Breast Reconstruction procedures are performed for patients following removal of breast tissue for breast cancer. Type and timing of breast reconstruction procedures are determined by many factors including:
- Patient’s desires and expectations of reconstruction
- Location of breast cancer
- Size of breast cancer
- Type of breast cancer
- Planned surgery for removal of breast cancer (lumpectomy vs mastectomy)
- Size of breasts
- Prior surgery on the breast, back, or abdomen
- Prior radiation
- Possibility of post-operative radiation
- Body habitus or weight
- Medical comorbidities
Current options for breast reconstruction include oncoplastic reconstruction, implant-based reconstruction, autologous reconstruction, or a combination of these.
- Oncoplastic reconstruction – a reconstructive technique usually utilized when a patient is undergoing lumpectomy and the planned resection is amenable to removal at that same time as doing a breast reduction or lift. This type of reconstruction is reserved for patients with low-grade breast cancer and moderate to large breasts.
- Implant-based reconstruction – this is currently the most common technique used for breast reconstruction. This technique involves the placement of a tissue expander into the breast pocket at the same time as the breast surgeon performs a mastectomy. The tissue expander is then inflated in the office over the next few months until the skin is stretched to a chosen size. Once the pocket is of sufficient size, the tissue expander is removed and a permanent implant is placed. Under certain circumstances, a permanent implant can be placed at the same time as the mastectomy.
- Autologous reconstruction – this reconstructive technique uses the patient’s own tissue to reconstruction the breast. The most common site used for autologous reconstruction is the abdomen. The second most common site is the back. This technique is commonly used for patients that require radiation to the operative site. Using a patient’s own tissue allows for a softer, more natural appearing breast. The drawback of this technique is the additional surgical site required to provide adequate tissue for reconstruction.
Ultimately, the decision to proceed with breast reconstruction should involve a discussion between the patient, the breast surgeon, and the plastic surgeon. To ensure the best result possible, make sure you request a Board Certified Plastic Surgeon with experience in all types of breast reconstruction.
66 year old woman prior to right mastectomy for breast cancer (row 1). The patient underwent a right mastectomy and tissue expander reconstruction (row 2) followed by a right breast implant exchange and left breast reduction for symmetry (row 3).
60 year old woman prior to right mastectomy for breast cancer (row 1). The patient underwent a right mastectomy and tissue expander reconstruction (row 2) followed by a right breast implant exchange and left breast lift for symmetry (row 3).
49 year old woman prior to a bilateral mastectomy for left breast cancer (row 1). The patient underwent a bilateral mastectomy and tissue expander reconstruction (row 2). The patient is pending final reconstruction with a DIEP flap from the abdomen.
58 year old woman that underwent a left mastectomy and implant reconstruction. The patient also had radiation to the left breast after mastectomy. The implant reconstruction failed and the implant was removed. The patient was then referred to Dr. Pierce for autologous reconstruction (column 1). The patient underwent a left breast reconstruction with a DIEP flap from the abdomen (column 2). The patient is pending right breast augmentation and lift for symmetry along with left nipple reconstruction.
*individual results may vary