Although the desire for breast reconstruction can arise from many situations, such as congenital breast issues, the vast majority of women seeking breast reconstruction have been given a diagnosis of breast cancer. The diagnosis of breast cancer represents an incredibly difficult time in a woman’s life as well as her family’s. Breast cancer can occur in males but with less frequency. Considering breast reconstruction during this volatile period takes time, understanding and a gentle approach. We strive to make the acquisition of information and choices as easy as possible thru multiple visits and open communication.
The options for reconstruction depend on the nature of the surgery required to treat the breast cancer, your individual anatomy and any additional therapy to that may be required following surgery. Ultimately the new breast will be completely covered by your own skin. The volume however can come from several places and/or choices. The volume can be replaced with your own tissue by complete surgical removal from one location and reattached in the region of the breast to be rebuilt (DIEP flap). Alternatively your breast can be rebuilt with your own tissue by direct movement maintaining the connections from one location to the next (TRAM flap). Each of these two examples have their own risks and benefits.
The volume can also be replaced with an implant (saline or silicone). A tissue expander is a temporary implant that is placed in surgery and filled with saline to a safe volume. Subsequent increases in volume are done in the office This technique requires a subsequent operation to change the temporary tissue expander to a permanent implant. Depending on many factors, a permanent implant may be able to be placed as a single stage.
Breast reconstruction is a process. The number of operations or procedures varies based on your own tissue available for reconstruction and other treatment requirements (chemotherapy, radiation, hormonal therapy). Reconstruction can be done at the same time as your primary surgery to remove the breast cancer, or can be delayed. Some choose to delay reconstruction until a later date for many reasons. Any and all procedures are covered by insurance, regardless of timing (immediate vs delayed). The process can be individualized and may require a more complex coordination between your treating physicians.
Your team of doctors, nurses and support staff all have the same goal in mind, your wellbeing and success through this difficult time. Although an immediate reconstruction can have provide significant emotional assistance with processing the changes to your body, the reconstruction can not interfere with the treatment of the breast cancer. You will be given all the information you and your loved ones need to decide if reconstruction is right for you and the options available.