Losing one or both breasts to breast cancer may be traumatic. For some women, losing breasts may involve feelings of a loss of self or a loss of feminine identity. For others, it may simply mean feeling less rather than whole. Whatever the feelings associated with mastectomy after breast cancer, breast reconstruction may be a good option for rebuilding the breasts and also for rebuilding a sense of self and wholeness after breast cancer.
Breast reconstruction basics
Breast reconstruction is performed after a breast, or a significant portion of a breast, is removed. The procedure is meant to rebuild the breast to the same size and shape that it was before breast cancer, although some women may opt to make changes to the size or shape of the breasts. At one time, the nipple and areola were typically lost in the process of breast reconstruction after mastectomy; however, modern surgical techniques are now able to not only rebuild the breasts, but often are able to either preserve the nipple and areola or recreate them. The two most common types of breast reconstruction are implants or tissue flap procedures, but some patients benefit from a combination of the two.
Implants and breast reconstruction
Breast implants used in breast reconstruction are the same as those used in breast augmentation — silicone or saline implants. However, breast implant surgery for breast reconstruction has more considerations than breast augmentation. The first consideration is whether the breast reconstruction with implants will be performed as a one-step or two-step procedure. A one-step breast reconstruction using implants is performed immediately after the mastectomy, essentially combining the two procedures. In a two-step reconstruction, a tissue expander is placed beneath the skin to stretch the skin and tissues to build a pocket for the implant.
In some women, the skin and tissues left after the mastectomy may be too tight to easily perform an implant procedure right away. A second surgery is performed later, during which the expander is removed and the implant is placed. A common reason for a two-step breast reconstruction is whether or not additional breast cancer treatments may be needed, such as radiation therapy prior to the final breast reconstruction procedure.
Tissue flap procedures to rebuild the breasts
Tissue flap procedures use tissue from other areas of the body, typically the abdomen, back, thighs, or buttocks, to rebuild the breasts. One of the benefits of these procedures is that they make use of your body’s natural tissues. With tissue flap procedures, because the breast is rebuilt using your own body, the tissue behaves like the rest of the body if you gain or lose weight. In addition, there is no risk of rupture or need for replacement as there is with breast implant procedures. Although there are other types of tissue flap procedures, the most common types are the TRAM flap, using muscle and tissue from the lower abdomen, and the latissimus dorsi flap, using tissue from the upper back.
Considerations after breast reconstruction
After breast reconstruction, it is important to continue performing self-care measures including mammograms and breast self-exams. However, after breast reconstruction, be sure to seek out a mammogram center and technologist that have experience performing mammograms on women with breast reconstructions. Be sure to inform the technologist ahead of time of your reconstruction and whether or not you have implants and what type of implant. Your plastic surgeon and oncologist will also be able to provide you with additional guidance regarding the need for mammograms and frequency of exams. WIth regard to breast self-exams, your reconstructed breast will feel different than natural breast tissue. Work with your plastic surgeon to determine the new normal for your breasts. Practice performing your breast self-exams so that you know how your breasts feel and will be able to recognize any changes.
To learn more about your reconstructive options after breast cancer, please call Monarch Plastic surgery today at (913) 663-3838 for our Leawood and Lansing offices or (816) 436-3262 for our Kansas City location. We look forward to working with you on your road to recovery and healing.