Breast Reconstruction: Choosing the Best Options

Mastectomy, whether preventative or as a response to a positive cancer diagnosis, is one of the most common and often effective procedures for treating breast cancer, especially when combined with chemotherapy or radiation.

Post-mastectomy, women have multiple options for having their breasts reconstructed depending on the status of their cancer treatment and exact details of their surgery. You will work closely with your team of doctors to custom a plan that works best for you. Here are some things to consider about Breast Reconstruction. 

 Skin- and nipple-sparing procedures

A traditional mastectomy removes most, if not all, of the breast tissue, which can make reconstruction a more complex process. While they are not an option for all women, skin- and nipple-sparing procedures leave behind as much skin as possible and might even be able to preserve a woman’s nipples entirely. The tissue that is removed can either be replaced using tissue from other parts of a woman’s body or supplemented with a breast implant. Whether or not you are a candidate for a skin- or nipple-saving procedure generally depends on the amount of your breast and/or skin tissue that’s affected by cancer.

Immediate vs. delayed reconstruction

Depending on your cancer treatment plan and the reconstruction methods you are considering with your team of doctors, the timing of your reconstruction procedures is another important element to consider when looking at your overall options.

 With immediate reconstruction, where surgery is performed at the same time of breast removal, women have their breast tissue removed and their breast partially or fully reconstructed during the same surgery. Immediate reconstruction can mean fewer surgeries and can often lead to less scarring, though the recovery time can be longer because you’re essentially recovering from two procedures at once. Another thing to think about is that while immediate reconstruction does not interfere with the effectiveness of additional cancer treatments, radiation treatments are known to alter the appearance of reconstructed breasts, so if you’re going to be undergoing additional radiation therapy, it’s likely that the look of your reconstructed breasts will change.

Delayed reconstruction usually begins six months to a year after undergoing a mastectomy, some women wait much longer before deciding to undergo a reconstruction procedure. Waiting to undergo any type of reconstruction can give your body ample time to recover from your mastectomy and complete any additional cancer treatments without the fear of your reconstructed breasts being affected. It also gives women additional time to consider all of their reconstruction options before making a decision. On the flipside, for many women, waking up from their mastectomy without a breast can be quite jarring, and delaying reconstruction means that recovering from two major breast surgeries. It’s usually also associated with increased scarring.

Implants vs flap reconstruction

There are two methods women have to choose from when considering breast reconstruction — reconstruction with breast implants or reconstruction with autologous tissues. Each has its own distinct advantages and disadvantages that should be carefully considered before making a decision.

 Reconstruction using implants usually requires less complex surgeries, which generally means less scarring and shorter recovery times. Before insertion of an implant, most women require a tissue expander, which is similar to a balloon, that is slowly filled over time to stretch the skin to make room for the implant, which adds some time to the overall reconstruction. Implants are not able to replicate the look and feel of natural breasts as reconstruction with autologous tissue, but silicone-filled or gummy implants are usually considered to be closer than saline-filled implants. Another thing to consider is your cancer treatment plan, as radiation therapy can alter the final look of an implant and lead to capsular contracture, which is a hardening of the tissue surrounding the implant.

 Autologous methods for breast reconstruction use tissue from a variety of donor sites including the abdomen, back and buttocks to make a new breast. Autologous reconstruction methods can better mimic the look and feel of natural breasts but require much more involved surgeries, take longer periods of time to recover from and cause more scarring. A woman’s general health and lifestyle also factor in very heavily into her choice regarding autologous reconstruction, and women who are smokers or have an otherwise compromised immune system due to conditions like diabetes are not usually good candidates because of potential difficulties during the healing process.

Recovery and risks

As with all surgeries, the recovery process is quite different for everyone and depends heavily on a patient’s health. Each reconstruction method comes with its own set of risks outside of the general risks associated with any type of surgery performed under general anesthesia. It’s important to discuss all of your reconstruction options with every member of your health care and support teams to find the best choice for your own reconstruction.  

Dr. Samson has many successful years of experience performing Breast Reconstruction Surgeries; 14 years at the Cleveland Clinic as Senior Plastic Surgeon and the Director of the Plastic Surgery Residency Program, and 6 years in Private Practice in Volusia County, Florida. Dr. Samson and his staff are devoted to making the reconstruction process as smooth as possible for each patient and focused on helping each woman to achieve a natural, healthy, whole look post mastectomy.

 No matter what your aesthetic, Samson Aesthetics offers a full range of cosmetic surgery and reconstructive services to clients in the Port Orange, Ormond Beach, and Daytona Beach area and a long and successful track record in helping women recover from breast cancer. Visit us online at drsamson.comor call us at 386-262-1556 to set up an appointment.