Breast reconstruction is a surgical procedure that can be performed in a few different situations to optimize the shape and size of the breasts. While this transformative procedure is sometimes performed to treat congenital deformities, it is more common after mastectomy or lumpectomy.
There is no right or wrong decision when it comes to breast reconstruction. Approximately half of mastectomy patients decide to go ahead with reconstruction, while half do not. Top plastic surgeon Dr. Gregory Dumanian of Northwestern Plastic Surgery discusses what to consider in making a breast reconstruction decision.
Breast Reconstruction
If breast reconstruction is performed on only one breast, the reconstructed breast will not look exactly like the other breast. In a prophylactic double mastectomy, which is performed due to high risk of breast cancer, the reconstructed breasts can look more alike. Reconstructed breasts have little or no feeling.
For women who always wanted bigger breasts, reconstruction gives them that opportunity.
Types of Reconstruction
There are two main types of breast reconstruction. Reconstruction with implants involves the placement of saline or silicone implants as replacements for the lost breast tissue. The procedure can begin at the time of the surgery. An expander is installed after the surgery, and requires regular inflation for a few months prior to the implant surgery.
The downside of implant reconstruction is that implants do not last forever. The patient can expect to replace the implants within 10 to 15 years. In rare cases when an implant leaks or if scar tissue develops around the implant, surgery becomes necessary.
Deep inferior epigastric artery (DIEP) flap reconstruction combines breast reconstruction with a tummy tuck. The tissue from the abdomen is used to reconstruct the breast.
Psychological Benefits
For many women, there is a psychological benefit to reconstruction. When the breast surgeon and the plastic surgeon work in conjunction during the mastectomy, the patient wakes up from the procedure with a breast mound in place. Although they have lost a breast, and the chest looks very different, they do not see a flat, empty area where the breast used to be. Nipple preservation is sometimes possible.
Keep in mind that not all breast reconstruction can start right away.
The Time Factor
Breast reconstruction is time-consuming. The implant method requires numerous office visits for expander inflation. The DIEP method is major surgery with a significant recovery period. There is a greater risk of infection or complications with DIEP flaps including the risk of an abdominal hernia or bulge.
Breast Reconstruction and Radiation
Women undergoing radiation after breast cancer may not have the option of immediate reconstruction. DIEP flap surgery is the better option for these patients.
Contact Us
If you would like to know more about breast reconstruction surgery and whether it is the right choice for you, contact Dr. Dumanian at Northwestern Plastic Surgery and schedule a consultation. The best time to make the decision is before the mastectomy, but delayed reconstruction is possible. Whether a woman is a candidate for reconstruction depends on her physique and the type of cancer treatments undergone.