Breast Reconstruction: Overcoming the Trauma of a Mastectomy
For many women breast reconstruction is the first step to overcoming the trauma of a mastectomy. The surgery can restore a breast to near natural shape, appearance, and size. Breast reconstruction is also helpful after a lumpectomy, since the “preserved” breast may be deformed by the surgery, especially after a large tumor has been removed.
In both situations, women today have many options that depend on their personal wishes, body type, further cancer treatment plans, and desire for a speedy recovery. A consultation with the surgeon is necessary to determine the best option for a particular patient. As Deborah Pan, MD explains, “Breast reconstruction not only restores a woman’s physical form after surgery, but also helps heal her emotionally from the cancer battle.”
Thankfully, breast reconstruction is usually covered by medical insurance.
The following is a summary of common reconstruction options:
Many women choose an implant-based reconstruction. This typically involves the placement of a tissue expander at the time of the mastectomy (although some women are not able to begin reconstruction during the actual mastectomy). Over several weeks, the tissue expander is gradually filled with fluid to stretch the chest muscle and skin. When the tissues have been stretched to the correct size, the expander is removed, and the permanent gel implant is placed. The patient and surgeon will sort through the many options of implants now available. Reconstruction can also include a subsequent procedure to create a nipple.
If the patient prefers using her own tissue to reconstruct the breast, the surgeon can do an autologous reconstruction, a more involved procedure with longer recovery time. A “flap” or the tissue itself is taken from the lower abdomen, inner thigh, upper back, or buttock. With advances in reconstructive microsurgery, skin and fat can be removed from the donor site without damaging the muscles below.
Some surgeons add autologous fat grafting to this procedure. Through gentle liposuction of the woman’s own fat cells anywhere in the body, the surgeon has fat cells to inject to rebuild the breast. This technique can also help to improve breast shape and symmetry after a lumpectomy.
The whole process of breast reconstruction may require two to three procedures over a six-month period or longer (depending on complications, size of breast, other cancer treatments). However, despite the demanding nature of breast reconstruction, most women find the process well worth it if they work with a compassionate and skilled surgeon who keeps them informed and engaged at every step and who puts their personal desires and goals first in the recovery process.