Breast reconstruction is plastic surgery to reconstruct one or both breasts that have been lost due to cancer.
The current lifelong risk of breast cancer for women in the United States is one in eight. Despite advances in breast conservation therapies, mastectomy remains an important tool in fighting this disease. For many patients breast reconstruction is chosen to restore body image and allows the patient to feel “whole” again. Breast reconstruction is a process, requiring several operations to arrive at the final result. Preferably the patient consults with the plastic surgeon prior to her mastectomy so that these stages can be thoroughly discussed and so that she may have an understanding of what she can expect.
Timing of the Procedure
Breast reconstruction can be “immediate” or “delayed”. In other words, the reconstructive process can begin at the time of the mastectomy or at a later date after the mastectomy has completely healed. Studies would suggest that there is a psychological advantage to immediate breast reconstruction.
Breast Reconstruction Options
Autologous breast reconstruction
Autologous reconstruction involves creation of a breast mound with the patients own tissues, most commonly from the abdomen or the back. Excess fatty tissue and skin are transferred to the chest to create a breast based upon the blood supply to abdomen or back. The primary advantages of autologous breast reconstruction are that the breast is reconstructed from the patients own tissue and it is often softer and can have a degree of ”droop” to match the opposite breast. The trade-off is that these operations are longer, more technically demanding procedures with increased postoperative pain, a more difficult recovery period, and a higher complication rate.
Implant breast reconstruction
Dr. Yates prefers implant breast reconstruction in most cases when able. The major exception is when there is significant radiation injury to the tissue. Radiation does not necessarily prohibit a patient from choosing implant reconstruction, however, the risks of implant complications is higher. An implant reconstruction can be done in one or two stages. Dr. Yates prefers a two stage technique in most patients. The first stage of this technique involves placement of a tissue expander beneath the pectoral muscles which gradually stretches the skin and pectoral muscle creating a breast mound. The second stage , which occurs around 3-6 months later, involves removal of the expander and placement of a permanent breast implant. Oftentimes the patient would benefit from a procedure on the opposite breast for symmetry including; mastopexy, breast reduction or breast augmentation as indicated. In the third stage, a nipple is reconstructed which is later pigmented to match the opposite breast with tattoo.
How about nipple sparing mastectomy?
Nipple sparing mastectomy can lead a very good cosmetic outcome in the appropriate patient. Generally the best candidates for nipple sparing mastectomy have cancers that are small and not adjacent to the nipple. The best candidates also have a good breast shape before mastectomy without significant skin excess or droop.
Does insurance pay for breast reconstruction?
Yes. All insurance providers are required to pay for breast reconstruction including opposite breast surgery as necessary for symmetry. Dr. Yates proudly provides plastic surgery and breast reconstruction service to the Salt Lake City Utah metro area.
What risks are associated with the procedure?
Dr Yates will thoroughly discuss the rare but potential risks at the time of your consultation.
Before & After
Severe Tuberous Breast Deformity Reconstruction, Right Breast Lift only, Left Breast Lift with 325cc Saline Implant Life changing and rewarding! View More.