Reconstructive Surgery

Breast reconstructive surgery is a procedure that can rebuild a portion of a breast or reconstruct a breast entirely. It can be an effective way to regain confidence after surgery and begin healing emotionally from cancer. Learn more about the different types of reconstructive surgery.

Types of Breast Reconstructive Surgery

There are many different ways to reconstruct a breast. However, the two general reconstructive techniques are implant reconstruction and autologous or "flap" reconstruction. Both of these can be combined with oncoplastic surgical techniques.

Autologous or “Flap” Reconstruction

This technique uses the body’s own tissue to reconstruct the shape of the breast.

This tissue most often comes from either the belly, back, buttocks, or inner thigh areas, and can consist of skin, fat, and sometimes muscle. Because it is more complex procedure than implant reconstruction, it takes longer and involves a lengthier recovery period. However, unlike implant reconstruction, flap reconstruction will last a lifetime. It will also feel very natural.

Implant Reconstruction

This technique uses an implant made out of silicone gel, saline (salt water), or a combination of the two to recreate the shape of the breast.

Unlike flap reconstruction, it does not involve any incisions elsewhere on the body. Because of this, the length of the procedure and the recovery period are usually much shorter. However, it may involve additional surgeries in the future as the implant wears out, which can happen after 10 to 20 years.

When to Get Reconstructive Surgery

Breast reconstructive surgery can be done at different times. What works best will depend on a patient’s health, cancer size and type, and unique situation.

During Surgery

This strategy involves performing plastic surgery right after a surgical operation on the breast. It requires close coordination between the breast cancer surgery and plastic surgery teams, but it can be accomplished with only one session. The patient will wake up afterward with her cancer removed and her breast or breasts reconstructed.

After Surgery

This strategy involves performing plastic surgery once all additional treatments following surgery are complete. For example, radiation therapy is often required after breast cancer surgery. This is particularly true for breast cancer in advanced stages and/or larger than 5 centimeters. Since radiation therapy can interfere with implants, doctors may recommend waiting at least six to 12 months to get reconstructive surgery.

Both During and After Surgery

This strategy is also referred as a staged approach. It involves having a tissue expander placed under the chest muscle after the cancer has been removed in order to preserve the shape of the breast. Once radiation therapy and any other treatments are finished, surgeons then remove the tissue expander and replace it with tissue from another area of the body (see flap reconstruction above).

Alternatives to Reconstructive Surgery

Getting breast reconstructive surgery is a very personal decision that may not be right for every woman. Some may simply not like the idea of additional surgery, while others may prefer to get back to their regular activities as soon as possible. Reconstructive surgery may also be difficult or even impossible for women with additional health issues.

There are two main alternatives to breast reconstruction.

Breast Prosthesis

A breast prosthesis is an artificial breast that can be worn underneath a woman’s clothes. It is a good option for women who don’t want or can’t get reconstructive surgery but would like to keep the look they had before breast cancer surgery. A breast prosthesis can be fitted for a woman’s unique shape and made from materials that give it a natural look and feel.

Going Flat

There are many reasons why some women may prefer not to get either reconstructive surgery or a breast prosthesis. They may find that a prosthesis is uncomfortable or they may not be able to afford the costs of an artificial breast. For these reasons, going flat can be an appealing option for some women. If they feel self-conscious or change their mind later on, reconstructive surgery or prosthetics will still remain viable options.