The Basics
Breast reconstruction is a physically
and emotionally rewarding procedure for
a woman who has lost a breast due to
cancer or other condition.
The creation of a new breast can
dramatically improve your self-image,
self-confidence and quality of life.
Although surgery can give you a
relatively natural-looking breast, a
reconstructed breast will never look or
feel exactly the same as the breast that
was removed.
The Ideal
Candidate for Breast Reconstruction
Breast
reconstruction is a good option for you
if:
You are able to cope well with your
breast cancer diagnosis and treatment
You do not have additional medical
conditions or other illnesses that may
impair healing
You are a non-smoker
You have a positive outlook and
realistic goals for restoring your
breast and body image
Breast
Reconstruction
Breast
reconstruction typically involves
several procedures performed in multiple
stages. It can begin at the same time as
mastectomy or may be delayed until the
patient has healed from mastectomy and
recovered from any additional cancer
treatments that may be necessary. There
are multiple reconstruction techniques,
which differ in process and outcome.
Sometimes a
mastectomy or radiation therapy will
leave insufficient tissue on the chest
wall to cover and support a breast
implant. The use of a breast implant for
reconstruction almost always requires
either a flap technique or tissue
expansion.
The Flap
Technique
The flap
technique involves repositioning a
woman’s own muscle, fat and skin to
create or cover the breast mound. Flap
techniques may result in a more natural
feel breast and are necessary when
little tissue or muscle remains
following mastectomy. Incision lines
appear at both the donor and
reconstruction sites and a lengthy
recovery follows. Depending on the
patient’s size, a breast implant may be
used to augment the breast.

A TRAM flap
uses muscle, fat and skin from a
woman’s abdomen to reconstruct the
breast. The flap may either remain
attached to the original blood supply
and tunneled up through the chest wall,
or be completely detached, and formed
into a breast mound.
A latissimus
dorsi flap uses muscle, fat and skin
from the back tunneled to the mastectomy
site and remains attached to its donor
site, leaving blood supply intact.
Occasionally,
the flap can reconstruct a complete
breast mound, but often provides the
muscle and tissue necessary to cover and
support a breast implant.
The
Prosthetic Technique

The prosthetic
technique involves the use of saline or
silicone breast implants to create the
breast mound. Unless the patient had a
Skin-Sparing Mastectomy, tissue
expansion is necessary before the
implant can be placed. This involves
placement of a tissue expander inside
the removed breast to expand the skin
and create adequate healthy tissue. Over
the course of 4-6 months, many office
visits are necessary to slowly fill the
device through an internal valve to
expand the skin. Through a second
surgical procedure, the tissue expander
is replaced by a permanent implant.
The Results
Breast
reconstruction is completed through a
variety of techniques that reconstruct
the nipple and areola.
The final
results of breast reconstruction can
help lessen the physical and emotional
impact of mastectomy. Over time, some
breast sensation may return, and scar
lines will improve, although they’ll
never disappear completely. There are
trade-offs, but most women feel these
are small compared to the large
improvement in their quality of life and
the ability to look and feel whole.
Careful monitoring of breast health
through self-exam, mammography and other
diagnostic techniques is essential to a
breast reconstruction patient’s
long-term health.
Recovery
Following your
surgery for flap techniques and/or the
insertion of an implant, gauze or
bandages will 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.
A pain pump may also be used to reduce
the need for narcotics.
Click Here For Recommended
Post-Mastectomy Exercises
Insurance
and Costs
Breast
reconstruction surgery is considered a
reconstructive procedure and insurance
companies are required by law to provide
at least partial coverage for breast
reconstruction. Financing plans are
available to cover the remaining fees.
Costs may include:
Surgeon’s fee
Facility costs
Anesthesia fees
Prescriptions for medication
Post-surgery garments
Medical tests and x-rays
Breast Cancer
Support Groups:
Dr. Bolitho supports breast cancer
awareness and research
- Young Survival
Coalition (www.youngsurvival.org)