin in a two-step process. First, a temporary expander like a flat balloon is inserted behind the chest muscle, a pocket is developed to cover it, and the skin is closed. Gradually, over the course of several weeks or months, sterile saline solution is injected into the expander through a valve, until the skin has stretched enough to allow a permanent implant to be inserted. Saline is usually added once a week, over the course of six to ten office visits.
Implant breast reconstruction may be done weeks or months after mastectomy, if you decide then to have breast reconstruction. Or you may elect to have the expander implanted in conjunction with the mastectomy as a single operation.
In the flap technique, done immediately following mastectomy as a single operation, the surgeon uses the woman’s own tissues to reconstruct the breast. Muscle, fat, and skin from the abdomen, back, or buttocks are repositioned to create and cover the breast mound.
Though this requires a longer hospital stay after surgery, many women feel it results in a more natural-looking and natural-feeling breast. However, it’s a more complicated procedure than the implant method, requiring a more lengthy surgery. And you will have additional scars on the area of your body from which tissue was taken to form your new breast.
Factors to consider
Whatever reconstruction method you choose, you should be aware that the appearance of a reconstructed breast will improve with time, as the implant or new tissues heal, settle into place, and gradually assume their final shape. Over time, the scars associated with breast surgery will fade, and any numbness and tightness you feel in the breast after surgery will get better.
After your breast reconstruction you will need to continue breast self-examinations every month, and to have regular mammograms. Breast reconstruction will not make it any more (or less) likely that cancer will recur. Reconstruction will not interfere with additional cancer treatments like chemotherapy or radiation, and it should not make it harder to detect a recurrence of cancer under or near the reconstructed breast.
For more information about breast reconstruction, please contact Cosmetic & Reconstructive Plastic Surgery and Dr. Rick Rosen, M.D., F.A.C.S. today to schedule your initial consultation.