What's involved with Breast Reconstruction?
Choosing to have breast reconstruction is a very individualized decision. Breast reconstruction can improve your self-esteem and make you feel more whole again and confident about your body after having had one or more of your breasts removed for breast cancer. Dr. Sharma will sit down with you to discuss your goals for the surgery and the options that may be most suitable for you. It is important to remember that breast reconstruction is unable to recreate the breasts you had before cancer surgery, and the goal is to reconstruction breasts that look reasonable in clothing. Perfect symmetry is not possible, and it is critically important to ensure that your goals and expectations for reconstruction are in line with what can be reasonably achieved through surgery.
Breast Reconstruction surgery involves rebuilding a new breast following a mastectomy, using either a breast implant, a tissue expander, or your body’s own tissue (skin flaps from the breast, nearby flaps from the back or free flaps from the abdomen), or a combination of the these options.
Frequently Asked Questions
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How does immediate breast reconstruction work?
Your general surgeon will perform the mastectomy and this may or may not involve removing the nipple and areola. If using an implant for reconstruction, this may be placed below the muscle (retro-pectoral) or above the muscle (pre-pectoral) in order to achieve the desired reconstruction. Depending on the discussion that Dr. Sharma has with you, your surgery may involve the use of an acellular dermal matrix, which is a piece of cadaver skin that has all of the cells removed from it, and acts like a scaffold to help support the implant either above or below the muscle. Sometimes, depending on factors during surgery, it may not be possible to go with the original plan for reconstruction in terms of implant size, location of placement above or below the muscle, or it may need a tissue expander instead.
Reconstruction may also be done using tissue from the abdomen (using DIEP flaps) at the time of the mastectomies and involves detaching an ellipse of skin and fat from the abdomen and then re-attaching the tissue to the chest wall and connecting small blood vessels together with a microscope to re-establish the blood flow and bring the tissue back to life.
Dr. Sharma will discuss all of this information with you and go over any questions.
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How does delayed breast reconstruction work?
In delayed reconstruction, the breast has already been removed at a prior date before any reconstruction. If radiation has occurred, options for reconstruction generally require the use of some non-radiated flap of tissue from either the abdomen (DIEP flap) or using a combination of a back tissue (latissimus flap) with an implant. If there has not been any radiation then a tissue expander may be used to help stretch out the skin before a second stage operation is done to replace the tissue expander with a breast implant.
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