If you need to have a mastectomy, it is likely that breast reconstruction will be a subject of discussion.
Breast reconstruction is a term describing surgical procedures used to rebuild the shape of your lost breast. This would help you to regain symmetry when wearing a bra, for instance, and can be an important part of the healing process.
Alternatively, symmetry can be gained by the use of padded bras and specially developed swimsuits.
| There are two main types of reconstruction available: 1. Saline breast implants
2. Muscle flap reconstruction |
Which one, if either, is more appropriate for you will depend on a number of factors such as your overall health, anatomy, associated risk, and your personal goals for the outcome of the procedure.
Be sure you have all the relevant information you need to be able to participate in the decision of what is right for you.
| Questions you may like to ask your cancer treatment team are: - Am I a candidate for breast reconstruction?
- Would having a breast reconstruction interfere with my cancer treatment?
- What type of breast reconstruction would you recommend and why?
- What kind of results am I likely to get from the procedure?
- How would the procedure be done?
- How long would an implant last?
- What changes could I expect over time in the reconstructed tissue as I get older?
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It may help to talk to someone who has had a similar reconstruction they will be able to give you personal experience of the procedure and what the reconstruction feels like to touch, etc.
Saline breast implants
First, a tissue expander is placed between your skin and chest muscle. This is similar to a balloon and will be gradually filled with salt water over a few weeks, allowing the tissue over the expander to grow and enlarge to replace the breast skin previously removed.
Once the breast has been sufficiently stretched, a permanent implant may be inserted - or the initial expander may be the final implant.
Complications
The most common complication with implants is a condition called capscular contracture. This is where the scar or the capsule around the implant begins to tighten and squeeze down on it, causing the breast to feel hard. This can be treated with additional surgery to remove the scar tissue.
Muscle flap reconstruction
This procedure uses some of your own tissue from your back, stomach, or buttocks to rebuild the contour of the breast.
Tissues from the abdomen include skin, fat, and muscle tissue to help recreate the contour of your breast. Tissue taken from the back does not have as much fat and sometimes an implant is also used to improve the final breast shape. Whilst there are more scars than with implant surgery, some think that the end result is more natural.
As blood vessels are involved in this procedure, women who smoke and/or suffer from diabetes, vascular, or connective tissue disease cannot have this type of surgery.
Nipple reconstruction
Because many cancers involve the nipple/areola complex it is likely that the nipple will be removed during a mastectomy. Once the breast area has had time to heal from surgery and reconstruction, this area too can be reconstructed using a combination of surgery and tattooing.
Mastectomy and immediate breast reconstruction
It is increasingly likely that you may be offered the option of breast reconstruction at the same time as your mastectomy. This has advantages and disadvantages (listed below) and is something you should discuss with your family and cancer treatment team.
| Advantages - You dont wake up to the shock of losing a breast
- You avoid additional surgery
- Your mastectomy surgeon and your plastic surgeon can plan the operation together
Disadvantages - It can be emotionally difficult to weigh all your options when dealing with treatment and diagnosis alternatives
- If your cancer is found to be more advanced than previously thought, it may interfere with treatment options for the future
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02/06/2009