Breast Reconstruction Surgery

Questions to Ask for Mastectomy Patients

Jul 30, 2009

In most cases, when a woman has a mastectomy, she thankfully has the option to have her breast(s) reconstructed.

However, breast reconstruction is a major surgery and women should fully educate themselves before having this surgery. There are a number of issues to consider. The following are some common questions that women should think about before having this surgery.

What Is Breast Reconstruction?

Breast reconstruction is surgery to rebuild a breast’s shape for women who have had a breast removed (mastectomy). Most women who have had a mastectomy can have breast reconstruction surgery.

It is similar to breast augmentation in that it involves placing silicone or saline breast implants either behind the breast tissue or beneath the chest muscle to add size, shape and fullness to the breast. Breast reconstruction may also include reconstruction of the nipple and areola (the dark area around the nipple). This is not typically needed for a breast augmentation. Both procedures are done by a plastic surgeon. Breast reconstruction provides better symmetry between breasts, so they look similar under clothing, and avoids the need for a woman to wear an external prosthesis.

Should Breast Reconstruction be Performed at the Same Time as a Mastectomy?

Breast reconstruction can be performed at the same time as a mastectomy or delayed until a later time. The benefit to having immediate reconstruction is that the chest tissues are undamaged by radiation therapy or scarring, and the final result often looks better. Another benefit is that one less surgery is needed.

Delayed reconstruction may be recommended if a woman needs radiation to the chest area after the mastectomy. Radiation therapy given after breast reconstruction surgery can cause complications.

One-stage immediate breast reconstruction is performed at the same time as the mastectomy. After the general surgeon removes the breast tissue, a plastic surgeon places a breast implant where the breast tissue was removed to form the breast contour.

Two-stage reconstruction or two-stage delayed reconstruction is done when the skin and chest wall tissues are tight and flat. An implanted tissue expander, like a balloon, is placed beneath the skin and chest muscle to stretch the area. The surgeon injects a salt-water solution at regular intervals to fill the expander over time. After the skin over the breast area has stretched enough, a second surgery is done to remove the expander and put in the permanent implant. Some expanders are actually left in place as the final implant.

What Things Should a Woman Consider Before Having Breast Reconstruction?

Before having a breast reconstruction, a woman should consider and to speak to her surgeon about:

Are There Different types of Breast Reconstruction Surgery?

Several types of breast reconstruction surgeries are available. The type of breast reconstruction procedure that is appropriate for a woman depends on her medical situation, breast shape and size, general health, lifestyle, and goals.

A new breast can be shaped with the use of a breast implant, the woman’s own tissue flap, or a combination of the two. A tissue flap is a section of skin, fat, and muscle which is moved from the stomach, back, or other area of the body and surgically implanted into the chest area.

The most commonly used breast implant is a saline-filled implant-- a silicone shell filled with sterile saline (salt water). Silicone gel-filled implants are another option for breast reconstruction, but are not used as often because of concerns that silicone leakage might cause immune system diseases. However, most of the recent studies show that implants do not increase the risk of immune system problems.

Breast reconstruction cannot give a woman back her breast, but most women who have had breast reconstruction are glad they did.

The copyright of the article Breast Reconstruction Surgery in Breast Health is owned by Jacqueline Trovato. Permission to republish Breast Reconstruction Surgery in print or online must be granted by the author in writing.