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Breast Reconstruction Following Cancer

Gary F. Wingate, M.D., Plastic and Reconstructive Surgeon
The Chester County Hospital

Published: October 22, 2007

Unfortunately, the incidence of breast cancer has increased over the last few decades. More and more women will require treatment for breast cancer and possible reconstruction to help restore what has been removed. Fortunately, breast cancer treatments can be very effective and reconstructive options tailored to the individual needs of the patient are available.

Although breast reconstruction following cancer treatment may not be for everyone, there are a number of physical and emotional advantages of the restorative procedures. It's comforting to know also that insurance companies are now required by law to cover the costs of reconstructive surgery both to the cancer breast and also the opposite breast, if necessary, even if it is just for symmetry. Once the diagnosis has been made, the breast cancer specialist may recommend a consultation with a board certified Plastic and Reconstructive surgeon to discuss and review options regarding reconstruction. Each individual is different regarding their medical condition, anatomy, previous medical history, and desired result. The surgeon and the patient will then decide upon a course of treatment that will hopefully provide the best result regarding shape and symmetry based upon the specific needs of that person.

When a portion or the whole of the breast is removed as part of the cancer treatment, there are two basic ways of thinking about how to restore what is now a tissue deficiency. First, the most common method is skin expansion and a breast implant. Just like in pregnancy, skin will stretch significantly if necessary. Following mastectomy, a balloon-like expander is placed beneath the residual skin and muscle of the chest. This expander is then gradually inflated in the doctor's office weekly until the desired volume is achieved. The expander is then surgically replaced with a permanent breast implant. Within this general concept, there are a number of expander and permanent implant options available to match the right one for the right person. Second, instead of tissue expansion and implants, the patient and the surgeon may prefer using the patients' own tissue from elsewhere on the body to restore the tissue that was removed. This is called Flap Reconstruction and involves transferring a portion of skin, fat, and often muscle along with a blood supply to the mastectomy site from typically the lower abdomen, back, or buttock. The intent is to reconstruct the breast using the patients own tissue at the initial operation. This is obviously a bigger procedure, but can provide an excellent result for the right candidate. Follow-up procedures such as nipple reconstruction and revisions to the reconstruction to optimize the results are common.

Most women who undergo breast reconstruction will find that the individualized procedures provide both physical and emotional rewards. For many women, breast reconstruction represents a new start, the chance to put breast cancer behind them and to get on with their lives.

This article was published as part of the Daily Local News Medical Column series which appears every Monday. It has been reprinted by permission of the Daily Local News.

Last Updated: 7/27/2009