What are your breast reconstruction options after a lumpectomy or mastectomy?
Breast reconstruction makes women physically whole again after breast cancer. It restores something that nature provided but cancer has taken away. In the US, it is covered by insurance thanks to a 1998 Federal Mandate.
Unfortunately, many breast cancer patients are not offered the option of breast reconstruction after mastectomy or lumpectomy.
Women have several reconstructive options regardless of the type of breast cancer surgery being performed. After a mastectomy, options range from implants to “flap” techniques which use the patient’s own tissue to recreate a “natural”, warm, soft breast. Breast reconstruction can also be performed at the same time as a lumpectomy to maximize the cosmetic results and maintain breast symmetry. This is known as “Oncoplastic surgery”.
PRMA is one of the leading breast reconstruction practices in the World. We are very experienced with all types of reconstructive breast surgery, but do have a strong focus on state-of-the-art microsurgical procedures using the patient’s own tissue. This is because these procedures generally provide superior and much more “natural” results long-term than implants. Flap procedures are also strongly recommended instead of implants if the patient has had or will be having radiation.
Immediate vs. Delayed Breast Reconstruction
These terms define when the reconstructive process begins.
Immediate reconstruction is performed at the same time as the mastectomy and provides the best cosmetic results. Advantages include keeping the natural breast skin (“skin sparing mastectomy”) and less scarring. In some cases nipple-sparing mastectomy can be performed; this preserves the nipple and areola as well as the breast skin.
Immediate reconstruction enables the patient to wake up from the surgery “complete” and avoid the experience of a flat chest. Most women with early breast cancer (stage I or II) are candidates.
Delayed reconstruction usually takes place several months after the mastectomy. Patients having radiation may be advised to delay the surgery for the best results. This delay may be for several months. This allows the chest tissues to heal as much as possible after the radiation. Other reasons for delaying reconstruction include advanced disease (stage III or IV) and lack of access to a reconstructive surgeon.
Whether the reconstructive process is started at the time of the mastectomy (“immediate”) or some time after (“delayed’), it important for patients to realize that in most cases, further surgery is required to complete the reconstructive process and achieve the best cosmetic results.