| Some women may choose to undergo breast reconstruction after a mastectomy rather than wear a breast prosthesis. This decision is based upon personal preferences and the specifics of their situation. Reconstruction can sometimes occur at the time of the mastectomy or at a later date. One consideration to take into account regarding timing is the effects of radiation therapy on saline or silicone implants – while women who have had these implants can undergo radiation therapy, treatment planning is more complex and they make shrink after radiation therapy, leading to a poor cosmetic result. The breast surgeons at University Hospital work closely with their colleagues in Plastic and Reconstructive Surgery to plan the most effective approach to reconstruction for their patients. There are two types of breast reconstruction: Implants: Inserting an artificial implant (e.g. saline) is generally a two or three step process. First, a tissue expander is placed beneath the skin and chest muscles to gradually stretch the skin so it will cover the permanent implant. That process can take 4 – 6 months, at which time the permanent implant is inserted. Next, reconstruction of the nipple is performed, either at the time of implant insertion or at a later date. Some women do not need tissue expansion and the implant can be directly inserted. While this is a relatively easy and quick procedure, artificial implants may not look like the other breast, particularly as the woman ages and breast shape changes naturally. Natural Grafts: Using skin and tissue from the woman’s own body (grafts) to reconstruct the breast tends to have better outcomes in terms of the look and feel of the breast. However, it is a much more complicated procedure. Skin-Sparing Mastectomy: If a woman has chosen to have her reconstruction performed immediately after her mastectomy, the breast surgeon may attempt to preserve as much skin around the breast as possible. That skin can then be used to cover a natural graft or artificial implant. | 
Reconstruction
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