If you are having surgery for breast cancer and some other types of cancer, such as cancer of the jaw, you may require or choose reconstructive surgery to restore appearance. Reconstructive surgery is not cosmetic surgery done to improve your looks, but surgery designed to rebuild or restore to normal a body part damaged by cancer treatment.
Breast reconstructive surgery is commonly performed after a mastectomy, or removal of the entire breast. The operation rebuilds the breast to about the same size and shape it was before the mastectomy. Women who have had a lumpectomy, or removal of a cancerous lump in the breast, do not typically undergo reconstructive surgery.
The surgery is performed by a plastic surgeon experienced in breast reconstruction. If you think you will choose reconstructive surgery after a mastectomy, it’s wise to discuss your choice with your cancer surgeon and a plastic surgeon before the mastectomy so they can properly plan your treatment, even if you are not having reconstructive surgery right away.
You may choose breast reconstruction for a variety of reasons, such as making your breasts look balanced and improving your body image and self-esteem. Make your decision only after getting as much information as possible about the procedure and your options. Ask your doctor about the benefits and risks.
Types of Operations
Different types of breast reconstruction operations are available to you:
One-stage breast implants — If you choose to have reconstructive surgery at the same time as your mastectomy, your plastic surgeon will place a breast implant (commonly made of a silicone shell filled with sterile saline, or salt water) where your cancer surgeon has removed breast tissue.
Two-stage reconstruction — Whether you have reconstructive surgery at the same time as a mastectomy or later on, your plastic surgeon will implant a tissue expander, which is somewhat like a balloon, under the skin where the breast tissue was removed and inject a salt-water solution periodically to fill the expander. In a second operation, the surgeon will remove the expander and place a permanent breast implant. Sometimes, the expander may be left in place to serve as an implant.
Tissue flap procedures — These breast reconstruction operations use patches or flaps of tissue from your stomach, back, buttocks or thighs. The two most common types take tissue from your stomach or your upper back. Both procedures leave scars on your reconstructed breast and where the tissue was taken. The scars fade over time but never go completely away. Ask you doctor about other possible complications.
After you have breast reconstructive surgery, you might experience so-called late effects of treatment, which are side effects that become apparent after your treatment has ended. Breast implants can cause muscle soreness and discomfort in the chest and upper back due to a stretching of the muscles by the implants. Implants that are either too large or too small for your body can also cause discomfort. Ask your doctor about the possible late effects of implants before you have them put in.