Breast reconstruction generally falls into two categories: implant-based reconstruction or flap reconstruction. Implant reconstruction relies on breast implants to help form a new breast mound. Flap (or autologous) reconstruction uses the patient’s own tissue from another part of the body to form a new breast.
There are a number of factors that should be taken into consideration when choosing which option is best:
- Type of mastectomy
- Cancer treatments
- Patient’s body type
Breast Reconstruction with Implants
Another option for breast reconstruction is to use a combination of tissue expanders to stretch the skin and then replace the breasts with an anatomical cohesive gel implant. This is a procedure best suited for women for whom the TRAM flap breast reconstruction technique is not an option.
TRAM Flap Breast Reconstruction
Using tissue from the transverse rectus abdominis muscle, located in the lower abdomen between the waist and the pubic bone, natural-looking breasts can be made that mimic the look and feel of real breast tissue.
In the procedure, an oval-shaped section of fat, muscle, and skin tissue is removed from the area around the lower abdomen, then shaped to form a natural-looking breast and stitched into place inside the patient’s chest. While it is possible to use a TRAM flap procedure for double breast reconstruction, there must be sufficient abdominal tissue available to create two whole new breasts.
The procedure is most often considered a medically necessary surgical procedure that is covered by the Ontario Health Insurance Plan.
Breast Reduction Candidate
You may be a candidate for breast reconstruction if:
- You are able to cope well with your diagnosis and treatment and have a positive outlook and realistic goals
- You are not taking additional medications or have any other underlying health conditions
Although breast reconstruction can rebuild your breast, the outcomes can be variable:
- You may experience a loss of sensation
- There will be visible incision lines, whether from reconstruction or mastectomy
- Certain surgical techniques will leave incision lines at the donor site, commonly located in less exposed areas of the body such as the back, abdomen or buttocks
Breast Reconstruction Recovery
Following your breast reconstruction surgery using flap techniques and/or the insertion of a breast implant, gauze or bandages may be applied to your incisions. An elastic bandage or support bra will minimize swelling and support the reconstructed breast. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid.
You will be given specific instructions that may include: How to care for your surgical site(s) following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.
Healing will continue for several weeks while swelling decreases and breast shape/position improves. Continue to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled.
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Commonly Asked Questions
What are my breast reconstruction options?
There are 3 categories for breast reconstruction:
- Using your own body tissue only
- Implant on it’s own
- Implant combined with using your own body tissue
All reconstructive options may require multiple surgeries and take time to achieve the final result.
Which surgical method may be best for me?
When consulting we take multiple factors into consideration, including:
- The shape of your body
- Surgery history
- Individual treatment needs
- Personal preferences
Are there risks associated with breast reconstruction?
Yes. As with any surgery, there are risks. The plastic surgeon will review these risks during your clinic visits and answer any questions. Risks of breast reconstruction surgery may include:
- Pain, bleeding, infection, healing issues
- Changes in sensation
- Fluid build up (such as hematomas and seromas)
- Implant failure/rippling/extrusion
- Partial or complete loss of flaps
- Failure or loss of implants
- Asymmetry (lopsidedness)
- Poor cosmetic results