What are the options for breast reconstruction
Alarmingly, 70% of American women facing surgery for breast cancer are not told about the option of breast reconstruction.
Perhaps one of the best things about breast reconstruction is that it can be performed at any time…. you can never “miss the boat” so to speak. Regardless of the timing of the procedure, breast reconstruction enables women to feel whole again, not just physically but also emotionally.
There are several reconstructive options ranging from breast implants to using the patient’s own tissue. Tissue (or “flap”) procedures recreate a “natural”, warm, soft breast and are associated with fewer complications than breast implants.
Breast reconstruction can be performed at the same time as the mastectomy (“immediate reconstruction”) or any time after mastectomy (“delayed reconstruction”). When the mastectomy and reconstruction are performed at the same time, a skin-sparing mastectomy can usually be performed which saves most of the natural breast skin envelope. Only the actual breast tissue under the skin is removed. The reconstruction then “fills” this empty skin envelope. In some cases nipple-sparing mastectomy can be performed. This preserves the nipple and areola as well as all the breast skin.
Skin-sparing (and nipple-sparing) mastectomy and immediate breast reconstruction produce the most “natural” results with the least scarring. Patients undergoing immediate reconstruction also avoid the experience of a flat chest altogether. Immediate reconstruction is therefore preferred whenever possible and should be the goal for patients with early breast cancer (stage I or II).
In some cases breast reconstruction cannot be performed at the same time as the mastectomy. Reasons include advanced breast cancer (stage III or IV), inflammatory breast cancer, and lack of access to a reconstructive plastic surgeon. Most plastic surgeons recommend also delaying reconstruction if there is a plan for radiation therapy after mastectomy (ranging from a few weeks to several months depending on the situation).
As I already mentioned at the beginning of this post, most women unfortunately are not made aware of their breast reconstruction options. I therefore encourage all women interested in breast reconstruction to research their options and seek a referral or consultation with a plastic surgeon specializing in breast reconstruction. If possible, this should be very soon after the diagnosis, before any cancer surgery is scheduled, so that immediate reconstruction can be considered.
For real patient results after immediate and delayed breast reconstruction please visit our before and after photo gallery here.
Author: Dr. Minas Chrysopoulo
There are several reconstructive options ranging from breast implants to using the patient’s own tissue. Tissue (or “flap”) procedures recreate a “natural”, warm, soft breast and are associated with fewer complications than breast implants.
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Tammy
Is it true that you can’t have reconstructive surgery after Radiation Treatment until after waiting 6 mos?
PRMA Plastic Surgery
Hi Tammy, most patients wait a minimum of 3 months after radiation to have breast reconstruction but it can be as little as a few weeks in some cases. This ensures that you are completely healed from the treatment. If you have additional questions, feel free to give me a call at 800.692.5565 or email patientadvocate@prmaplasticsurgery.com
Cathy
After waiting three years after a radical mast. And radiation, can we delay expanders? Will the skin stretch to a full C cup without a flap?
PRMA Plastic Surgery
Hi Cathy, since you’ve had radiation, you would most likely fair better with a flap (if you’re a candidate) rather than expanders and implants. Each patient is different though and one of our surgeons would need to review your medical history to say for sure. Feel free to complete our virtual consultation form and one of our surgeons can review your case and give you his suggestion regarding reconstruction. You can find the form here: https://prma-enhance.com/schedule-your-consultation/