Breast reconstruction encompasses several different types of procedures that attempts to rebuild a breast's shape after a mastectomy. The specific type of reconstruction will depend on factors such as your age and body type. While it cannot give a woman back her breast – a reconstructed breast may not have normal sensations – the procedure does offer a result that looks like a normal breast.
Breast reconstruction typically involves several procedures performed in stages, and can either begin at the time of mastectomy or be delayed until a later date. In all of these procedures, the plastic surgeon forms and positions a breast mound using an implant or natural body tissue. And while the main focus is to add volume and size to the reconstructed breast, other procedures such as nipple addition, changing the size/shape of the new breast, and enhancing the opposite breast to match size are common as well. For example, you may elect to have a breast lift, breast reduction or breast augmentation on the other breast to achieve breast symmetry.
Breast reconstruction after a mastectomy may be a good option for you if:
Although most women qualify as breast reconstruction patients, there are several factors that may disqualify you. Our highly trained and sensitive plastic surgeons will discuss this with you at the time of your consultation.
One of the first decisions a patient must make is what type of reconstruction procedure she will choose – and when. The breast reconstruction process can start at the time of your mastectomy or it can be done as a delayed procedure.
Reconstruction generally falls into two categories: implant-based or autologous flap procedures (using a patient’s own tissue). Factors to consider include the type of mastectomy, cancer treatments and your body type.
Some women are opting for surgeries that remove the breast tissue but not the skin, nipple, and areola. An advantage of this procedure is that this procedure maintains your natural nipple and areola and minimizes the number of procedures that you will undergo. A disadvantage of nipple-sparing mastectomy is that the nipple and areola lose sensation.
Nipple-sparing mastectomy may be available for patients whose tumor is small and positioned away from the nipple. It may also be an option for patients undergoing preventive mastectomy or patients with ductal carcinoma in situ (a very early stage of cancer).
Nipple-sparing mastectomy is often performed when breast removal and reconstruction are completed during the same operation. If an axillary dissection or a sentinel lymph node biopsy is necessary, another incision is usually made in the armpit area.
Having a nipple and areola tattooed onto your reconstructive breast is a simple and fast procedure that can be done in your plastic surgeon's office. Your surgeon will either match a new nipple to the one on your un-reconstructed breast, or if you had bilateral reconstructions, your surgeon can use your preoperative photos to recreate the nipple color, or you can pick a new color that you like against your skin tones.
Breast reconstruction following cancer surgery is usually covered by health insurance policies. The Women's Health and Cancer Rights Act (WHCRA) includes protections for individuals who elect breast reconstruction in connection with a mastectomy. WHCRA provides that group health plans and health insurance issuers that provide coverage for medical and surgical benefits with respect to mastectomies must also cover certain post-mastectomy benefits, including reconstructive surgery and the treatment of complications (such as lymphedema).
It is always good to check with your individual health insurance carrier for definitive information regarding your coverage.
If you have further questions, or would like to schedule a breast reconstruction consult, please contact us.
Dr. Matthew Carty describes breast reconstruction techniques known as flaps which take tissue from one part of the body and move them to the chest to reconstruct a patient’s breast.
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