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Breast Reconstruction

Being diagnosed with breast cancer and learning that you need a mastectomy can be devastating. Breast reconstruction is a cosmetic and functional process to help you feel more comfortable with your appearance if you have lost one or both breasts. Breast reconstruction restores your breast to a normal size, shape and form.

You will have a chance to meet with a breast surgeon and a plastic surgeon to discuss your options for reconstruction.

Timing of breast reconstruction

You can have breast reconstruction either at the same time as your mastectomy (immediate) or after the mastectomy (delayed), typically upon completing other treatments, such as radiation therapy. 

Talk to your doctors to help you determine the best surgery for you.

Immediate reconstruction

A good option if:

  • You are in good health
  • You have adequate breast skin to accommodate an implant
  • You have sufficient tissue from your own body to reconstruct your breast

How it works:

  • Your breast surgeon will work as a team with a plastic surgeon to do or start the reconstruction at the same time as your mastectomy.

Benefits:

  • You can have your mastectomy and reconstruction in just one surgery.
  • Immediate reconstruction can help ease the psychological impact of having a breast removed.

Additional considerations:

  • You may need additional procedures to complete the reconstruction process for balancing and symmetry or to create a nipple.
  • Treatments after surgery, such as radiation therapy, may negatively affect your breast reconstruction.

Delayed/staged breast reconstruction

A good option if:

  • You have other health problems and need time to make breast reconstruction surgery medically safe.
  • You need time to stop smoking prior to your breast reconstruction.
  • Your breast reconstruction will interfere with the timing of your breast cancer treatments.
  • You need radiation therapy after your surgery.

Benefits:

  • You will be able to have treatment, such as radiation or chemotherapy, before your breast surgery and reconstruction.
  • By staging your surgeries, there are fewer operative risks and the surgery is shorter than immediate reconstruction.

Additional considerations:

  • It will take several months or longer before your breasts will look the way you want them to.
  • Radiation therapy can scar your remaining breast and chest tissues, making reconstruction a bit more difficult

Types of breast reconstruction

You have a number of options when it comes to the material used to reconstruct your breasts. You will discuss your breast size and cosmetic goals with your plastic and breast surgeons to determine what will work best for you.

Surgeons at Rush can use any of these for breast reconstruction:

  • Silicone breast implants
  • Saline breast implants
  • Tissue from another area of your body

Tissue expander and implant reconstruction

Implants are one of the main ways plastic surgeons can restore your breast. In these procedures, your surgeon will use saline or silicone gel-filled implants to reconstruct the shape and look of your breast.

You can have this procedure at the same time (immediate) or after (delayed) your mastectomy.

  • After your breast surgeon removes the tumor and breast tissue, your plastic surgeon will place a tissue expander under your chest muscles. The expander stretches the chest skin to accommodate a permanent implant. 
  • Your surgeon will gradually increase the tissue expander at weekly and bi-weely in-office visits for six to eight weeks. This process helps your skin, grow, stretch and prepare the area for the final shape.
  • After a few months, your plastic surgeon will remove the expander and replace it with a permanent implant. You can also choose to enlarge, lift or reduce the other breast during this second operation to achieve better symmetry.

Combined tissue expander and implant reconstruction with latissimus flap 

  • If you have previously had radiation or your breast skin is not adequate, your plastic surgeon may need to bring in additional unscarred tissue, such as a latissimus flap, to reconstruct the breast properly.
  • A latissimus flap uses your back tissue to replace the scarred breast tissue and helps cover the implant.
  • You will not notice any significant difference in your normal day-to-day activities.
  • You may have a back scar that can be hidden under your bra strap.

Tissue flap procedures

Your plastic surgeon at Rush can also perform a TRAM flap or DIEP flap procedure, which uses your own abdominal tissue to recreate your breast (depending on your anatomy).

Your surgeon will typically use tissue from your stomach (“tummy tuck”) to rebuild your breast. Your surgeon can also use tissue from your thighs or buttocks, though those areas are less common. You will discuss with your plastic surgeon the different ways this procedure can be performed to find the right fit for you.

  • A skilled surgeon who specializes in microvascular breast reconstruction does these very complex procedures.
  • This procedure offers a soft, natural looking and long-lasting breast.
  • You may have a cosmetic benefit to the abdomen.
  • Flap surgery is longer and more involved than implant surgery.
  • Flap procedures have evolved in recent years, giving women more and safer options than they had 10 years ago.

Reduction lumpectomy and oncoplastic breast reduction

  • A relatively new option for women having a lumpectomy (the removal of the tumor and some breast tissue, while saving the rest of the breast).
  • This is a good option if you have large or sagging breasts.
  • First, your breast cancer surgeon will remove the tumor.
  • Your surgeon will then work with a plastic surgeon to perform a breast reduction or lift.

When breast reconstruction is not an option

Although most women are able to have breast reconstruction, you might not be a good candidate if you:

  • Are obese
  • Are too thin
  • Have blood circulation problems
  • Smoke cigarettes

Why choose Rush for breast reconstruction

  • Specialists in the Department of Plastic and Reconstructive Surgery at Rush are highly experienced in performing breast reconstruction surgery, including advanced tissue flap procedures.
  • Many women with breast cancer receive care through the Coleman Foundation Comprehensive Breast Cancer Clinic at Rush. At the clinic, you’ll meet with a multidisciplinary team of experts to determine a personalized plan of care for you.
  • The Rush University Cancer Center has received outstanding achievement awards from the Commission on Cancer of the American College of Surgeons. The awards recognize programs that excel in providing quality cancer care.
  • At Rush, you have access to the Cancer Integrative Medicine Program, which offers complementary therapies, such as acupuncture, massage and yoga to help ease the mental and physical stress that accompanies breast cancer treatment.