Breast reconstruction can be an effective medical means of improving the appearance of the breast after mastectomy or other surgery.
Despite the fact that mastectomy is sometimes the only way to save the life of a person with cancer, the loss of any part of the body can cause psychological trauma and damage to the patient’s self-esteem. This damage also occurs in cases of patients with serious breast deformities, abnormalities, or other defects in the appearance of the breasts.
Fortunately, plastic surgery offers hope to patients recovering from mastectomy or other disfigurement: breast reconstruction surgery. The surgical reconstruction of lost or disfigured breasts does more than help heal the patient’s physical wounds – it enables them to confidently resume their normal lives.
“To many women, breast reconstruction is a symbol of hope that they can get past this cancer diagnosis,” University of Michigan plastic surgery professor Dr. Amy Alderman told Medical News Today. “Reconstruction is not necessarily the right option for every woman and not everyone is going to choose reconstruction, but I think it’s important that every woman is informed of what the benefits of reconstruction can be for their physical and emotional well being.”
Two forms of breast reconstruction surgery exist: immediate breast reconstruction and delayed breast reconstruction. Immediate breast reconstruction is breast reconstruction that is performed at the same time as the mastectomy. Immediately after the patient’s breast or breasts are removed by a general surgeon, a plastic surgeon begins creating new breasts. The primary advantages of immediate reconstruction are the reduction or elimination of psychological trauma, a lessening of scar tissue and combined recovery time for the two procedures.
The main problem with immediate reconstructive surgery is the possible necessity of future surgeries. Should the patient’s cancer return in a form that requires more surgery, the entire reconstruction could be jeopardized. Another problem arises if the patient needs radiation therapy – the reconstructed tissue could be negatively exposed to radiation as a result. And of course a patient who is one the fast track to surgery for her breast cancer will probably not be given sufficient time to discuss the planned appearance of her reconstructed breasts. This can lead to aesthetic issues later.
Delayed breast reconstruction is performed after the mastectomy itself. Some choose this option for the sake of simplicity – after all, dealing with a cancer diagnosis is stress enough without having plastic surgery options to worry about. Delayed reconstruction also allows patients to examine her reconstructive surgery choices at length, reducing the risk of dissatisfaction with the size or appearance of the reconstructive work. Finally, delayed reconstruction allows for chemotherapy or radiation treatment to be carried out without damaging reconstructed tissue or risking unplanned changes in the reconstructed breasts.
The reconstructive process itself can take several forms. The most common is the implant procedure. In implant reconstruction, a breast-like “mound” is formed by the surgeon by combining a surgical breast implant (silicone or saline types are both used) with the remaining tissues of the breast. Additional tissues from other parts of the body (e.g. the buttocks) may also be used to add fullness and weight.
Tissue flap reconstruction is another form of breast reconstruction surgery. It may be done in two basic ways:
• Pedicle Flap: a flap of tissue from the back or belly is pulled under the skin up to the chest area and attached there without cutting its blood supply
• Free flap: the same, only the tissue and blood vessels are cut and surgically re-connected to blood vessels in the chest area
Nipple reconstruction is another, separate step. This is a difficult task, but one performed successfully in most cases. Although there is a variety of procedures for nipple reconstruction, the most common involve the placement of a plastic tissue expander under the skin of the new breast, which is gradually filled with saline over a period of weeks until the skin is stretched into a nipple shape; a permanent implant can then be implanted. Tissue grafts from a remaining, undamaged nipple, or from some other part of the body, can also be performed. In all cases the color and appearance of the nipple and surrounding area is restored primarily by tattooing.
When considering breast reconstruction surgery, it’s important to remain realistic about outcomes. No surgery can give a woman a new breast; the reconstructed breast may appear natural, but it will lack the natural sensation of a real breast. That being said, skillful breast reconstruction surgery can restore the mastectomy patient’s womanly shape and feel, giving her the confidence and good self-image that can lead to a full recovery and a return to normal life.
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