Being diagnosed with breast cancer is a difficult time for anyone. It’s normal to be concerned about what the future holds - many patients find the time after a breast cancer diagnosis to be a challenging period of transition and adjustment. While it can feel overwhelming, understanding your options for treatment can help prevent the anxiety and fear of the unknown. In discussing your treatment options with your doctor, you may have, or are about to consider having a mastectomy or lumpectomy (i.e., the entire or partial removal of breast tissue). Breast reconstruction surgery is common after cancer tissue has been removed and can take place during, or soon after this surgery.
Deciding whether or not to have breast reconstruction surgery is a personal choice. It can allow you to feel comfortable in clothing and restore your sense of body image. In addition to restoring self- image the goal of breast reconstruction is ultimately to recreate the breast and to achieve symmetry. While a reconstructed breast will not be identical to your original breast and restore full sensation to that area, medical advances to date provide an expansive range of options for women facing the loss of one or both breasts.
To that effect, should you decide to go through with this type of surgery there are two main techniques for breast reconstruction; Flap Surgery which uses tissue from another area of the body and Implant Surgery that uses a carefully chosen implant.
Flap surgery (also referred to as Autologous surgery) involves using tissue from another area of your body such as your abdomen, thigh, back or buttock to form a reconstructed breast, which is then stitched into place. The ultimate source of the tissue is dependent on factors such as your body type, how much tissue is available, breast size and whether you plan on becoming pregnant in the future. There are various flap procedure options including: Deep Inferior Epigastric Artery Perforator Flap (“DIEP”), Lattissismus Dorsi Flap; Superior Gluteal Artery Perforator Flap (“SGAP”) and Transverse Upper Gracilis Flap (“TUG”). These can be illustrated by tissue source as follows:
Implant surgery creates a breast that is round and involves inserting an implant filled with salt water (saline) or silicone. Breast implant reconstruction surgery can be performed in one or two stages. One-stage implant reconstruction is performed immediately after your mastectomy. Two-stage implant reconstruction involves using a temporary tissue expander causing the surrounding tissue to stretch to the desired size. After a couple of months, the tissue expander is replaced with a permanent breast implant.
Patients often come into our office unsure of which technique is best for them. Of course, there are considerations for both techniques and it’s a matter of the individual circumstances. In consultation with your surgeon, you may ultimately choose one technique over the other if:
Whichever option you end up choosing – implant surgery or flap surgery- it’s important to make this decision in consultation with your surgeon. Establishing open channels of communication is of the upmost importance to the success of your recovery and satisfaction of the final surgical outcome.