Breast Reconstruction Surgery is a surgery procedure of rebuilding a breast, usually in women, to give a very attractive and natural look to the breast. Often this includes the reformation of a natural-looking areola and nipple.
There are two types of Breast Reconstruction Surgery. These are prosthetic reconstruction, where artificial implants are used, and autogenous, where tissue from elsewhere in the woman’s body is used to create the breast mound.
When is reconstruction done?
It depends on your situation. Reconstruction surgery can be carried out at the same time as your mastectomy (immediate reconstruction), but, this isn’t always possible. If you have radiotherapy after your mastectomy, you’ll be advised to wait until after this has finished. Patients with significant medical complications like high blood pressure, obesity, diabetes etc, this surgery can be delayed. Surgeons may choose to perform delayed reconstruction to decrease this risk.
The infection rate may be higher with primary reconstruction (done at the same time as mastectomy), but there are psychological and financial benefits to having a single primary reconstruction. Patients expected to receive radiation therapy as part of their adjuvant treatment are also commonly considered for delayed reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients. Waiting for six months to a year following may decrease the risk of complications, but, this risk will always be higher in patients who have received radiation therapy.
Delayed breast reconstruction is considered more challenging than immediate reconstruction. Frequently not just breast volume, but also skin surface area needs to be restored. Many patients undergoing delayed breast reconstruction have been previously treated with radiation or have had a reconstruction failure with immediate breast reconstruction. In nearly all cases of delayed breast reconstruction, tissue must be borrowed from another part of the body to make the new breast.
Breast reconstruction usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revision surgeries.
Your surgeon will match your new breast as closely as possible to your existing breast. In some cases, women consider surgery on both of their breasts to ensure a good match. This can involve lifting the existing breast, or making it larger or smaller. Some women with a high risk of breast cancer choose to have both breasts removed (a double mastectomy) and two reconstructed breasts made, to reduce their risk of getting cancer again.