Breast reconstruction offers a lifeline to women who have undergone breast cancer-related surgery. The procedure is performed to create a sense of balance and symmetry after one or both breasts undergo reduction or removal owing to breast cancer. For women considering breast reconstruction, there are several options available.
Your doctor and surgeon will address these at the clinic, but it is also good to know something about each type beforehand. In this article, Samuel Lin, MD, a double board-certified plastic surgeon based in Boston, Massachusetts, offers insights into the types of breast reconstruction you can expect your doctor to discuss with you.
Implant Reconstruction
Implant reconstruction involves the use of breast inserts to increase the volume of the breast, explains Samuel Lin MD. Breast implants are considered the simpler and more straightforward means to breast reconstruction. During implant reconstruction, the surgeon will insert a breast implant filled with either silicone gel or saline solution under or on top of the pectoral chest muscle.
Samuel Lin MD says it is important to note that implant reconstruction may sometimes require additional procedures to enhance the shape and size of the breast. So, what are some pros and cons of implant reconstruction surgery? On the upside, implant reconstruction surgery takes a relatively shorter time compared to other types of reconstructive surgery. Also, gaining or losing weight will not significantly affect the size and shape of the breast.
Some disadvantages of implant reconstruction include the need for multiple visits to the surgeon before achieving the final result; the implant won’t last a lifetime; and in most cases, the breast may not look, feel or move like a natural breast.
Tissue Flap Reconstruction
Also known as autologous or autogenous reconstruction, tissue flap reconstruction uses skin, fat, and, at times, muscle from other parts of your body to reconstruct the breast. Compared to implant reconstruction, says Samuel Lin MD, this option is more complex and often requires longer surgery times.
So, what happens during tissue flap reconstruction? Usually, the surgeon will look for a suitable site on another part of your body, such as the belly, back, inner thighs, or buttocks from which to harvest tissue. This tissue is then either cut out completely (free flap) and transplanted onto the breast area or moved under the skin to the breast site, maintaining the tissue’s vascular and nervous connections (pedicled flap).
An advantage of tissue flap reconstruction is that the resulting breast often feels and looks more natural. Once complete, the results can also last a lifetime. However, some challenges with this procedure include the possibility of a lack of adequate tissue to harvest (especially in thin people), flap necrosis (tissue death), and additional scarring at the site of tissue harvest.
Factors to Consider
Various factors come into play when choosing which option will work best for you. These include:
- Overall health
- Location and size of your breast cancer
- The extent of breast cancer surgery
- Tissue availability
- Cost and insurance coverage (especially for the unaffected breast)
- Personal preferences relating to the look of the breast, recovery timelines, number of potential procedures, and the overall impact on the rest of the body.
Generally, says Samuel Lin, MD, your surgeon will review your medical history and current health and offer you the best option based on the factors above as well as others like age, body type, health, goals, lifestyle, among others.
