Breast Reconstruction

Women who have lost one or both breasts to cancer may desire to have their breasts reconstructed. Reconstruction may be done at the same time as the breast is removed via mastectomy (immediate reconstruction) or at a later time (delayed reconstruction), and is often covered by insurance. A variety of reconstruction options exist and can restore breasts to near normal shape, size, and appearance.

Some options involve using a flap of your own tissue, called an autologous flap, which is taken from your abdomen, back, buttocks, or other area to reconstruct your missing breast. Other options involve using a breast implant, which is an elastic silicone sac filled with sterile saline solution or silicone gel. Sometimes autologous flaps and implants are used together. The type of reconstruction you choose will depend on your body type, lifestyle factors, procedure risks and benefits, and personal preferences. Your plastic surgeon will help you decide which procedure is best for you.

Introduction

Women who have lost one or both breasts to cancer may desire to have their breasts reconstructed. Reconstruction may be done at the same time as the breast is removed via mastectomy (immediate reconstruction) or at a later time (delayed reconstruction), and is often covered by insurance. A variety of reconstruction options exist and can restore breasts to near normal shape, size, and appearance.

Some options involve using a flap of your own tissue, called an autologous flap, which is taken from your abdomen, back, buttocks, or other area to reconstruct your missing breast. Other options involve using a breast implant, which is an elastic silicone sac filled with sterile saline solution or silicone gel. Sometimes autologous flaps and implants are used together. The type of reconstruction you choose will depend on your body type, lifestyle factors, procedure risks and benefits, and personal preferences. Your plastic surgeon will help you decide which procedure is best for you.

Anatomy

The breast is composed of mammary glands and milk ducts surrounded by fatty tissue, which provides shape, and ligaments and connective tissue, which provide support. The pectoralis muscles lie underneath the breasts, separating them from your ribs. The breast does not contain muscle tissue, except for tiny muscle fibers in the nipple. The circular, darker region around the nipple is called the areola. Blood is supplied to the breast by a network of blood vessels, providing cells with oxygen and nutrients and removing wastes. Lymph, a fluid which helps fight infection and eliminate waste material, circulates through the breast and the rest of the body through a series of lymph vessels and lymph nodes. During a mastectomy, all fatty tissue, connective tissue and glands are removed. Depending on findings and the extent of the cancer, lymph nodes in the armpit area may also be removed. Although there are skin-sparing and nipple-sparing mastectomy options, the nipple and areola are also commonly removed to minimize the risk of recurring cancer.