Breast cancer can take an enormous toll on your life and your body. After diagnosis and treatment, you may be wondering how to move on with your life after such an experience. If you are among the thousands of women who have had a mastectomy as part of treatment for breast cancer, then reconstructive surgery could be the start of getting back to your normal life.
A mastectomy involves the removal of a part of the breast (lumpectomy), one single breast (single or unilateral mastectomy), or removal of both breasts (complete mastectomy). Surgical management of breast tumours aims to remove the malignant tissue from the body to prevent it from spreading.
Types Of Reconstructive Breast Surgery
Breast reconstruction surgery involves rebuilding breast tissue using prosthetics or tissue taken from other parts of the body. The reconstruction is purely aesthetic in most cases and the rebuilt breast tissue is numb.
The types of breast reconstructive surgery are:
- Reconstruction with implants or tissue expander
In this type of breast reconstructive surgery, an implant is used to recreate the shape and size of the breast tissue that was removed.
An implant is placed in a space created under the pectoral or chest muscles. The implant is usually made of silicone, sometimes with an acellular human or animal graft being used as an overlay to improve the function and aesthetic appearance of the implant. Implant reconstructive surgery creates a natural look but the implant can create a stark contrast in shape and movement if it is done only on one side. The implant will not move or age and this can look unnatural in comparison to the normal breast tissue which will change with time.
This type of breast reconstruction is the most common type and can be performed simultaneously with the mastectomy.
- Reconstruction with autologous tissue
Tissue flap reconstructive surgery involves using tissue taken from another part of the body to reconstruct the breast tissue. This tissue is commonly taken from the buttocks, the back, the thighs, or the abdomen. The tissue taken involves skin, fat, and sometimes muscle as well.
This type of reconstruction gives a natural shape and movement, which may be preferable to some women. However, the reconstruction procedure with a flap is longer and more complex. The benefit is that it doesn’t require many follow-up surgeries and the reconstructed breast will age as normal and not create any inconsistency with the natural breast.
Flap reconstructive surgery is often done after treatment for breast cancer is complete.
- Reconstruction with breast tissue preservation
This type of reconstruction is commonly done for women who have undergone a lumpectomy procedure in which the tumour and some healthy breast tissue is removed but the rest of the breast is left intact. The missing tissue is what needs to be replaced or reconstructed.
The missing tissue can be replaced with tissue from another part of the breast. This will reduce the size and volume of the breast so in most cases, the second breast is also reduced to maintain symmetry. Tissue from other parts of the body can also be used to replace the removed breast tissue.
Who Can Get Breast Reconstructive Surgery?
Any woman who has undergone or is yet to undergo a mastectomy is given the option of reconstructive surgery. The reconstructive surgery can be done along with the mastectomy (immediate reconstruction) or after the treatment plan is completed (delayed reconstruction).
The decision between immediate or delayed reconstruction is decided by the condition of the patient, the overall treatment plan, the advice of the doctor, and the patient’s preference. In some cases, delayed reconstruction may be better for the patient and the doctor will inform them if this is the case.
Some women cannot undergo breast reconstructive surgery due to medical complications or if they need further radiation therapy. These factors are best discussed with the cancer care team.
Breast cancer can be devastating but with advances in medicine and surgery, it gets more and more likely that you will live a completely normal life after treatment.