What is breast reconstruction?
Breast reconstruction is surgery to recreate all or part of a breast that has been removed by mastectomy. This surgery is performed by a plastic surgeon. A breast can be reconstructed with an implant, your own body tissue, or a combination of an implant and body tissue.
Who can have breast reconstruction?
Most women who are having or have had a mastectomy are candidates for breast reconstruction. Women who have had a lumpectomy may also have options for reconstructing partial breast defects.
If you have had, or will need radiation therapy to the breast, it may influence the type of reconstruction, and when you can have it. Some patients will need chemotherapy after their mastectomy, and this can delay reconstruction surgery.
If you are considering breast reconstruction, you should schedule an appointment with a plastic surgeon to find out what options are available to you.
What is involved in breast reconstruction?
There are 3 main steps in any breast reconstruction:
1) creation of a new breast mound
2) touch-ups of the reconstruction, and possible modification of the opposite breast (lift, reduction) in patients having a mastectomy of one side (optional)
3) creation of a new nipple and areola (optional)
How is a breast reconstructed?
There are three main types of breast reconstruction. The first type of reconstruction uses an implant filled with silicone gel to recreate the breast mound. A second option is to build a breast mound using tissue “borrowed” from another part of your body. The last type of reconstruction uses “borrowed” tissue from your back as well as an implant. To learn more, visit our page on the types of breast reconstruction.
Your plastic surgeon and his/her team will discuss the different methods with you and which option may be best suited for you based on your physical characteristics and treatment plan.
What will my new breast look and feel like?
Although there are many techniques of breast and nipple reconstruction, none of them will be able to give you back the exact same breast you had before. Here are some things to keep in mind:
- Visible incision lines will always be present on the breast, whether from reconstruction or mastectomy. Also, certain surgical techniques will leave incision lines at the site where tissue was taken for reconstructing the breast (the back, abdomen or buttocks).
- If only one breast is affected, it alone may be reconstructed. A breast lift, breast reduction or breast augmentation may be recommended for the opposite breast to improve symmetry of the size and position of both breasts.
- A breast implant has no natural sag and will remain firm over time. Using your own tissue for reconstruction results in a softer breast with a more natural feel.
- Most women find the skin of the chest wall has less sensation after a mastectomy. Nerves that were removed during the mastectomy cannot be replaced and the loss of feeling is, unfortunately, permanent.
When can reconstruction be done?
Reconstruction can be either immediate or delayed.
Immediate reconstruction is done at the same time as the mastectomy. As such, the number of anesthetics required to complete the reconstruction is reduced. If you are interested in beginning reconstruction at the time of mastectomy, you must ask your breast surgeon to make a referral for you to see a plastic surgeon.
Delayed reconstruction is performed several months or even years after the mastectomy and any other cancer treatments are finished.
Factors that may affect the timing of your reconstruction include:
- the characteristics and stage of your cancer
- if you have had or will need radiation therapy to the breast (generally surgeons prefer to wait a minimum of 6 – 9 months following the completion of radiation therapy to allow time for the chest skin to heal before performing breast reconstruction)
- if you will need chemotherapy after your mastectomy
Where will my surgery be performed?
Surgery for your breast reconstruction is most often performed in a hospital setting, possibly including a short hospital stay, and your doctor will likely use general anesthesia. Some follow-up procedures may be performed on an outpatient basis, and local anesthesia with sedation may be used. These decisions will be based on the requirements of your specific procedure and in consideration of your preferences and your doctor’s best judgment.
Do I need to pay for breast reconstruction?
Post-mastectomy breast reconstruction is covered by provincial health plans in Canada so you will not have to pay for it.
What are the possible risks of breast reconstruction?
As with all types of surgery, there are risks involved with breast reconstruction. Your plastic surgeon can help you weigh the pros and cons of breast reconstruction so that you can make an informed decision.
Can I talk to someone who has had breast reconstruction?
It may be very helpful to speak with someone who has had breast reconstruction and can share their knowledge and experience. There are women on our Breast Cancer Support & Information Team that have had breast reconstruction and can address your questions and concerns. Please call us toll-free 1-888-778-3100 to speak with a member of our team.
Links to more information
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Reconstructive Breast Surgery
Johns Hopkins Medicine
Breast Reconstruction (video)
Memorial Sloan Kettering Cancer Center