Breast Reconstruction FAQS
What is breast reconstruction?
Breast reconstruction is an elective procedure that is designed to recreate the breast, whether in its entirety or just a portion of it.
Who is an ideal candidate for breast reconstruction?
An ideal candidate for this surgery is a woman who has had one or both breasts removed due to disease or trauma and feels insecure about her appearance as a result. She should be physically and mentally healthy. A typical candidate is a woman who has had her breast removed due to cancer (mastectomy). Breast reconstruction may be performed at the same time as the mastectomy, known as “immediate” reconstruction, or afterward, known as “delayed”. As a breast cancer survivor, please speak with Dr. Jugenburg to find out if you are a suitable candidate for this surgery. Make sure to mention if you are planning to undergo radiation therapy as it may make surgery unsafe.
What types of breast reconstruction techniques are available?
Currently, three types of breast reconstruction techniques are most common. One involves the use of a tissue expander/implant, a second uses only your tissues, and the third is a combination of the aforementioned. For each technique, there a variety of sub-techniques that are more specific in detail. The following is a brief overview of each: Tissue Expander/Implant
- Reconstruction for Breast Cancer Survivors Using Implants: This is suitable for women who may not have a sufficient amount of excess skin and fat or prefer to avoid the prolonged recovery and risks associated with flap reconstruction. Many women prefer this method because it is generally a faster and easier surgery that features a shorter recovery period and minimal risks.
- Single Stage Breast Implant Techniques with Alloderm and Specially Designed Implants: Alloderm is a muscle substitute that provides coverage over the implant. Its usage enables the patient to undergo just one surgical procedure, rather than the two required in traditional techniques. As a result, it is referred to as a single stage implant breast reconstruction technique. Some specially designed breast implants specifically for breast reconstruction also involve just a single surgical procedure. They are created to expand, like a tissue expander, so that they may remain in place without needing to be replaced by a breast implant, unlike a tissue expander.
- TRAM flap: TRAM is an acronym for Transverse Rectus Abdominis Myocutaneous. Simply put, this type of reconstruction involves using the skin and fat of your stomach, along with the rectus muscle, to reconstruct your breast. Many women like this technique because it can be considered as a tummy tuck and breast reconstruction at the same time! A downside of this technique is that it weakens the abdominal wall, increasing the risk of hernia and abdominal bulge.
- DIEP flap: DIEP is an acronym for Deep Inferior Epigastric Perforator is a variation of the TRAM flap, however it does not involve transferring the rectus muscle. Considered to be a ’microsurgical’ procedure, it is associated with unfortunate risk of total flap failure.
- Gluteal flap: Tissue from the buttocks can be used to reconstruct the breasts, although this technique tends to be the most surgically complicated with several limitations.
- Latissimus Dorsi flap: This technique involves transferring the Latissimus Dorsi, a muscle in the back, to provide adequate coverage of the implant. This technique is preferred by Dr. Jugenburg for patients who have had radiation therapy as it transfers healthy, non-irradiated skin and muscle to cover the chest and the implant.
A mastectomy involves the removal of almost all your breast tissue. Little skin remains. To accommodate this, a tissue expander is used to gently and very gradually stretch the tissues so that an implant may be more safely placed.
What is Nipple Reconstruction?
Nipple reconstruction is the recreation of your nipple and areola. This can be performed a little while after breast reconstruction to allow for the recreated breast mound “settle in”, making the final result more aesthetically pleasing and natural-looking.
Another procedure that can be performed after your breast reconstruction is a Balancing Procedure. This is any subsequent surgery that achieves symmetry between the reconstructed and natural breast, such as augmentationor augmentation mastopexy.
How long will I need take off from work?
This depends on the type of breast reconstruction you’ve undergone and if a mastectomy was involved. Most women take about 4-6 weeks off from work. Flap techniques generally require a longer recovery.
What is the recovery process like?
When you get home after your surgery and Recovery Room stay, you’ll need the assistance of someone you can trust to help you, since your mobility will be very limited. You’ll need to avoid excessive stretching of your arms and limit physical activity immediately after your surgery. Gentle exercises, such as walking, may be performed, but only as advised by Dr. Jugenburg. For a faster recovery, you should follow the pre and post-surgical care instructions provided to you prior to surgery. These instructions include what you should and shouldn’t do, tips on how to take care of your body while you recover and how you can expect to feel.
Can I pay for my procedure with insurance?
Most likely, however you’ll need to speak with your insurance provider before doing so. Breast reconstruction, although it does improve one’s appearance, is often perceived as a therapeutic procedure rather than purely cosmetic.
I’m a breast cancer survivor. Will my breast cancer come back after I’ve had reconstruction?
Breast cancer can return following your reconstruction surgery, but this is only a possibility.