Breast Reconstruction Surgery After Mastectomy
By
Breast Reconstruction Surgeon,
Dr. Mark Schusterman
Breast reconstruction after a mastectomy can be an empowering choice. When challenged with the loss of a breast due to breast cancer or other disease, women today have a wider range of treatment to choose from than ever before.
At a difficult time of your life, you find yourself faced with an array of decisions. There are medical, emotional, lifestyle and financial considerations, but exploring one's options is a bold, proactive way to move forward. Some of these options are explored below.
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Timing Your Breast Reconstruction Surgery
Immediate:
Breast reconstruction at the time of your mastectomy
is not only possible, but may be preferable in certain
patients. Immediate reconstruction not only spares you
the emotional burden of seeing ourself without a breast,
but also spares you the requirement of a second major
hospitalization and operation. Ask Dr. Schusterman whether
this is a possibility for you. When possible, immediate
breast reconstruction is preferred.
Delayed:
You or Dr. Schusterman may feel that you need a few weeks
or months following your mastectomy before you're ready
to face further decisions. There is no time limit, so
take the time that you need. Perhaps years have passed,
and now you're encouraged by the newer techniques.
Ask Dr. Schusterman to describe his or her expectations for your healing process. Sometimes there are advantages to completing other treatments (example: chemotherapy, radiation) before beginning reconstruction. Or you may choose to allow yourself more time to explore available reconstructive procedures and to develop a relationship with just the right plastic surgeon.
Types of Breast Reconstruction Surgery
There
are two basic categories of reconstruction:
1)
Breast Implants
Following a mastectomy, the surgeon places an inflatable
or balloon-type tissue expander behind the pectoral
(chest) muscle. The incisions are sewn closed, and the
patient is released within a short time. A tiny tube
and valve mechanism is part of the expander.
Over the next several weeks or months, the doctor will periodically inject saline solution to gradually fill the expander. This gentle stretching of the skin creates the space in which a permanent saline implant will be placed during a subsequent operation. Some patients find the "gentle stretching" involves a small degree of temporary discomfort. For more information on Breast Implants, visit and review the Breast Implants page.
2)
Tissue Flaps
In this surgical technique, the breast is reconstructed
using a flap of tissue harvested from your abdomen
or back and relocated to the breast area. The tissue
flap, also called myocutaneous flap, consists of skin,
fat and muscle. For more information, visit and review
the Breast
Reconstruction with Tissue Flaps page.
Nipple Reconstruction
As your recovery progresses, your doctor will more fully discuss nipple reconstruction. Two to three months of healing is required before this second surgery can be scheduled.
Shape and color are created separately. First, on an outpatient basis, tissue from the skin flap is rearranged to form a nipple mound.
When this is completed and the nipple mound has healed, you will be scheduled (also on an outpatient basis) for areola micro pigmentation. This process provides color and definition - essentially a tattooing of the area - in order to simulate a nipple and areola.
Areola
/ Nipple Repigmentation |
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Insurance Coverage for Breast Reconstruction
In most cases, health insurance will cover most or all of the cost of postmastectomy reconstruction. Consider each step (example: the anesthesiologist). Check your policy carefully to see if there are limitations on what types of reconstruction are covered.
After recovery from the primary surgery (and any requisite follow-up procedures), many surgeons recommend an additional operation to enlarge, reduce or lift the natural breast in order to more closely match the reconstructed breast. Keep in mind that this may result in scarring of an otherwise normal breast and may not be covered by your insurance policy.
Recurrence of Disease
According
to the American Society of Plastic Surgeons
(ASPS):
"Reconstruction has no known effect on the recurrence of disease in the
breast, nor does it generally interfere with chemotherapy or radiation
treatment, should cancer reoccur."
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To make an appointment with Dr. Schusterman to discuss
your Breast Reconstruction needs, call 713-794-0368,
or use our Contact From.
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