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Breast Reconstruction Surgery: What Are Your Options?

The decision to get reconstructive surgery after breast cancer is a personal one—here’s what you need to know.

Our relationship with our breasts can be personal, complicated and ever-changing, especially for breast cancer survivors. After a mastectomy or lumpectomy, some survivors may elect to undergo breast reconstructive surgery. This may not be the decision for everyone, but for some, it represents a confidence boost, an attempt to maintain some form of normalcy or a celebration of survival.

No matter where you are in your journey, it’s important to understand your options and speak to your care team about what’s right for you and your body. Plastic surgeon Dr. Andrew Newman performs reconstructive surgeries on many cancer survivors and speaks to us about the most common options.

The Types of Breast Reconstruction Surgery

The goal of breast reconstructive surgery is to restore breasts to a symmetrical size and shape after a mastectomy—the removal of the whole breast(s)—or a lumpectomy—the removal of a portion of the breast.

There are two main types of breast reconstructive surgery: implant-based reconstruction and flap (tissue-based) reconstruction. These surgeries involve multiple procedures, either completed in stages, or done immediately following a mastectomy or lumpectomy. “Patients who wish to delay reconstruction may also choose to pursue these options at a later date,” says Dr. Newman.

Implant-based reconstruction uses breast implants filled with silicone gel or saline to reshape and reform the breast. For flap reconstruction, tissue from another part of the person’s body, usually the lower abdomen, is taken to form a new breast.

Other forms of reconstruction may accompany these procedures. “There are a lot of options out there. For example, after a lumpectomy, you can elect to have a breast augmentation or a breast reduction to the other breast to restore symmetry to the size and shape of both,” says Dr. Newman.

Implant-based vs. Flap Reconstruction

Implant-based reconstruction is the most common type of breast reconstruction. It is less invasive than flap reconstruction, which requires two operations at once in order to use tissue from a separate part of the body before reconstructing the breast. Because of this, recovery time is longer for people who wish to undergo flap reconstruction—about 12 weeks.

While the recovery time for implant-based reconstruction is only half the time—about six weeks—this procedure typically requires at least two surgical operations and several appointments with your plastic surgeon to expand and stretch the skin before your surgery. For some patients, however, there is an option for a single-stage implant reconstruction at the time of mastectomy.

“While flap reconstruction is less common and more invasive, it does have an added benefit over implants—longevity. Although aesthetic revision surgeries are common for both, flap reconstruction doesn’t require any long-term follow-up procedures or maintenance,” says Dr. Newman. “Artificial breast implants don’t last forever. After about 15-20 years, implants should be removed and replaced to avoid rupture. Younger people who get implants are signing up for long-term maintenance and future breast surgery.”

Cancer Recurrence and Possible Risks

After treatment, breast cancer recurrence is possible but uncommon. “Many people who get breast reconstruction surgery after treating their breast cancer are worried about a cancer recurrence,” says Dr. Newman. “It’s important to know that reconstruction does not affect the rate of cancer recurrence, nor does it delay detection of a future recurrence.”

As with any invasive procedure, there are risks with breast reconstruction, including infection, delays in healing, pain or, rarely, problems with transferring tissue to the breast area. Talk with your plastic surgeon to understand the risks and help you decide whether breast reconstruction is right for you, Dr. Newman advises.

[Main photo credit: YakobchukOlena/iStock/Getty Images Plus]

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