A breast cancer diagnosis is devastating. It changes your life and forces you to make critical decisions quickly. If your surgeon recommends mastectomy, you will have options when it comes to breast reconstruction. In fact, the breast reconstruction process usually begins in conjunction with mastectomy.
While many women prefer a lumpectomy rather than a mastectomy, that is not feasible for many patients. Women with tumors exceeding four centimeters are not candidates for lumpectomy. Neither are those who do not have clear margins around the tumor. That means no cancer cells were found in the tissues around the tumor.
Breast reconstruction aims to restore the breasts to as close to a “normal” appearance as possible. A woman who has breast cancer or whose breasts are deformed may benefit from reconstruction.
Losing a breast affects a woman emotionally as well as physically. Breast reconstruction can help restore a woman’s confidence and self-esteem.
If she opts for breast reconstruction surgery beginning at the same time as mastectomy, there is never an empty space where the breast used to be. Many women find that comforting.
Women have two basic choices when it comes to breast reconstruction: breast implants or flaps.
If a woman chooses implants, the reconstruction can start during the mastectomy, with the plastic surgeon working alongside the surgical oncologist. She may also opt to begin reconstruction at a later date. In fact, she can undergo breast reconstruction years after the mastectomy.
After the surgical oncologist removes the breast, the plastic surgeon inserts a tissue expander either in front of or behind the pectoral muscle. Some plastic surgeons place implants at this point, but that is the exception rather than the rule. An expander is used initially for most breast implant reconstructions.
Over the next several months, the patient visits the plastic surgeon’s office regularly so that the doctor can fill the expander with more saline. The doctor installs a small valve beneath the skin into which saline is added via a needle.
The patient decides beforehand just how large her new breasts will become. Many women opt for somewhat larger breasts than their original. In a single mastectomy, the remaining breast also receives an implant and lift, so it is the same size and shape as the new breast.
Once the expansion goal is reached, another surgery is performed to take out the expander and put in the implant. The patient chooses whether she wants a saline or silicone implant ahead of time.
Implants will eventually need replacement. Implants can collapse or leak if they suffer damage. Even if under perfect conditions, surgeons recommend replacing implants every ten to 15 years.
Keep in mind that even the most skilled plastic surgeon cannot construct a new breast that looks exactly like the other breast. Women undergoing double mastectomies can have matching reconstructed breasts.
Flap reconstruction uses tissue from other parts of the woman’s body to create the reconstructed breast. The tissue is generally removed from the abdomen, back, or buttocks to form the new breast.
When abdominal tissue is removed to make the flap, the patient receives a tummy tuck. However, if the tissue is removed from the back, an implant may still prove necessary. Much will depend on the individual patient, and her build.
On the plus side, a flap reconstruction looks more natural. This is because the patient’s own skin is used. Recovery from a flap reconstruction is harder and takes longer, but some women may feel the results are worth it.
Flap surgery is permanent. There is no implant needing eventual replacement.
If a woman wants to become pregnant, she is more limited in her flap reconstruction choices. The expanding abdomen during pregnancy may overstress some abdominal incisions.
A woman must also make a decision regarding her nipples. Some women may decide not to undergo nipple reconstruction. The patient has time to think about it, as nipple reconstruction only occurs after the breast has healed.
Options include medically tattooing the nipple on or reconstructing the nipple from skin removed from another part of the body, typically the inner thigh. The plastic surgeon can form skin elevations resembling the nipple and areola by making minute incisions.
Whether you have just received a breast cancer diagnosis or have been a survivor for many years, schedule a consultation with board-certified New Jersey plastic surgeon Dr. Alexis Parcells in Eatontown, to discuss your breast reconstruction options. She will answer your questions so you can make an informed decision regarding a breast reconstruction procedure.
Parcells Plastic Surgery offers the most advanced surgical and cosmetic medical spa treatments to women in New Jersey.
Board-certified plastic surgeon Dr. Alexis Parcells is here to educate and empower you to celebrate your natural beauty.4 Industrial Way West #101, Eatontown, New Jersey 07724