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Breast cancer is highly treatable when found early, and mastectomy or lumpectomy can effectively eliminate the disease. 

But those procedures may make some women feel less feminine, so most eventually consider breast reconstruction

Below is more information about current breast reconstruction options. 

Breast Reconstruction Overview 

Several procedures are available, and the process may require more than one operation. This is a personal and individualized process, so it’s essential to take a lot of time to decide what’s best for you. 

You and your plastic surgeon will talk about the various factors that affect which procedure may be your best option. Significant aspects to consider are: 

  • Your general health, including problems that could affect the healing process, such as smoking or blood disorders
  • The location and size of the breast cancer
  • The size of your breasts
  • Whether you had a full or partial mastectomy or lumpectomy
  • Whether you need more cancer treatments other than surgery
  • How much breast tissue is available
  • Whether you need breast reconstruction for both or one breast
  • How much do you want the breast to look like the other
  • How fast do you want to recover
  • How different breast reconstruction options may affect other parts of the body 
  • Whether you are open to having more than one procedure

Your plastic surgeon will go over your general health and medical history. Then, they’ll review the reconstruction options that could be best based on your health, age, lifestyle, and goals. 

Breast Reconstruction With Implants

Using a breast implant is the most popular option to reshape the breast after mastectomy. Breast implant surgery can be performed simultaneously with breast reconstruction. Or, you can have this procedure done months or even years after the cancer surgery. 

Saline Implants

Saline implants are filled with sterile saltwater and have a long, impressive safety record. The shell is inserted in the breast pocket, and the surgeon then fills it with the appropriate amount of solution. 

Silicone Implants 

Silicone gel implants feel more natural than saline. A recent enhancement is cohesive gel implants that contain a thicker silicone gel. As a result, the implant will keep its shape even if the shell is damaged. 

There are many sizes and shapes of silicone and saline breast implants that can have a smooth or textured shell. However, any implant may need to be eventually replaced if it ruptures or leaks. 

There were concerts in the past about potential health problems from implants containing silicone, including breast cancer. But clinical studies show that silicone implants are safe. 

Implant Procedures

Your surgeon can do your breast reconstruction as part of your cancer surgery or later: 

Immediate Reconstruction 

This is where the breast reconstruction is done or started during the cancer surgery. The implant will be placed immediately after the surgeon does the mastectomy. 

After the surgeon removes the tissue, the breast implant is placed. The breast implant may be put above or below the chest muscle, depending on your anatomy and other factors. 

The advantage of immediate breast reconstruction is that it can preserve the breast skin and have better results. However, many women also want to have the breast shape as soon as possible after surgery. 

Delayed Reconstruction 

This means the breast reconstruction is performed at a different time than cancer surgery. The surgeon places a tissue expander during the mastectomy for this procedure to prepare the area for reconstruction later. 

The tissue expander is an expandable sac that starts flat and is expanded over several weeks to the desired size, so the skin stretches. Once the breast skin has been stretched enough, another surgery takes out the tissue expander and places the implant. 

Flap Procedure Breast Reconstruction 

Another way to rebuild the breast after cancer surgery is a tissue flap procedure. This procedure uses tissue from other body areas, such as the belly, back, buttocks, or thighs, to rebuild the breast. 

Tissue flaps generally look more natural and feel more like actual breast tissue than implants. For example, a breast rebuilt with a tissue flap procedure will get bigger or smaller if your weight changes. 

And while an implant may need to be replaced eventually, this isn’t a factor with the flap procedure. Tissue flaps are usually used alone to rebuild the breast, but your surgeon might use a flap procedure with an implant. 

TRAM Flap

This flap procedure uses muscle and tissue from the abdomen to reconstruct the breast. A breast implant may be used with this procedure, but some patients have enough breast tissue to rebuild the breast without the implant. 

The TRAM flap procedure can also tighten the belly, which gives you a tummy tuck simultaneously. 

Your surgeon can use a flap that is attached to the original blood supply or not. Both procedures have their advantages and disadvantages your surgeon will discuss with you. 

DIEP Flap

This flap procedure uses skin and fat from the same body area as the TRAM flap, but it doesn’t use muscle. Instead, this technique uses a free flap,  which means the tissue is free from the belly and moved to the chest. 

Breast Reconstruction After Partial Mastectomy 

Most women who have a partial mastectomy or lumpectomy don’t need breast reconstruction. But you could have a breast deformity from cancer surgery, such as a dimple in the breast from removing a large tumor. 

Some surgeons address this issue by combining plastic surgery and cancer surgery, which is called oncoplastic surgery. This procedure reshapes your breast during cancer treatment. 

These patients may be candidates for other breast reconstruction procedures, such as: 

One of the above procedures may be ideal for getting the results you want. 

You have many breast reconstruction options, and that’s a good thing. Your surgeon will discuss all the choices, and you both can decide what’s best for you. 

Request A Breast Reconstruction Consultation 

Thinking about breast reconstruction in Chicago? Dr. Otto Placik is proud to serve Chicago area patients at his practice. He’ll discuss the breast reconstruction process and help you decide if you want to move ahead with this procedure. 

References

Breast Reconstruction Overview. (n.d.). Accessed at https://www.breastcancer.org/treatment/surgery/reconstruction/types

Breast Reconstruction Options. (n.d.). Accessed at https://www.cancer.org/cancer/breast-cancer/reconstruction-surgery/breast-reconstruction-options.html

Breast Reconstruction Flap Procedure. (n.d.). Accessed at https://www.cancer.org/cancer/breast-cancer/reconstruction-surgery/breast-reconstruction-options/breast-reconstruction-using-your-own-tissues-flap-procedures.html

Breast Reconstruction Implants. (n.d.). Accessed at https://www.cancer.org/cancer/breast-cancer/reconstruction-surgery/breast-reconstruction-options/breast-reconstruction-using-implants.html

Author: Dr. Otto Placik

Dr. Otto Placik is a Double-Board Certified Plastic Surgeon in Chicago, a leader in the field of body sculpting, and is recognized for his artistry in a wide range of modern cosmetic enhancements.

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