After mastectomy, a surgery in which the entire breast is removed, usually because of cancer, a breast reconstruction surgeon rebuilds breasts. Patients may opt for this procedure to restore symmetry if the other breast is left intact, or because they are distressed by the aesthetic and psychological effects of mastectomy. When mastectomy is conducted because of cancer, the oncologist and breast reconstruction surgeon can coordinate to reduce the risk of recurrence while optimizing conditions for reconstruction. This can increase the chances of a successful cosmetic surgery in addition to helping the patient stay cancer free.
Breast cancer patients who think they might want a reconstruction may be encouraged to discuss this before a mastectomy. There are some measures a surgeon can take to conserve skin and tissue which will make it easier to rebuild the breast. Depending on the type of cancer, a breast reconstruction surgeon may be able to be present at the mastectomy to take some preliminary steps, like implanting a tissue expander. These devices can be slowly inflated over time to encourage the skin to stretch and expand, creating a flap of skin that can be used in a reconstruction.
One or more surgeries may be necessary, depending on how the initial mastectomy is handled and the specifics of the patient’s case. The breast reconstruction surgeon can use tissue grafts or implants to rebuild the shape of the breast. Nipples are repositioned or created, if necessary. In the surgery, measures to increase symmetry may also be taken, such as lifting the intact breast so it matches visually. All of these options can be discussed before the patient goes into surgery.
There are a number of reconstruction techniques in use. Patients looking for a breast reconstruction surgeon may want to meet with several specialists and ask to see portfolios of their work. They can ask about the surgeon’s approach, what to expect after surgery, and patient satisfaction rates. Breast cancer support groups can be another valuable resource, as patients may be willing to discuss their surgeries and recommend surgeons on the basis of their experiences.
Rebuilt breasts do not have the same sensation as the original tissue, and they aren’t capable of generating breastmilk. They can increase confidence for some patients and may make it easier to find clothes that fit and feel comfortable in social environments. Insurance may cover a breast reconstruction surgeon because the procedure could be deemed necessary for patient well being, even if it isn’t specifically lifesaving.
