Breast Reconstruction Surgery

Breast Reconstruction Surgery

Breast Reconstruction Surgery
Women who have aggressive forms of breast cancer, or who are at high risk of developing the disease, sometimes choose to have a mastectomy, the surgical removal of one or both breasts. Some patients may then choose to have surgery to reconstruct their breasts to restore their form and shape. During this procedure, doctors can replace any skin, breast tissue or a nipple that they may have removed during the surgery. (If you still need radiation therapy after your mastectomy, your doctor may suggest you wait for reconstructive surgery until after you finish treatment.) Breast implants, filled with either silicone or saline, can be used to reshape your breast, or you can even use your own tissue, a procedure called flap surgery. Both breast implants and flap surgery are complex procedures, each with their own risks; they may require second surgeries to position the breasts correctly. Most insurance companies will cover this type of reconstructive surgery. Learn more about breast reconstruction with expert advice from Sharecare.

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  • 4 Answers
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    A Plastic Surgery, answered on behalf of

    Staged breast reconstruction rebuilds the breast in several stages to avoid complications. Doctors often advise women who need radiation therapy following mastectomy to have staged breast reconstruction, instead of simultaneous reconstruction. When a newly reconstructed breast is exposed to radiation, it can result in altering its cosmetic appearance, making the implant hard, painful, deformed, contracted, or even exposed. It may also cause severe fibrosis or shrinkage of the fatty tissue used to rebuild the breast. In this procedure, your surgeon will insert a tissue expander after mastectomy to keep the breast skin stretched and supple. A few months after you complete radiation therapy, your surgeon will complete the final reconstruction.

    For this reconstruction, your surgeon will place a temporary tissue expander at the time of mastectomy. The expander gradually stretches the muscle and skin in preparation for either an implant or flap reconstruction.

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    A , Plastic Surgery, answered
    During delayed prosthetic breast reconstruction, a tissue expander or a permanent implant may be placed carefully under the breast flap. Most often, after total mastectomy, expansion is required with the use of a tissue expander. The expansion continues for several months on a weekly basis. Fluid is placed into the port each week. On a separted surgical setting, the expander and port are then removed and a permanent prosthesis (silicone gel implant) is exchanged. Candidates for this delayed procedure may include women undergoing chemotherapy, radiation therapy, tamoxifen, or psychological desire to wait. 
  • 8 Answers
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    A Plastic Surgery, answered on behalf of

    Federal and state laws require insurance companies to pay for all or part of the cost of breast reconstruction at any time after removal a patient's breast tissue. This includes any surgery required on the opposite breast for symmetry.

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    A , Plastic Surgery, answered
    The 2 most common complications of any surgery are Bleeding and Infection. This is also true for breast reconstruction surgery. Other complications may include hematoma, seroma, wound dehiscence, necrosis of tissue or the nipple-areolar complex, deep venous thrombus, pulmonary embolus, asymmetry, requirement for secondary surgery.
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    Reconstructive surgery

    After having a mastectomy (or some breast-conserving surgeries), a woman may want to consider having the breast mound rebuilt; this is called breast reconstruction. These procedures are not done to treat cancer but to restore the breast's appearance after surgery. If you are going to have breast surgery and are thinking about having reconstruction, it is important to consult with a plastic surgeon who is an expert in breast reconstruction before your surgery.

    Decisions about the type of reconstruction and when it will be done depend on each woman's medical situation and personal preferences. You may have a choice between having your breast reconstructed at the same time as the mastectomy (immediate reconstruction) or at a later time (delayed reconstruction). There are several types of reconstructive surgery. Some use saline (salt water) or silicone implants, while others use tissues from other parts of your body (autologous tissue reconstruction).

    For a discussion of the different reconstruction options, see the American Cancer Society document, Breast Reconstruction After Mastectomy, available on www.cancer.org or by calling 1-800-227-2345. You may also find it helpful to talk with a woman who has had the type of reconstruction you might be considering. The American Cancer Society's Reach to Recovery volunteers can help you with this.  Call 1-800-227-2345 to find a program near you.
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  • 2 Answers
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    A Plastic Surgery, answered on behalf of

    Many women, following cancer treatment, would like to recreate the feeling of having breasts. By delaying reconstruction you may not feel whole without your breast or breasts. The delay also extends the total time it takes to complete your breast cancer treatment process.

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    A , Plastic Surgery, answered

    Breast reconstruction may be performed by two specific methods: tissue expander/implants or autologous tissue transfer. The most common method involves the use of a tissue expander under the pectoralis muscle immediately after the mastectomy. After several months of weekly serial tissue expansion, the expander is removed and replaced with a permanent silicone gel implant. The other most common method uses direct tissue from the body as either a pedicled flap or a free flap to recreate the breast. The two most common tissue flaps include the Latissimus Dorsi flap (back muscle and tissue) and the TRAM flap (lower abdominal tissue transfer). 

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    A , Plastic Surgery, answered

    Breast reconstruction after a mastectomy is usually performed in 2 stages. The first stage can be performed concurrently with the general surgeon performing the lumpectomy or mastectomy. It consists of placement of a tissue expander under the muscle on top of the chest wall. This expander will be filled with saline every week, thereby increase the space under the skin to place a final prosthesis. After about 3-4 months, a permanent silicone gel implant is placed under general anesthesia. Drainage tubes may be placed if necessary. 

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    A , Plastic Surgery, answered

    After undergoing a mastectomy for breast cancer, many women decide to undergo reconstruction either immediate or at a later date. To create symmetry, either a tissue expander and later a permanent silicone gel implant, or an autologous tissue transfer may be performed. The risks of the reconstruction include: bleeding, hematoma, infections, flap necrosis, need for revision surgery, pulmonary embolus, pain, and severe scarring. Scarring is Unpredictable and can include: hypertrophic, keloids, widespread, hyper or hypopigmented scars. Future complications of the implant may include: rupture, calcification, capsular contracture, malposition, bottoming out, and need for re-operation. 

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    A Plastic Surgery, answered on behalf of

    When to have breast reconstruction has to do with many different issues. Some women choose to delay breast reconstruction. This option allows enough time to make sure all of the cancer has been treated before reconstructing the breast. Some women may opt for delayed reconstruction if a plastic surgeon was not involved after her mastectomy. Other women aren't comfortable weighing all of their options at once when they are struggling with a diagnosis of cancer. Some women need time to come to terms with losing their breasts. Women who are smokers, overweight or have high blood pressure may be advised to wait.

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