Reconstructive Surgery

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After a mastectomy, it is often possible to reconstruct the breast area to restore the contour and original appearance of the breast. The surgery rebuilds the size and shape of the breast and, if desired, the nipple and areola (the darker area surrounding the nipple). Most women who have had a mastectomy can have reconstruction. Women who have had a lumpectomy usually do not need reconstruction.

Not all women want reconstruction, but if you think that it might make you feel more positive, ask if it’s available in your case. It may not be suitable for women with very advanced disease, nor those whose cancer is actively spreading.

Reconstructive surgery can be done immediately (the time the natural breast is removed) or later, when other treatment is completed. The advantage of immediate reconstruction is that you will need only one major operation.

Goals of reconstruction

Women choose breast reconstruction for different reasons. These reasons may be:

  • To make the breasts look balanced when wearing a bra.
  • To permanently regain the breast contour.
  • To provide the convenience of not needing an external prosthesis.

Types of implants

The most common implant is a saline-filled implant that has an external silicone shell and is filled with sterile saline (salt water). Silicone gel-filled implants are another option for breast reconstruction, but they are not used as often as they were in the past because of concerns that silicone leakage might cause debilitating immune system diseases.

Issues to consider before you opt for implants

  • Your implants may not last a lifetime, so you may need additional surgeries to replace them.
  • You can have local complications with breast implants such as rupture, pain, capsular contracture (scar tissue forms around the implant), infection and an unpleasing cosmetic result. This means that implants may become less attractive over time.