Second only to non-melanoma skin cancer, breast cancer is the most common cancer in women in the United States. About 200,000 women a year are diagnosed with breast cancer. American women have about a one in eight chance of being diagnosed with breast cancer at some point in their lives (the risk obviously increases with age). Treatments are improving, and more women are surviving breast cancer. In order to survive, they may have had either one or both breasts removed (called a mastectomy). If you are facing a breast cancer diagnosis, it may feel like your world is upside-down. But if it helps, take comfort in the fact that reconstruction techniques are better today than ever, and can recreate the size and shape of a your natural breast, ultimately helping you feel more like yourself again. Breast reconstruction may be the last thing on your mind, or the first thing on your mind. Either way, understanding the various techniques can empower you to make the right decision for you.
The Main Difference
Like breast augmentation (breast implants), breast reconstruction is a cosmetic procedure. However, the main difference is that it aims to recreate what was lost, rather than to enhance purely for the sake of enhancement. (That’s one reason why breast reconstruction is covered by insurance, whereas traditional breast augmentation is not). However, implants are one method of breast reconstruction.
There are different techniques (and time lines) for reconstructing one or both breasts, and it’s wise to consult with a plastic surgeon alongside with your oncologist, even if you’re not sure what you want to do. One technique is tissue expansion, where an inflatable device is placed beneath the chest muscle. Over a period of weeks, the surgeon injects saline solution into the expander through a tiny valve that lies just below the skin’s surface. Once the skin has stretched sufficiently, the doctor removes the expander and replaces it with a permanent implant. A final operation reconstructs the nipple and areola. Sometimes, the tissue expansion isn’t necessary, and the permanent implant can be inserted during the initial surgery.
Another technique is flap reconstruction, where the surgeon creates a flap of chest tissue (skin, fat, and muscle still attached to its blood supply) that serves as a pocket for an implant or as the chest mound itself. The surgeon may decide to create flap tissue from the abdomen, thigh, or buttocks and relocate it to the chest area.