What Are Your Options for Breast Reconstruction?

The American Society of Plastic Surgeons recent Plastic Surgery Statistics report showed that 109,256 reconstructive breast procedures were performed in 2016. Breast reconstruction is common following a mastectomy, or surgical removal of one or both breasts. Sometimes a mastectomy is indicated to treat cancer or to prevent cancer if you have specific genes that place you at high risk for cancer. A common question we hear from women is – what are my options for breast reconstruction?

While your breast cancer surgeon will treat your cancer, it is your plastic surgeon who will reconstruct your breast. Breast reconstruction might seem complicated at first, but your options are quite straightforward. Below we discuss two options for breast reconstruction – using a breast implant or using a flap.

Implant-based breast reconstruction

Implant-based breast reconstruction takes place in a minimum of two stages, or two surgeries. The first surgery is performed immediately after your mastectomy while you are still under anesthesia. Your plastic surgeon will place a tissue expander to stretch your skin and soft tissues to make space for a breast implant. At Tannan Plastic Surgery, we offer pre-pectoral reconstruction (above the muscle) or sub-muscular reconstruction (below the muscle). These types of details are important to discuss with your plastic surgeon in person.

Over three to six months, I add saline to your inflatable breast tissue expander in the office until your body is ready for the final breast implant. That is the second surgery – where I remove the expander and put your breast implant in place. Following that, fat grafting, nipple reconstruction or nipple tattooing are future options you might consider for your breast. We go over these approaches during the consultation to help you make the best decision.

Flap-based breast reconstruction

Flap-based breast reconstruction also involves stages, but the first stage is a lengthy one. I take your own tissue from somewhere in your body and transplant it to a new location to create your new breast. Flap-based reconstruction can be done with a breast implant if the amount of tissue is insufficient to create a proportional breast. That is typically the case if I use your latissimus muscle and skin as the source, or donor tissue.

Another option, the DIEP flap, takes the tissue from below your belly button along with its attached blood vessel. I then re-connect those blood vessels under your rib to the vessels in your chest. The tissue that was once on your belly is now your new breast. Once again, you might consider fat grafting, nipple reconstruction or nipple tattooing as future options.

Evaluating your options for breast reconstruction

A quick recap on your options for breast reconstruction. One approach is to place a breast implant to create the shape of a breast. Another approach is to take tissue from your back or belly to create the breast. The specifics of each operation are important to discuss in person. Your board certified plastic surgeon will help you make an informed decision that’s right for you and your body.

Breast reconstruction is a process that takes time. Choosing your plastic surgeon and evaluating options for breast reconstruction are key parts to a successful journey. I am here to help!