Breast reconstruction is a surgical procedure often performed after a mastectomy to offer patients psychological and aesthetic benefits when recovering from breast cancer. This procedure allows many women to fully return to the life they enjoyed before being diagnosed with breast cancer, with barely any signs of the disease remaining. This procedure may also be performed to correct congenital or traumatic deformities or any other condition that may result in breast deformity.
For many women, breasts are an important symbol of femininity that helps define their self-confidence and body image. The emotional effects of an altered appearance can be as psychologically damaging as the condition or injury that caused it. Breast reconstruction serves to restore a woman’s body to its original condition after the treatment of breast cancer.
What Are My Breast Reconstruction Options?
There are two basic types of breast reconstruction: those that use a breast implant to replace the removed breast tissue, and those that use skin and fat from another area of the body (known as autologous tissue). With both procedures, there are several different modifications that can be made to best suit the individual patient’s needs. Many women choose autologous breast reconstruction when possible to avoid the need for foreign substances. Dr. Trussler will help you choose which type of breast reconstruction is most appropriate for your individual condition.
Considerations
Although breast reconstruction is a beneficial procedure for many women, it is not right for everybody. In order to undergo any kind of breast reconstruction surgery, women should be in good general health and able to handle the stress of a surgical procedure. Certain factors may increase your risk of complications with breast reconstruction surgery, and it may be best to postpone this procedure until risk factors are reduced.
Expectations
Although breast reconstruction is a beneficial procedure for many women, it is not right for everybody. In order to undergo any kind of breast reconstruction surgery, women should be in good general health and able to handle the stress of a surgical procedure. Certain factors may increase your risk of complications with breast reconstruction surgery, and it may be best to postpone this procedure until risk factors are reduced.
Surgery
Autologous tissue-based breast reconstruction uses a flap of the patient’s own skin and fat from another part of the body, with or without the underlying muscle, which is transported to the chest to create the reconstructed breast. This flap may remain attached to its original blood supply or can be reattached to another part of the body. There are several different types of flaps that can be used during breast reconstruction depending upon the condition of the breast area after the mastectomy.
A perforator flap is an advanced breast reconstruction technique that allows a woman to achieve successful reconstruction through the use of her own abdominal or buttock tissue, without the need for muscle or implant use. This technique creates a breast that is soft and warm and can restore a woman’s natural, healthy body image.
Excess skin and fatty tissue from the abdomen (deep inferior epigastric perforator, or DIEP) or buttocks (gluteal artery perforator, or GAP) is transplanted to the chest wall area to reconstruct a new breast. A perforator flap reconstruction is performed by transplanting the skin and fat with its own set of blood vessels, which have been carefully separated from the muscle. This allows for less pain and quicker recovery with no reduction of function.
Breast Reconstruction Recovery
Most patients are highly satisfied with the results of their tissue-based breast reconstruction, as they are able to achieve breasts that look and feel natural, with or without the use of implants. Scars usually heal well after surgery and will fade over time to become less noticeable. The recovery time after surgery will vary depending on the type of procedure performed and each patient’s individual condition, but most patients will be able to resume most regular activities after four to eight weeks.
Which Type of Breast Reconstruction is Best?
Your options for breast reconstruction are more complex than choosing between breast implants or autologous tissue taken from another area of your body. Dr. Trussler is well aware of the importance of this decision and the ways in which your choice may affect your overall sense of well-being. He understands that your breast reconstruction is a very personal choice and one that is best made with an abundance of clear, detailed information about all available options, including the expected outcome of each.
When you consult with Dr. Trussler about breast reconstruction after mastectomy, you can expect to consider several factors. Some of the factors that can influence your treatment options include:
- Your preferences and your desired cosmetic outcome from breast surgery.
- The location and stage of your breast cancer at the time of your mastectomy.
- Your body type (do you have sufficient fat for an autologous procedure?).
- Your general health status and need for additional oncology services after your lumpectomy or mastectomy.
What are the Benefits of Using My Own Tissue for Breast Reconstruction?
Many patients express a desire for "natural breast reconstruction." This requires the use of tissue harvested from another part of the body, typically the abdomen or the buttocks. While flap procedures are more involved than breast implant placement, there are benefits that make this option appealing. A significant benefit is that the tissue transferred from one area to the breast will feel like natural breast tissue. This is because the fatty tissue has the same makeup. Another advantage of flap reconstruction procedures is that the appearance of the breasts will change with age in the same way. This is particularly relevant for women who undergo unilateral mastectomy and want their breasts to age symmetrically.
Do I Have to Have Breast Reconstruction at the Time of My Mastectomy?
Every breast cancer case is unique, as is the treatment and reconstruction of the treated breasts. You might choose to have a mastectomy and reconstruction at the same time. This is referred to as immediate reconstruction. You may be better served by delayed reconstruction, in which your breasts are reconstructed months after your lumpectomy or mastectomy. Finally, your breast reconstruction may occur in stages.
Immediate breast reconstruction is nearly always done for patients who undergo prophylactic mastectomy, the removal of high-risk natural breast tissue as a preventive measure. Immediate reconstruction may also be selected after mastectomy to remove cancerous breast tissue. In this singular procedure, which can take several hours, the oncological surgeon removes the breast tissue, then the plastic surgeon rebuilds the breast mound using implants or fat and skin from another part of the body. You'll wake up with newly-built breasts. If your breast cancer treatment involves radiation therapy or chemotherapy after mastectomy, it may be in your best interest to complete these treatments before beginning the reconstruction process. Sometimes, the reconstruction is started and then finished after chemotherapy or radiation. These details are all discussed with you during your consultation for care.
Delayed breast reconstruction may be necessary due to ancillary therapeutic treatments. This may be recommended if there is a chance that needed therapy like chemo or radiation might alter the texture, color, volume, or overall appearance of the reconstructed breast. Some studies have suggested that breast implants may undergo changes due to radiation treatment. Conversely, some studies suggest that breast implants can diminish the maximum efficacy of radiation treatment due to obstruction of the affected tissue. Some delayed breast reconstruction procedures are patient-driven.
It's entirely up to you when you choose to have breast reconstruction. Some women choose to never rebuild their breasts after cancer treatment. Here in our Austin office, you'll receive the information you need to help you make this personal decision with confidence.
Whether you have a question or would like to set up a consultation, Dr. Trussler and his staff are here to help. Please fill out our contact form, or call our Austin office at 512-450-1077 to schedule an appointment. Start your journey to not only looking, but feeling better today!
