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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.
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Reconstruction
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