Reconstruction After Mastectomy
Being diagnosed with breast cancer is devastating news. Your personal world comes to a halting stop and all focus is directed at your newly diagnosed breast cancer. It is often times overwhelming because things begin to move so fast with so much unfamiliar information. Patients will often feel alone and confused as to which way to proceed.
With advances in medical technology, it is now easier than ever for women to recover from the loss of a breast due to cancer or other diseases. Breast reconstruction surgery has improved by leaps and bounds over the last few years, and the results are more natural and pleasing overall. Women who choose this surgery are almost always pleased and empowered by the results, feeling as if they’ve regained their original body shape. There are a medical, emotional, lifestyle and financial considerations, but exploring one’s options is a bold, proactive way to move forward.
Picking the right team of doctors is essential in assembling a team approach to your cancer treatment. Cancer treatment will often include a breast surgeon, oncologist, radiation oncologist, and reconstructive plastic surgeon. Although the breast surgeon is oftentimes the first cancer-related doctor that you will meet, it is just as important to have a qualified reconstructive plastic surgeon on board. Dr. Patrick Hsu works with many qualified breast surgeons around Houston and is always willing to offer their recommendations. If you have not found a breast surgeon, they can refer you to breast surgeons that they routinely work with to achieve the natural and beautiful results that you see in their photo gallery.
Dr. Hsu has a special passion for treating breast cancer patients and dedicated an additional year of training at MD Anderson Cancer Center focusing on the most advanced microsurgical techniques offered to breast cancer patients to date.
DIEP Flap Surgery Before and After Photos
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Timing Your Breast Reconstruction Surgery
A mastectomy is traumatic enough without the added emotional burden of seeing yourself without a breast. That’s why Dr. Hsu recommends immediate reconstruction whenever possible. The removal of the breast and reconstruction of the new one take place in the same surgery, sparing you the emotional burden and second surgery. Immediate reconstruction also results in the best cosmetic outcome when it comes to breast reconstruction.
Sometimes complications, need for additional radiation therapy or emotional burdens prevent immediate reconstruction. Fortunately, there is no time limit, so whether you choose to wait for months or even years, your breast can still be reconstructed without ill effects. Technology continues to advance, so many women who have passed on the procedure in years past have begun exploring their options once more. Please discuss your feelings and expectations with Dr. Hsu to learn more about this life-changing procedure.
Types of Breast Reconstruction Surgery
A mastectomy involves removing all the breast tissue and leaving behind a thin layer of skin and fat. Dr. Hsu works with surgeons who perform either skin-sparing or nipple-sparing mastectomies. That means as much skin as possible is saved, sometimes including the nipple and areola as well. Saving as much skin as possible will give you the best results. Much of this is dependent upon how large the cancer is and where it is located. Ask Dr. Hsu if you’re a good candidate for a nipple-sparing mastectomy.
There are three distinctly different types of procedures used in breast reconstruction surgery.
- Implant-based reconstruction with tissue expanders: After the mastectomy, they will insert an inflatable silicone implant behind the pectoral muscle, then close the incision. This implant is referred to as a tissue expander and is only a temporary device. The tissue expander is expanded over time by being slowly filled with saline, which gently stretches the skin over a period of months. Once the expander reaches the desired shape and size of a breast, it is removed in a second surgery and replaced with a soft permanent silicone implant. Most patients do report some discomfort from the stretching process, but the pain is minimal and easily controlled with medications. The final breast mound is essentially created from a breast implant.
- Using your own tissue: This revolutionary procedure uses tissue harvested from the patient’s back, buttock or abdomen to reconstruct the breast. The tissue taken contains mostly fat, muscle and skin that will be relocated to the breast area to reconstruct a breast mound. Most commonly, the abdominal area is the donor site since this is frequently where excess skin and fat can be harvested to adequately reconstruct a breast. For a more detailed explanation of these procedures, please see our Breast Reconstruction with Tissue Flaps page.
- Using your own tissue and implants: Patients can also have their reconstruction performed with both. Sometimes there is not enough volume with just using your own tissue and an implant can be utilized to increase the breast volume. The latissimus flap reconstruction will often include an implant in addition to your own tissue.
Nipple Reconstruction and Areola Tattoo
After the breast mound is successfully reconstructed, full reconstruction finishes with the recreation of the nipple. The nipple is recreated using existing tissue on the breast itself. It is folded together much like Origami to form a new nipple. Once that has healed, you will return for a final procedure that will instill the new nipple mound with color. The areola is also pigmented during this process, known as micro-pigmentation, which is basically a tattooing process. Color, size, and shape of the nipple and areola will be matched to your existing breast as closely as possible, though exact matching may not be possible. All in all, women are extremely pleased with the results of these procedures, saying they’ve regained their confidence in their bodies after seeing the reconstructed breast completely renewed with both a nipple and pigmentation.
Insurance Coverage for Breast Reconstruction
Just as most insurance policies cover the initial mastectomy, they also cover post-operative reconstruction. Dr. Hsu has a compassionate staff of individuals whose purpose is to help walk you through this unchartered territory and provide you with guidance. You will work with their personnel who will handle almost everything to make this tedious part of your cancer treatment as easy as possible.
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.”