Breast Reconstruction

Breast reconstruction is a general term for many techniques used to rebuild the breast after it has been removed (mastectomy)- usually following cancer. This can be achieved by using a muscle from the abdomen or back or by using an implant.

Who should have breast reconstruction?

The decision to undergo breast reconstruction is a decision best made in consultation with your general surgeon, your oncologist, and your plastic surgeon. The stage and extent of your cancer as well as the planned treatment all effect this decision. Sometimes the reconstruction can be performed immediately after mastectomy, and other times the surgery will need to be delayed. Not all women chose to have breast construction, and some women have health problems that would interfere with a safe recovery. Each individual needs to look at her own situation and goals to make an informed decision with the help of the health care team.

What are the most common types of breast reconstruction?

There are 3 types of breast reconstruction surgery performed most often in the United States. You may not be a candidate for all types of reconstruction.

TRAM Flap
(Transverse Rectus Abdominus Myocutaneous Flap) This procedure can be performed to reconstruct one or both breasts if needed. A muscle from your abdomen (half of your “six-pack”) is used along with the overlying tissue and skin to reconstruct your breast. This results in a tightening of your stomach, somewhat like a tummy tuck, however this may result in a scar located higher on the abdomen.

Implant
Immediate implant following a mastectomy. A breast implant can be used alone if enough of your skin is left to cover the implant. The implant is placed under your chest muscle. Usually a temporary implant will need to be used first called a Tissue Expander to stretch the muscle and skin prior to placing the permanent breast implant. Silicone gel implants are often used to obtain a more natural breast shape and feel.

Latisimus Flap
This flap is designed from the muscle that goes from your shoulder across your back. Sometimes a small area of skin and fat are used to build a more natural breast. The muscle is usually placed over a tissue expander or implant because it is not large enough to create a whole breast alone. The muscle provides more protection and camouflage for the implant than using the chest muscle alone.

What about the nipple?

Nipples can be reconstructed by moving around the tissue to create a mound, and tattooing can be done to recreate the areola and coloring of the nipple.

Will it match my other breast?

How well your reconstructed breast matches the normal breast depends on the size and shape of your normal breast and the reconstructive options available. You may chose to have the normal side altered (breast lift or augmentation) to achieve better symmetry.

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