The term breast reconstruction is the rebuilding of a breast after mastectomy. The goal of surgery is to restore a breast to its near normal appearance in size and shape. Reconstruction can be performed at the time of the mastectomy (while the patient is still under general anesthesia), or it can be done in a delayed or secondary fashion. Each patient is different and the decision to proceed with immediate or secondary breast reconstruction is a personal one. Since breast reconstruction often requires multiple surgeries and up to a year to complete, many defer and have it done secondarily when they are healthier and have more time and can better plan for surgery. It is important to note that excellent results may be obtained with both immediate and secondary breast reconstructions.
There are three methods of reconstruction of the breast:
- breast implants
- the patient’s own tissues (‘autologous’ reconstruction)
- combination of both
- If only one breast is affected, it alone may be reconstructed. In addition, 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. Many women today opt for both breasts to be removed, even if one does not have cancer (“prophylactic mastectomy”). This is the case with women who are gene positive and at increased risk for cancer.
- Immediate reconstruction has been shown to be a safe option when performed well. There are increased risks to immediate reconstruction, such as skin and nipple loss, infection, and bleeding. Make sure your plastic surgeon is up-to-date on the use of laser angiography (SPY) during mastectomy to make sure it is safe to proceed with immediate reconstruction. Modern techniques, like staging reconstructions (“Zenn Delay”) deliver beautiful results for immediate reconstruction without the use of tissue expanders. For more information see Dr. Zenn’s reconstruction web site zennplasticsurgery.com.
- Not all patients are candidates for all types of reconstruction. The type of reconstruction you undergo will be decided by the patient and surgeon, depending on particular needs, anatomy and previous treatments.