As part of breast cancer treatment or prevention, some women may need to undergo a mastectomy. During the procedure, breast tissue is removed to treat or prevent breast cancer. As losing breast tissue can be traumatic, some women opt for breast cancer reconstruction surgery.
Breast reconstruction surgery is a broad umbrella term that refers to a range of procedures that rebuild and reshape the breast to improve its look and feel after a mastectomy. There are varying types of breast reconstruction surgeries, each with their own benefits and drawbacks.
Breast reconstruction surgery can be incredibly rewarding for many, and can have an invaluable impact on your self-esteem. However, breast reconstruction is a major surgery, and one that often follows long, stressful medical procedures that treat cancer. It’s important to give the matter serious thought before undergoing breast reconstruction surgery.
There is no right or wrong answer when it comes whether you should undergo breast reconstruction surgery. Below, we’ll provide you with a brief overview of the procedure to help you decide what’s best for your physical and mental well-being.
The Types Of Breast Reconstruction
There are varying types of breast reconstruction surgery. Which surgery type works for you depends on a variety of factors, from personal preference to your current health to your stage of cancer treatment.
The best way to figure out what type of surgery is right for you is going over your options with an experienced plastic surgeon with a successful track record of performing breast reconstruction. Below, we’ll provide you with a brief overview of surgery types.
Implant Free Reconstruction
Non-implant methods use tissue from your own body to rebuild the breast, eliminating the need for an implant. There are different types of implant free reconstruction.
The TRAM (Transverse Rectus Abdominis Myocuteanous) flap procedure uses tissue from your own body to reconstruct the breast. Tissue is taken from the rectus muscle and lower belly to create a new breast mound.
The Latissimus Dorsi Flap technique harvests tissue from the latissimus muscle, found on your back, to create a new breast mound. This method is typically used for patients who have had radiation therapy but – for a variety of reasons – are not good candidates for breast implants.
The DIEP (Deep inferior epigastric perforator) flap is a free flap, similar to the TRAM flap which preserves the rectus, or abdominal, muscles. It has a similar cosmetic result to a TRAM flap, but tends to have less long term ill effects on the function of your abdominal muscles.
There are numerous other types of autologous reconstructions. The ones listed above are the most common. Ask your surgeon what the best options are for you.
Breast Implants
Both saline and silicone implants are used for breast reconstruction. Saline implants contain sterile salt water, while silicone implants contain gel designed to feel more like natural breast tissue.
As with implant-free reconstruction, you have multiple surgical options if you’re getting breast implants.
Immediate reconstruction, also called direct-to-implant reconstruction, is done at the same time as your mastectomy. After removing breast tissue, your surgeon puts the breast implant in place, either under the skin or muscle. This helps conserve breast skin and shape.
During staged breast reconstruction, the restructuring of the breast begins after your initial surgery. A short term tissue expander – a sac that starts flat and expands over time – is put in place. This stretches the skin to the right size for the permanent implant. The main benefit of staged reconstruction is that it allows time for other cancer treatments to take place between the initial mastectomy and implant placement. If you intend to have a mastectomy without immediate or staged reconstruction, a delayed reconstruction can always be performed at a later date, though sometimes the cosmetic outcome is not quite as good.
What Is Recovery Like?
While you’ll be able to get back to your regular routine within a few months, full recovery from breast reconstruction surgery can be a long process.
Depending on the type of reconstruction, you should be able to leave the hospital anywhere from the same day to several days after surgery. You may need to have drainage tubes put in place, tubes which drain fluid into a small bulb that you empty regularly. Your surgeon will tell you how long drainage tubes need to be in place.
For the first four to six weeks after your surgery, you’ll need to avoid heavy lifting, strenuous sports, and some sexual activities. It may take many weeks for swelling to subside, bruising usually subsides more quickly.
It can take one to two years for tissue to fully settle and for scars to fade. However, you’ll be feeling mostly back to normal within a few months.
Recovery times can vary greatly depending on your health, your surgery type, and other factors. It’s vital to follow all aftercare instructions closely and ask your surgeon any questions you have about the recovery process.
How Do I Decide If Breast Reconstruction Is Right For Me?
Breast reconstruction is a major surgery, so you should give the matter serious consideration. While many women who’ve lost breast tissue due to cancer find reconstructive surgery rewarding, it can be a taxing experience physically and emotionally. Breast reconstruction is not right for everyone.
There are many pros of breast reconstruction surgery. Many find reconstruction raises their self-esteem and self-image and makes their body look more like it did prior to cancer. It can be an invaluable way to feel like you’re getting back to normal after a long, difficult illness.
Contrary to popular belief, there is no evidence undergoing breast reconstruction surgery makes your breast cancer more likely to return. Nor does it make breast cancer recurrences harder to detect during a medical exam.
There are also cons of breast cancer surgery. As with any medical procedure, it comes with the risk of complications. Immediately after the surgery, you may experience bleeding, blood clots, or fluid build-up and in some instances infection or loss of tissue. Over a few months or years, you may experience uneven breasts, or loss of muscle strength in the donor site.
Keep in mind having a complication does not indicate a failed surgery. Many common complications of breast reconstruction surgery can be successfully fixed with follow up surgery. However, many women do not want to undergo further surgeries, especially after already enduring cancer treatment.
The decision to undergo breast reconstruction should not be made lightly. Many women find it helpful to talk to someone who has already undergone the procedure about the experience. There are plenty of support groups you can find, including online groups, where you can ask questions and share your feelings about potentially undergoing breast reconstruction surgery.
Is Breast Reconstruction Surgery Covered By Insurance?
Yes. All major insurance providers cover breast reconstruction surgery after cancer treatment. It is also covered by Medicare. Medicaid coverage varies from state to state. In fact, the insurance coverage of breast reconstruction surgery after a breast cancer diagnosis is protected by a law.
The Bottom Line
If you’re considering breast reconstruction surgery, give the matter serious consideration. There is no right or wrong choice. While many women find the experience to be incredibly rewarding, some women opt to forgo reconstruction for a variety of reasons. Take some time to seriously weigh the pros and cons of surgery, and talk over your options with your doctor.
If you do decide to undergo breast reconstruction surgery, know that it’s very safe and most women are happy with their final results. If you work with a reputable surgeon and follow aftercare instructions closely, your recovery should be free of serious complications and leave you enjoying your reconstructed breasts.
Ready to get started? Leif Rogers is an Ivy League-educated, board-certified plastic surgeon and a standing member of the American Society of Plastic Surgeons. If you’re considering breast reconstruction surgery, get in touch with his team to schedule a consultation.
