Breast reconstructive surgery is designed for patients recovering from a single or double mastectomy. While mastectomies are the best way to ensure that breast cancer does not recur, many patients are unhappy with the results from a cosmetic standpoint. The goal of reconstructive surgery is to help cancer survivors complete the healing process by restoring the look and feel of their original breast tissue as much as possible.
Reconstruction patients often have a specific result that they envision achieving via surgery. Unfortunately, patients often do not have sufficient medical knowledge to understand their various reconstruction options and choose between them. This means that there are patients who go through the entire reconstructive process only to be disappointed by the final results.
In order to ensure their desired final appearance, patients are encouraged to speak directly with their surgeon about their individual situation. The type of surgery that a surgeon recommends will depend on the patient’s body type, lifestyle, and the type of mastectomy they have had.
This article presents a brief overview of the two most common surgery methods, standard recovery times, and the expected benefits of each procedure.
Implant Reconstructive Surgery
The most well-known reconstructive option, implant reconstructive surgery, involves inserting a saline, silicone, or combined type of implant under the pectoral muscle. A small silicone expander is placed during the initial mastectomy procedure to begin the gradual process of stretching the tissue. The expander is gradually filled via minimally invasive procedures to allow the healing tissue to stretch slowly and safely. These expansion procedures are typically repeated every two weeks until the desired breast size is achieved.
Implant surgery requires less surgery than flap surgery (covered below) because there is only one surgery site per breast instead of two or more sites. However, additional surgeries may be required in the future; implants do not last forever, and must be replaced when they begin to wear out.
Because nerves are often damaged or removed during mastectomy and implant surgeries, the reconstructed breast is unlikely to have much capacity for sensation.
Flap Surgery Reconstruction
Flap surgery involves removing a portion of a patient’s skin, muscle, and/or blood vessels from another area of the body (typically the back, belly, buttocks, or inner thigh) and moving it to the chest to replace the original breast tissue. Typically, no implant is needed.
Flap surgery usually yields a more natural result than implant surgery, and unlike an implant, tissue harvested from the patient’s own body will last a lifetime. Tissue from the belly, buttocks, or thighs is typically a very good match for the texture and appearance of the breast.
However, as with implant surgery, the reconstructed breast is unlikely to have much capacity for sensation. Nerves from the harvested tissue will not reconnect to nerves in the chest.
Typically, the belly is the preferred site for flap surgery reconstruction, but the buttocks, thighs, and back can be used in certain situations. There are pros and cons to each type of flap surgery, but ultimately choosing the site from which to harvest tissue must be made by the patient and surgeon together.
If you are a patient considering one of these procedures, it’s a good idea to contact other breast cancer survivors who have experienced them. Choose patients who have achieved results similar to the one you desire for yourself. Hearing about these successful operations from the patient’s point of view might help you feel more prepared to discuss your options with your surgeon.