Breast reconstruction after mastectomy, or the removal of one or both breasts, has to be tailored to the individual patient. Mastectomies are typically performed to remove breast cancer, but can have the unintended consequence of causing patients to lose self-confidence and feel less feminine. For this reason, some women choose to undergo breast reconstruction surgery at the time of mastectomy or some time following the mastectomy to regain a feminine silhouette and boost self-esteem. There are, however, many considerations that a patient and her surgeon should take into account to ensure the best results. Generally, these considerations include:

– Whether a patient is pre- or post-menopausal, and whether there is a strong family history of breast cancer

– The type of cancer treatments the patient will undergo

– Whether a patient is a candidate for one-stage immediate breast reconstruction or two-stage delayed reconstruction.

Menopause and Family History

Although the risk of being diagnosed with breast cancer increases with age, the disease tends to be more aggressive in pre-menopausal women (typically under the age of 50) than in post-menopausal patients. For women who develop breast cancer at an early age and/or have a strong family history of breast cancer, bilateral mastectomy (with risk-reducing prophylactic mastectomy on the opposite, cancer-free breast) may offer the best results. One benefit to doing a preventative prophylactic mastectomy is that reconstructive surgery can be performed on the entire bust at one time, potentially providing much better symmetry than if reconstruction is performed years apart on each breast.

Cancer Treatments

The biggest impediment to proper reconstruction is radiation therapy. If radiation or chemotherapy are to be used after mastectomy, the reconstructive effort should be delayed until adjuvant therapy (post-cancer removal treatments meant to prevent cancer from returning) has been completed. The main goal of radiation treatment is to chemically alter cancer cells to prevent additional growth, but normal, healthy breast tissue and skin cells are also affected. This can lead to complications following surgery, such as infection, fat necrosis, and delayed wound healing.

As a result, waiting to perform a reconstruction surgery after radiation treatment can help ensure the highest chance for a good reconstructive result. With this in mind, once a diagnosis of breast cancer has been made, it is advantageous to have the reconstructive surgeon consult with the oncologist to optimize timing and planning for surgery.

One-Stage vs. Two-Stage Reconstruction

Women who do not require radiation treatment after mastectomies may be candidates for one-stage immediate breast reconstruction. During this type of reconstruction procedure, a plastic surgeon places silicone or saline implants in a patient’s breast pocket immediately after a general surgeon removes the cancerous breast tissue.

Patients who require radiation therapy after mastectomies are sometimes candidates for immediate implant reconstruction or tissue expansion procedures, but the risks associated with these procedures after radiation are much higher. For a patient who has had significant radiation treatment, the only option is to move tissue from one part of the body to another. This type of reconstruction procedure is called a two-stage delayed reconstruction, which means that breast reconstruction, whether involving tissue expansion or a tissue flap procedure, will be performed several months after a mastectomy. The least risky operation is a tissue flap procedure, one of which involves taking a portion of skin, fat, blood vessels, and latissimus dorsi muscle from the upper back and placing that into position on the chest, usually in conjunction with an implant.

Abdominal and buttock flaps are also available for reconstruction procedures, but these flaps tend to require longer surgeries, extended hospitalizations, and have higher complication rates.

For the Best Results

Breast augmentation and reconstruction after mastectomy is a highly personalized procedure that varies greatly from one patient to another. It is in a patient’s best interests to work closely with her entire oncology team and her plastic surgeon to determine which course of action is best suited for her specific needs and treatments. Additionally, it’s important that a patient seek out a Board Certified plastic surgeon who has extensive experience with breast reconstruction procedures.

Katie Perry is an online content editor in the Tampa Bay area. She posts articles about plastic surgery topics and procedures including breast augmentation, breast implants, and more.

Katie Perry is an online content editor in the Tampa Bay area. She posts articles about plastic surgery topics and procedures including http://bayshoreplasticsurgery.com/ breast augmentation, breast implants, and more.

Author Bio: Katie Perry is an online content editor in the Tampa Bay area. She posts articles about plastic surgery topics and procedures including breast augmentation, breast implants, and more.

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Keywords: breast augmentation, breast enhancement, breast enlargement, breast implants