Many options to restore breast after mastectomy

You have many options to restore yourself after prophylactic mastectomy given your recent BRCA diagnosis. And the good news is that all aspects of your reconstruction will be covered by your insurance.

The two major categories for breast reconstruction are 1) implant-based and 2) autologous (using your own tissue).  With proper patient selection, we obtain outstanding results with both modalities. However, reconstruction is a process that requires some steps to achieve the best results.

Options will include Saline/Silicone Gel implants, Autologous reconstruction with DIEP or SIEA or TRAM flaps, etc.  There are pro's and con's to each option.  No single reconstruction is the best for everyone. 

We often visit with out of town patients to help them with their reconstructive journey.

Best wishes.

First, I want to recognize that you have gone through a lot to decide on this surgery, so I recognize the importance of having your breasts restored to as natural as possible.

The best reconstructions are by far those that use your own tissue, generally the stomach or back fat.  You have to have the excess tisuue to begin with, so if you've had children the abdomen may be a good source of extra skin and fat.

Taking the stomach tissue is best done using the DIEP flap, which spares disturbing the abdominal muscles and makes recovery and future problems much less common.

If you do not have enough of your own tissue, an implant or expander may be needed. 

You will likely have a skin-sparing masetctomy and no other therapy, so immediate reconstruction usng whatever technique should be possible.

You and your doc will need to explore all the options in detail.  Best wishes and keep us posted.

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