Types of breast reconstruction
There are many different ways to reconstruct a breast reconstruction after mastectomy or lumpectomy. Not all surgeons practice all techniques and some options may only suit some people.
Broadly speaking, breast reconstruction can be one of three types:
The method that’s best for you will depend on a number of factors, including whether or not you want immediate results, type of breast deformity, your body type, whether or not you plan on getting pregnant, the characteristics and staging of your cancer, your own preference and the experience of the surgeons. Your healthcare team can talk to you about the options that are best for you.
RECONSTRUCTION USING A BREAST IMPLANT
An implant filled with silicone gel is placed under the skin and muscle that covers your chest to create a breast shape. The initial step in this process is to insert a tissue expander in order to stretch healthy skin to provide coverage for the implant. The tissue-expander is then slowly filled through an internal valve over the course of 4 to 6 months. A second surgical procedure may then be needed to replace the expander if it’s not designed as a permanent implant.
RECONSTRUCTION USING YOUR OWN TISSUE
Known as “flap” procedures, skin, fat and sometimes muscle are taken from another part of your body to make a new breast. This type of operation is more complex than using an implant alone. There are several types of flap procedures:
A TRAM flap, the most common type of flap procedure, uses muscle, fat and skin from your abdomen to reconstruct the breast. The flap may either remain attached to the original blood supply and be tunneled up through the chest wall, or be completely detached, and formed into a breast mound.
A flap can occasionally reconstruct a complete breast mound, but usually it serves to provide the muscle and tissue necessary to cover and support a breast implant.
A COMBINATION OF AN IMPLANT AND YOUR OWN TISSUE
WHICH IS THE MOST SUITABLE FOR ME?
Which type of reconstruction is most suitable for you depends on:
THE TABLE BELOW COMPARES THE BASIC TYPES OF BREAST RECONSTRUCTION.
COMPARED TO NATURAL BREAST
Looks and feels less like a natural breast (silicone implants look and feel more natural than saline implants)
Looks and feels more like a natural breast
LOSS OF SENSATION
Will likely lose some sensation in the breast
Will likely lose some sensation in the breast and tissue donor site
Time in surgery is shorter
Time in surgery is longer
Needed for the first procedure
Follow-up procedures can be on an outpatient basis
Needed for the procedure, with longer stay than with implants
Implants will likely need to be replaced during lifetime.
Flaps won’t need to be replaced during lifetime, but if there are complications, some procedures cannot be repeated.
2 to 3 weeks
3 to 6 weeks
RISK OF COMPLICATIONS
Some risk of surgical complications
Some risk of surgical complications (certain procedures have more risks than others)