Breast Reconstruction Part 1
July 28, 2014 What You Should Know About Breast Reconstruction (Part I) By Johnny Franco, M.D. What is reconstruction? Reconstruction is any procedure performed after the body has been altered from its normal form whether that is from cancer, burns or trauma. Breast reconstruction is a broad term that is used to describe the restoration of the breast to its natural shape and form. Reconstruction can be done by a variety of methods using implants, one’s own body tissue or a combination of these techniques. The reconstruction is customized to each patient. It is important for patients to have a discussion about reconstruction with their plastic surgeon so that all options can be discussed and tailored to the individual to give them the best possible outcome. What qualifies you for reconstruction? The most common reason an individual undergoes breast reconstruction is because of breast cancer. However, many more patients qualify for reconstruction then just those patients who have been diagnosed with cancer. Patients that have had trauma, burns or congenital deformities to the breast are all candidates for breast reconstruction. A bad breast augmentation does not qualify you for reconstruction. In terms of reconstruction related to breast cancer, patients who have had a lumpectomy, mastectomy or prophylactic mastectomy all qualify for reconstruction, if they need it. Many times, after a lumpectomy, no reconstruction is needed. It is important for patients to remember that if they have had a reconstruction and need revisions, such as their implants need to be exchanged, this also qualifies under reconstruction for their breasts. Patients who have had cancer, burns or trauma also qualify to have the opposite breast reconstructed (reduction, lift or augmentation) as this will allow the plastic surgeon to make the two breasts as symmetrical as possible. The goal is to help women regain the confidence to wear the formal gown or tank top they did prior to this process. Is reconstruction different for breast cancer survivors? Breast reconstruction depends on each patient’s individual situation. Breast reconstruction after breast cancer is typically a little different in that the plastic surgeon and breast surgeon typically work very closely together so that a portion of the surgery is coordinated. The plastic surgeon also has to take into account whether radiation or other treatment modalities will be used during the initial treatment course. However, as in any reconstruction, the ultimate treatment is tailored to the individual patient’s needs. Do I have to have reconstruction? No you do not have to undergo reconstruction. Reconstruction is completely optional for the vast majority of patients. The purpose of the reconstruction is to help restore patients back to their prior form. The goal is to help women through this process to regain control of their life. If recreating your breast is going to help you move forward with the process, then your plastic surgeon will do everything he or she can to help. Many patients do not want to do reconstruction or just do not want to do reconstruction at the time of their mastectomy. The process can be overwhelming and some patients do not want to add the additional procedure of reconstruction. The important take home message is that reconstruction is available to you if you would like to do it at the time of mastectomy or any time after, but it is your decision. It is important to have this discussion with your plastic surgeon so he or she can explain in detail the pros and cons. Is it ever too late to get breast reconstruction? Breast reconstruction is a very personal decision for women. A large percentage of women do not decide to undergo breast reconstruction for a variety of reasons. These reasons can range from not knowing that it was available to an individual decision that they were not ready for the reconstruction process at the time of mastectomy. The good news is that the opportunity to have reconstruction is always available to women who have had breast cancer. My own aunt had breast cancer fifteen years ago and at the time was just not ready to undergo breast reconstruction, however she has recently decided that she would like to reconstruct her breast and has just completed the process. The key point is that a woman can undergo breast reconstruction at the time of mastectomy, a year later or twenty years later, the option is always available, and patients should not feel like they missed their opportunity to have this done. They should speak to their plastic surgeon about their options. If you don’t have a plastic surgeon, ask your breast surgeon for a recommendation. Who is a good candidate for breast reconstruction? Every woman should have the discussion about breast reconstruction with her plastic surgeon. There are a multiple options for breast reconstruction that can be tailored to each patient. The vast majority of women can have their breast reconstructed at the time of their mastectomy. In rare cases, patients may be better served having their reconstruction at a later date.