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Overview

Breast reconstruction is a complex procedure performed by a plastic surgeon to rebuild the shape of a woman's breast after breast cancer surgery, such as a mastectomy. The goal of reconstruction is to restore a woman’s self-confidence by improving the contour, symmetry, and natural appearance of one or both breasts.

In many cases, breast reconstruction involves a series of surgeries, rather than a single procedure. The first surgery creates the breast mound and can be done at the same time as a mastectomy or later on. Follow-up procedures ensure that the size, shape, and appearance of the breasts align with the patient’s preferences.

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Two Types of Breast Reconstruction Surgery

Breasts can be rebuilt using implants or your body's own tissues.

Implant-based Reconstruction 
Implant-based reconstruction is done at the same time as, or following a mastectomy. The procedure involves surgically implanting a prosthesis consisting of a gel- or fluid-like substance over (not under) the pectoral muscle. This approach is less painful than traditional methods.

Autologous Breast Reconstruction 
Autologous breast reconstruction, also referred to as “flap” surgery, uses skin, fat, and sometimes muscle from another place on the body to build the breast. There are numerous varieties of autologous breast reconstruction, all of which are dictated by where on your body the extra tissue comes from.

Causes & Risk Factors

Women choose to have breast reconstruction for a variety of personal and medical reasons. The most common medical causes are related to cancer:

BRCA Gene
Inherited mutations in certain genes may increase your likelihood of breast cancer. If you've tested positive for mutations (changes) in the BRCA1 or BRCA2 genes, it can indicate a higher risk of getting breast cancer in your lifetime. Some women (and men) at a higher genetic risk will undergo a preventative mastectomy to reduce their risk of developing breast cancer later.

Breast Cancer 
Breast cancer surgery is the primary treatment option for patients with a breast cancer diagnosis. If cancer has not spread to other body parts, a breast cancer treatment that includes surgery can be 90% effective or higher. Mastectomy and lumpectomy are the two types of surgery used to treat breast cancer.

Mastectomy
Mastectomy is the most common breast cancer surgery. The procedure involves the complete removal of a breast. A mastectomy treats both early- and late-stage cancer and can be used as a preventative measure for patients with a high future risk of developing breast cancer.

Lumpectomy
Lumpectomy is known as breast-conserving surgery. Unlike a mastectomy, a lumpectomy removes only the tumor and a portion of your surrounding breast tissue. Lumpectomy surgery is usually paired with radiation therapy to treat early-stage breast cancer when a small tumor is present that has yet to spread. Lumpectomy surgery can preserve breast tissue and sensation compared to complete breast removal.

Oncoplastic Reconstruction
Oncoplastic reconstruction combines the removal of cancerous tissue with plastic surgery techniques for patients undergoing breast cancer surgery. The goal is to remove the cancerous tissue while preserving as much healthy breast tissue as possible, providing a better cosmetic outcome compared to traditional breast-conserving surgery or mastectomy alone.

Choosing a Procedure

Women have more options than ever when selecting a procedure for breast reconstruction, each with its own risks and benefits. Our plastic surgeons work closely with patients to determine the best approach. Recommendations are often based on the patient’s:

  • Type of cancer, including stage and location.
  • Body type
  • Medical History
  • Personal preferences

Breast Reconstruction Procedures

Breast implants are the most common approach to breast reconstruction, and involve replacing one or both breasts with a prosthesis filled with saline, or silicone to mimic the look and feel of a natural breast. This type of reconstructive surgery often requires a procedure called a tissue expansion to help the skin and muscle stretch over the implant. 

Flap surgical procedures are more complex than breast implants, but often result in a more natural look and feel. Because this procedure uses body tissue rather than synthetic materials, the breasts tend to age as they would normally. However, eligibility for flap surgeries depends on patients having enough skin and tissue to donate.

Our surgical team is highly trained and experienced in performing the most advanced breast reconstruction surgery, including:

  • Tissue expansion/implant based
  • Pedicled TRAM flap
  • Latissimus flap
  • Free TRAM flap
  • DIEP flap
  • Non-abdominal free flap
  • Nipple/areola reconstruction
  • Nipple/areola sparing mastectomy

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