What is breast reconstructive surgery?
Breast reconstruction is a surgical procedure performed to recreate the shape and appearance of a woman's breast following a mastectomy. At Penn, we believe that restoration of the breast following mastectomy is an integral part of the holistic treatment of breast cancer.
The procedure can also be used to help women with congenital conditions and those injured in accidents or other trauma.
Options for Breast Reconstruction
Breast reconstruction techniques vary greatly to meet the unique needs and goals of each woman. Some procedures use breast implants, others use autologous tissue transfer, or fat grafting, and some procedures use a combination of both.
These decisions are made on a case-by-case basis based on the particular circumstances involved. Our surgeons guide each woman through the process of breast reconstruction with the goal of restoring self-image, self-confidence and quality of life.
Breast Reconstruction with Implants
Implant reconstruction is the surgical placement of breast implants to reconstruct the breast size and shape. Clinically referred to as mammoplasty, the procedure is often used as part of breast reconstruction surgery following a mastectomy.
Breast implants come in a variety of shapes and sizes to create a natural-looking result. There are two types of implants:
- Saline-filled implants
- Silicone-filled implants
- Saline-filled implants contain silicone shells filled with saline. Silicone-filled implants are silicone shells filled with silicone. The implant your plastic surgeon recommends will depend on your anatomy and desired results.
Autologous Breast Reconstruction
In contrast to implants, autologous tissue reconstruction methods require the transplantation of living skin, fat and some muscle from a different part of the body to replace the breast tissue removed in the mastectomy. Once successfully transplanted, the tissue can be sculpted to create optimal shape and size fully restoring breast symmetry.
The benefits of this method of reconstruction include:
- The tissue is from the patient's body so the reconstructed breast is not a foreign material.
- The results are long lasting. Implants may leak and require replacement whereas the transplanted tissue will last a lifetime.
- If the autologous method is the selected option for reconstructive surgery, then the next choice is to decide where on the body to obtain the necessary tissue. There are five several areas that can be used but typically the tissue is transferred from the back or the abdomen.
Each alternative should be discussed with your surgeon and the most appropriate method should be selected to meet your specific requirements and personal preferences.
Timing of Breast Reconstruction
The timing of breast reconstruction is another important factor to consider. Breast reconstruction surgery can be performed either at the time of mastectomy or at some point after the initial mastectomy is completed.
Regardless of the timing or type, breast reconstruction improves the patient's quality of life by restoring a sense of self and body image.
Nipple-Areolar Complex Reconstruction
After breast reconstruction, many women choose to have nipple reconstruction, including nipple tattooing. Nipple tattooing, or micropigmentation, re-pigments the area to make it look more realistic.
Nipple tattooing is performed by a micropigmentation specialist in plastic surgery at Penn Medicine who is board certified by the American Academy of Micropigmentation and a member of the Society of Permanent Cosmetics.
Watch the following video to learn more about the process and see what it looks like.
Who is a good candidate for breast reconstruction?
Many women consult with a reconstructive plastic surgeon soon after being diagnosed with breast cancer. This allows the surgeon to be an integral part of the cancer treatment team.
However, if you had a mastectomy without reconstructive surgery, it may still be possible to restore a more natural appearance. Our surgeons will help you determine the best options for you.
What to Expect with Breast Reconstructive Surgery
Preparing for Breast Reconstruction
Following all pre-operative instructions and adhering to a healthy diet are important steps to take before surgery.
Because the effects are unique, the results of breast reconstruction are not uniform. Preparing emotionally for the possibility that several surgeries may be necessary is a helpful step toward reaching desired goals.
Recovery After Breast Reconstruction
You can expect to stay in the hospital for four to five days after breast reconstruction surgery.
Women who have received breast implants most often experience discomfort for about a week, and two or three days of tenderness.
In the case of autologous tissue transfer, discomfort around the breasts and from the area where the tissue was removed last for approximately two to three weeks.
Learn about our Breast Reconstruction Awareness (BRA) Day event
Risks and Outcomes of Breast Reconstruction
Every type of surgery has risks. You can help prevent complications by carefully following all pre- and post-surgery instructions. Our plastic surgeons will review all the potential risks and side effects with you.