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What are my breast reconstruction options if I have a mastectomy?

Question: What are my breast reconstruction options if I have a mastectomy?

Answer: There are three main options for breast reconstruction following a mastectomy. Implant reconstruction is most common, due to its relatively short hospital stay, tolerable recovery period and outpatient options for certain reconstruction stages. With this approach, an expander is placed underneath muscles in the breast region with a lower sling of donated human tissue. After a few months, the expanders are surgically replaced with either silicone or saline implants, both considered safe by the U.S. Food and Drug Administration. The last stage of the reconstruction is nipple areola reconstruction using the patient’s own tissues or via tattoo.

Tissue flap reconstruction using abdominal tissue is another option. Candidates for this procedure should be in a healthy weight range; thin women with less body fat may not be good candidates. A combination of abdominal skin, fat, blood vessels or rectus muscle is used to create a breast, which is attached to the breast region. The benefit of this procedure is the use of the body’s own natural tissue, but the surgery typically requires up to a week’s hospital stay. Recovery can be more difficult and longer than implant reconstruction, and scarring occurs in and around the abdomen, belly button and breast.

Tissue flap reconstruction using back muscle usually involves a combination of back tissue and an expander to create a breast with appropriate volume. Sometimes a piece of donated human tissue is used. Once the breast is created and the expander inserted, the process is similar to the later steps of an implant reconstruction. Patients tolerate loss of the back muscle tissue very well and recovery is usually easier than abdominal flap reconstruction.

Discuss your options with your plastic surgeon and cancer care team, all of whom can review your preferences and health history to help determine the ideal reconstruction for you.

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