Not every woman facing a mastectomy feels the need for breast reconstruction, but for many women it is an important next step in recovery and overall healing. Some women want breast reconstruction after a mastectomy because they feel a lack of wholeness or a loss of femininity. For others, the reason is more practical as they simply don’t like the hassle or worry associated with wearing breast prosthesis. The best decisions are made when you base them on your personal needs, desires and expectations. Breast reconstruction procedures vary depending on the results you desire along with your particular situation and other physical and psychological factors.
There are several ways to approach breast reconstruction:
- By the use of a prosthesis (a breast implant, either silicone gel or saline-filled)
- A tissue flap which is a combination of skin, fat, and/or muscle that is moved from your stomach, back, or other area of your body to the chest, where it is shaped into a new breast. A tissue flap also may be used to provide skin or other tissue needed to make up for what was removed at the time of surgery, or changed following radiation treatment.
- A combination of the two options listed above
It is likely you will undergo additional surgeries to improve symmetry and appearance whether or not you have reconstruction surgery with or without breast implants. These additional surgeries may be part of a several-stage reconstruction for the removed breast, or may be to shape the remaining breast to bring it into better balance with the reconstructed one. Most commonly, breast implants are inserted after a space has been created for them using a temporary soft tissue expander that can be placed at the time of your mastectomy, or at a later time.
Nipple reconstruction is normally done as a separate outpatient procedure after the initial reconstruction surgery is complete. Because the nipple and areola are usually removed with the breast tissue during mastectomy, the nipple is usually reconstructed by using a skin graft from another area of the body or from the opposite breast. The area also may be tattooed to obtain a better color match.
Being empowered with credible information is essential when it comes to your implant procedure, your recovery and your results. Here are some of the important factors you and your surgeon should discuss:
- The stage of development of the cancer when it was discovered
- The follow-up treatment that you will require
- Your overall health
- Your chest structure and overall body shape
- Your healing capabilities (which can be affected by smoking, alcohol and various medications)
- Prior breast surgeries
- Bleeding tendencies
- Shifting of the implant
- Scarring from the incision
- Pre-disposition to develop a hardened capsule around the implant