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This is an impossible question to answer as there are so many variables that need taken into account. Implant reconstructions look very different to tissue reconstructions. Delayed reconstructions have totally different scars to immediate reconstructions. Delayed reconstructions, however, almost never need to be subjected to radiotherapy. Some immediate reconstructions do then get given radiotherapy. The effects of radiotherapy are not usually severe, but are very variable. Tissue based reconstructions tend to withstand the effects of radiotherapy a little better, but this again is not absolute. There are all sorts of procedures that can be done to the other normal unaffected breast to patients having a single breast reconstruction to try and improve the overall appearance. Some people will be having double mastectomies anyway and then have similar procedures on each side. Some people are appropriate for nipple sparing mastectomies and reconstructions, some are not. The decision making here is really very complicated and depends on a combination of your anatomy, whether you have cancer or are having mastectomies for risk reduction, your own personal preferences and those of the surgeon you see. If you are considering reconstruction having either had your cancer treated or for a risk reducing procedure you have plenty of time to do your research thoroughly and get as much advice as you need to make the right decision. If you have cancer and are having a mastectomy as the initial treatment for this with an immediate reconstruction it is worth canvassing opinion on who to see initially from someone you trust (like your breast cancer surgeon) and then making your decision within a time frame that avoids delaying your cancer treatment. You should be reassured that there are always options if you are not happy with what you have chosen later on once all your cancer treatment has finished. This is a very emotional time for any woman to go through so consider taking the people close to you to these appointments to help you to talk through all the information you are given afterwards. They will also help you to remember bits you might otherwise forget. Any surgeon will make time to see you as many times as you need to help make your decisions and provide you with all the support you need. Good luck with it all!
Breast reconstruction is a stepwise process that may be performed at the same time as the mastectomy or a later time, for instance if radiation is involved- the 'look' of the reconstructed breast differs from an implant based reconstruction versus using one's own tissue..
The results following reconstruction today can look very close to the real thing, but they will never look quite like a real breast because it is not a breast. It is very difficult to achieve the natural ptosis (hanging) or projection of a natural breast. In the past, the goal of reconstruction has been to make you look good in clothes, but plastic surgeons today really try to make an individual look good naked. The amount of cancerous tissue and skin that must be removed does play a role. Other factors, including whether radiation therapy is needed, can also affect the outcome. The more mastectomy skin that can be saved, such as in a skin sparing (where only the nipple-areola complex is removed) or a nipple sparing (where the nipple-areola complex is spared), the more similar the reconstruction will be to the pre-mastectomy breast. Remember, adequately removing the cancer is the main priority.
Reconstructed breasts depend on a few factors. A couple of them are if the breast have been previously radiated or need radiation and how much skin needs to be excised. These two factors will determine scars and also the quality of your tissue and your surgical options. The main goal for breast reconstruction is to make a breast that looks and feels as good or better than before you had the diagnosis of cancer.
At my practice, my goal is to give the most natural result to each and every patient that I possibly can. I have had many patients tell me that when they go in for imaging (for example, to get a mammogram), the techs can't even tell that they've had breast reconstruction. With that said, there are many factors that affect how natural a woman's breast reconstruction will look:Is the reconstruction being performed at the time of mastectomy (immediate reconstruction) or at a later date (delayed reconstruction)? Scar patterns are more visible in the cases of delayed reconstruction.What kind of an incisional pattern was used for the mastectomy portion of the surgery? Certain incision patterns are more readily noticeable.Does the patient have a history of radiation? Radiation therapy can darken the skin's color and causes the tissue to tighten, sometimes resulting is asymmetry between the radiated and non-radiated breast.What is the patient's skin quality and thickness? Thin skin doesn't heal as well and may show scars more prominently. Older patients tend to have thinner skin, and healing can be delayed.It's important to see a board-certified plastic surgeon who specializes in breast reconstruction. You can ask to see photographic examples of patients before and after surgery; I would definitely encourage you to do this.Best of luck to you!
Different types of breast reconstruction include implants and autologous (your own) tissue. Reconstructions using your own tissue, like DIEP (deep inferior epigastric perforator) flaps and free ms-TRAM flaps reconstruct the breast using warm, soft natural tissue from a site on your body that has excess skin and fat, typically the lower abdomen. Because the breast is remade using your own tissue, it can feel and look very natural. Implants, for certain individuals, can be an excellent option. However, though implants can appear aesthetically pleasing, it is more challenging to achieve symmetry with a natural breast and to achieve a natural texture using an implant than natural tissue.
That is a very good question. There are many variables to answer that. Much of how well a breast can be reconstructed is dependent on what tissue is left over after mastectomy. The more aggressive the mastectomy the more difficult reconstruction can be. Depending on what is expected you Plastic Surgeon may elect to use a tissue expander and implant based reconstruction or Autologous tissue. Autologous tissue is using part of your own body to recreate a breast. This is typically from your abdomen or your back. You can really have great results with either form of reconstruction from an experienced surgeon. What's great is that there has been more and more focus on bringing concepts from aesthetic breast surgery to reconstructive surgery, and patients have benefiting greatly from this.I hope this helps :)
Our office performs all different types of breast reconstruction and we have found that we can restore a beautiful breast to women who have had mastectomies or breast surgery. We specialize in breast scars. Best, Dr. Karamanoukian
Answering this question as specifically as I can, a breast reconstruction can come so close to looking real that you wouldn't even be able to tell the difference. Depending on the technique used your tissues and some other variables a breast reconstruction can look and feel exactly like a natural breast. Isn't that amazing? So many exciting things have happened in breast reconstruction that we have reached this possibility in some cases! I would not set your hopes on that but it is the correct answer to the question and it's great news! There are many variables that can make a result stray from that perfect outcome but at least the results bar begins at a high pointier that.
The result of your reconstruction has many influences. The mastectomy surgery result, whether reconstruction is done immediately (time of mastectomy) or delayed, the role of radiation, your body habitus, and the appearance of the opposite breast amongst other things. Also very influential is the type of reconstruction that is performed. In most cases a reconstruction with your own abdominal tissue will provide a more natural look and feel to the breast. However, implant based reconstructions can also look quite nice. There are pros and cons to all surgery types that go beyond the final appearance. Ideally your surgeon would perform all types of reconstruction and be able to guide you based on your individual situation.
