Breast reconstruction

Mastectomy is more than just the loss of a breast for most women. This fearful event may negatively affect self-esteem, identity, and feelings of femininity. Breast reconstruction replaces the lost breast. It improves appearance and renews self-confidence.

New techniques have made it possible for surgeons to create a breast that comes very close to matching the natural breast in form and appearance. Sometimes reconstruction is done immediately following a breast removal. When a woman wakes up, she already has a breast mound in place. This spares her the emotional experience of seeing herself with no breast at all.

Some women want to wait. They do not feel comfortable weighing all the surgical options while they are worrying about coping with cancer. Others just do not want to have any more surgery. Some surgeons will advise their patients to wait, especially if the breast area needs to have the skin stretched to build a mound with a flap of skin. Women who have a history of high blood pressure, who smoke, or who are obese may also be advised to wait because of the amount of surgery that is required.

The type of reconstruction is based on the amount of breast tissue that is removed. It also depends on what you and your surgeon decide. The most common approaches used are skin expansion, implants, and flap reconstruction.

After removing cancerous breast tissue, a balloon expander may be inserted beneath the skin and chest muscle. For several weeks or months, saline is injected into the tissue expander. This process slowly stretches the skin covering the implant. The expander may be replaced by an implant in a second operation. Some expanders are designed to be left in place and used as the final implant.

Flap reconstruction is performed when more skin is needed to cover the chest wall or an implant. A skin flap is created using tissue taken from other parts of the body, such as the back, stomach, or buttocks. The flap makes a pocket for an implant or a breast mound itself.

Breast reconstruction surgery is done in a hospital. The surgery may take up to 7 hours and requires a 2 to 5 day stay. Stitches are removed within a week to 10 days. Reconstructing the nipple and the dark skin surrounding it may require an additional operation. Follow-up procedures may be performed in a hospital or outpatient facility.

Feeling tired and sore for up to 2 weeks after surgery is common, but recovery can last as long as 6 weeks. Light activity can be performed within a few days. Overhead lifting, strenuous sports, and sexual activity are discouraged for 3 to 6 weeks. Scarring is permanent, but in time, the scars are less noticeable as they flatten and lighten in color. Reconstruction cannot restore the normal sensation to the breast, but sometimes some sensation does return.

Breast reconstruction does, however, dramatically improve breast appearance and the quality of life following surgery. Breast Reconstruction surgery options and techniques should be discussed with a board certified plastic surgeon to determine the best procedure for you. It is important that you have realistic expectations and clearly understand what the procedure can do for you. This surgery is often covered by health insurance. Call your health plan to find out about your benefits.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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