Breast reconstruction is a surgical procedure that creates a natural-looking breast mound after a woman has undergone a mastectomy or lumpectomy. Women have several options for breast reconstruction, including the placement of implants or natural tissue transfer to restore breast volume. Each breast reconstruction is custom-tailored to match the wishes and needs of the individual.
Are You A Candidate for Breast Reconstruction?
If you have had a mastectomy or are scheduled to have a mastectomy, you are probably a candidate for breast reconstruction. In some cases, the reconstruction can be performed at the same time as the mastectomy. Other patients may need to wait until their cancer care is complete prior to reconstruction.
If you have had a lumpectomy (partial mastectomy) or are scheduled for a lumpectomy, you might also be a candidate for partial breast reconstruction with the goal of restoring the breast to a normal, symmetrical appearance. We will work with you to develop the best course of action in your case.
What Breast Reconstruction Procedure is Right For Me?
Your breast reconstruction is customized to match your individual needs, performed while you are under general anesthesia. Partial breast reconstruction may be performed as an outpatient procedure. In some cases, a hospital stay is required, but this decision is made on a case-by-case basis. Our team at Denton Plastic Surgery will develop a surgical plan that will safely and effectively meet your vision for restoring your breasts, and we are proud to assist you on your journey to better health and renewed confidence.
Breast Reconstruction Techniques for Women Facing Mastectomy or Lumpectomy
If you have experienced a mastectomy or lumpectomy procedure, there are several options for you to consider for your breast reconstruction procedure. Options can include:
- Implant-based reconstruction with tissue expansion and second stage exchange to a silicone gel implant
- Living tissue breast reconstruction with free tissue transfer from the abdomen
- Oncoplastic reconstruction for partial breast reconstruction
- Fat transfer to the breasts for partial breast reconstruction
Implant-based reconstruction with tissue expansion followed by a second stage in which the tissue expander is replaced by a silicone gel implant involves inserting the tissue expander at the time of the mastectomy. This expander is an inflatable device that is left in the body for a few weeks or months to stretch the skin and muscle to accommodate a breast implant. The process follows these steps:
- The tissue expander is placed at the time of the mastectomy, in most cases.
- A sterile saline solution is injected into the tissue expander, and as progressively more solution is provided, the device gradually stretches the tissue.
- The breast mound reconstruction is then complete.
- After the tissue has increased enough to accommodate an implant, the expander is removed, and the chosen silicone gel breast implant is inserted. Often, fat transfer is performed at this step to give the most natural shape.
- Nipple reconstruction is the final step.
In some cases, “direct to implant” reconstruction can be performed. This newer technique involves placing the implant at the time of mastectomy. This form of breast reconstruction requires that adequate skin tissue is available, with no need for tissue expansion.
Living Tissue Breast Reconstruction
A living tissue breast reconstruction with free tissue transfer from the abdomen involves harvesting tissue from the abdomen, transferring it as a graft to the breast, and connecting it to a new blood supply. This represents the most technologically advanced method of breast reconstruction available.
- This type of reconstruction has a longer recovery because it requires healing of both the breast and the abdominal areas. The DIEP flap is considered by many surgeons to be the superior tissue transfer method as it does not remove muscle. Dr. Flugstad and Dr. Rivet are highly skilled in this advanced breast reconstruction procedure.
- Living tissue breast reconstruction provides a very natural outcome, and in most cases, no implants are needed. This type of breast reconstruction has a major advantage over implants because it can last a lifetime.
Oncoplastic reconstruction is the process of combining cancer surgery with plastic surgery, often used in partial breast reconstruction for women who have undergone a lumpectomy as opposed to a full mastectomy.
- This procedure repositions breast tissue to restore proper shape to any areas where depressions or defects were left after a lumpectomy.
Fat Transfer to Breasts
Fat transfer to the breasts for partial breast reconstruction involves the use of liposuction to harvest fat from an area of the body with excess, such as the abdomen. This procedure may be appropriate for women who have undergone a lumpectomy.
For some patients, a combination of oncoplastic reconstruction and fat transfer may achieve the best aesthetic result.
In this procedure:
- The harvested fat is purified and then injected into the area of the breast affected by surgery.
- In the case of lump removal, the fat is injected to restore lost volume.
- Since the fat comes from your own body, there is no chance of the body rejecting or reacting to the fat transfer.
- Fat transfer is often used as a touch-up procedure in both implant-based breast reconstruction and living tissue breast reconstruction.
What is Involved in Breast Reconstruction Recovery?
The hoped-for result for all breast reconstruction surgery is to return to a normal look after losing a breast due to cancer treatment. The recovery after breast reconstruction varies, based upon the patient and the type of procedure.
For those who are receiving partial breast reconstruction after a lumpectomy, recovery is typically quite easy and fast. For those having more than one surgery after a mastectomy, recovery will require more time and patience.
You can expect some swelling, bruising, tightness, and soreness. You may need to wear a surgical bra for a period of time. Your team at Denton Plastic Surgery will, of course, follow your recovery carefully to make sure that you are healing properly and that you are satisfied with the aesthetic outcome. We will also provide you with full aftercare instructions, as well as pain medication to manage any post-surgical discomfort.
Breast Reconstruction Surgery Frequently Asked Questions
I had radiation. Am I a candidate for implant-based breast reconstruction?
Due to the impact that radiation can have on remaining breast tissue and healing, whether implant-based breast reconstruction is a viable option is determined on a case-by-case basis. If possible, fat grafting or living tissue transfer may be recommended to minimize the risk of complications and improve outcomes.
Will my nipples look natural after nipple and areola reconstruction surgery?
Advances in technology and techniques have made it possible to create realistic and natural-looking nipples and areolas as part of reconstruction surgery. Your new nipples will match one another and can be shaded to add contrast and enhance appearance. Nipple reconstruction can add dimension and boost confidence following surgery.
What are my options for delayed breast reconstruction?
Breast reconstruction does not have to be performed immediately after breast cancer surgery. You may choose to wait several months or several years. It all depends on your personal preference. Your plastic surgeon can develop a plan that fits with where you are in your life and recovery.
What is the difference between immediate and delayed reconstruction?
Immediate reconstruction can be performed in conjunction with a mastectomy using implants, fat grafting, or living tissue transfer. Delayed reconstruction may be performed months or years later to restore breasts and enhance your profile. Your doctor will discuss your options based on your individual situation and treatment plan.
Schedule your breast reconstruction consultation by contacting our office in Denton at (940) 353-5801.