Understanding Breast Reconstruction

When one or both breasts are completely removed during mastectomy or altered by lumpectomy or partial mastectomy, a woman will be faced with the option to not to have additional surgery and leave her chest as is or to undergo reconstruction to restore her breasts. 

Breast reconstruction is a surgery performed to rebuild the breast, restoring its shape and size. The nipple and the areola (dark area around the nipple) can also be reconstructed or even spared. 

Women can opt for immediate reconstruction (at the same time as her mastectomy) or delayed reconstruction (at a later date).  It is important to discuss reconstruction options with at least one breast or plastic surgeon prior to your mastectomy, to explore the opportunity to begin reconstruction at the same time as your mastectomy. Equally as important is discussing cancer treatments you’ve had or will have as it may not be beneficial in some cases to have immediate reconstruction.

Generally, there are four surgical approaches to restore the shape of the breast:
  • Use of an implant (saline which is filled with a substance similar to salt water or silicone which is gel-filled)
  • Use of tissue from another part of your body (abdomen, back, thighs, etc.)
  • Use of an implant and tissue from your own body (combination)
  • Rearrangement of your own breast tissue after a lumpectomy
Click here to review a comprehensive table on different breast reconstruction options and its process, benefits, and considerations. 

Nipple and areola reconstruction is a separate surgery and usually the final step in breast reconstruction.  Tissue from the reconstructed breast, opposite nipple, abdomen, eyelid, groin, inner thigh or buttocks can be used to recreate a nipple. Because reconstructed nipples tend to shrink, they are initially made up to 50% larger than the desired size. Tattooing can give the nipple a natural color and create an areola.  Click here to find a chart that compares different nipple and areola reconstruction methods and some of the pros and cons about each.

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