After Cancer: Breast Reconstruction Options

John C. Lincoln Center for Reconstructive and Plastic Surgery
9250 N. Third St., Suite 1003
Phoenix, AZ 85020
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» Request a referral to a John C. Lincoln breast reconstruction specialist in Phoenix, Arizona.

The decision whether to have breast reconstruction after cancer can be highly personal and complex. No one breast reconstruction option is best for all women. At John C. Lincoln's Center for Reconstructive and Plastic Surgery in Phoenix, our highly trained plastic surgeons treat patients with compassion, dignity and respect as they choose the surgery option that is right for them.

What, then, are the leading breast reconstruction options available to women after mastectomy? At John C. Lincoln, three categories of treatment are available:

Here, we will discuss the relative merits and considerations involved with each breast reconstruction option.

Breast Reconstruction Option 1: No Reconstruction

The timing of breast reconstruction after cancer depends upon the patient's readiness for surgery. For medical or emotional reasons, a patient may decline to have breast reconstruction immediately after mastectomy, or postpone reconstruction until a later date. For example, radiation therapy and chemotherapy exposure can impair the body's natural healing processes, especially for flap reconstruction.

For this reason, the best option may be to delay reconstruction until healing is complete. Again, to learn the options available to you, consult with your physician.

Some patients have breast reconstruction months or years following mastectomy. In the interim, a patient may choose to wear a prosthetic garment to simulate the appearance of the removed breast, or breasts.

Compared with delayed reconstruction, immediate reconstruction — when medically and surgically appropriate — offers several benefits: greater convenience for the patient, one less operation and less exposure to general anesthesia.

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Breast Reconstruction Option 2: Implant Surgery

An implant-based breast reconstruction option involves the use of permanent silicone or saline-filled implants to create a breast mound. This type of reconstruction often starts at the time of mastectomy. From a surgical standpoint, implant-based surgery is easier to perform and requires less training than flap-based procedures.

Breast skin is often removed during surgery, and missing breast skin can be replaced only with the patient's own skin. If skin is not available, it must be transplanted — as a "flap" — from another area of the body. In most cases, extra skin is created by stretching available skin, using a balloon-like tissue expander.

The expander is placed under the skin and pectoralis major muscle, then slowly filled with saline over several weeks, until the desired breast size is achieved. The expander is then overfilled slightly, to accommodate the permanent breast implant. Once the body adjusts to the filled expander, it is exchanged for the implant in an outpatient surgical procedure.

In a new technique, we can perform a one-stage "immediate implant reconstruction," where permanent implants are inserted into the chest at the time of the mastectomy, making a tissue expander and implant exchange surgery unnecessary.

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Breast Reconstruction Option 3: Flap Surgery

Flap-based breast reconstruction options involve the transplantation of the patient's own skin, fatty tissue and blood vessels (a flap) from another area of the body to recreate a breast mound. While flap surgeries require more surgical skill, more time in initial surgery, and longer hospitalization and recovery periods, these techniques typically lead to a higher quality of breast reconstruction, compared with implant surgery.

Flaps often look, feel and move more naturally than implants. Most important, flaps provide the added advantage of bringing in healthy tissue, with natural blood vessels, to the breast area. By incorporating a new source of blood flow into the surgical bed, flap surgery can be beneficial to women who have had radiation treatment.

Among the numerous flap surgeries provided at the John C. Lincoln Center for Reconstructive and Plastic Surgery in Phoenix, Arizona are:

  • DIEP Flap Breast Reconstruction: Skin and fat are removed from the patient's abdomen, along with perforating blood vessels from the abdominal muscle. This spares the abdominal muscle.
  • SIEA Flap Surgery: Similar to DIEP reconstruction, SIEA uses a flap taken from the abdominal wall. Instead of a deep artery, however, a very small superficial artery is transplanted.
  • SGAP and IGAP Breast Reconstruction: Because some patients do not have enough abdominal fatty tissue to create a breast mound, skin, fatty tissue and a blood vessel can be transplanted from the buttock.

When considering your breast reconstruction options, it is important to remember that plastic surgery procedures depend upon a surgeon's expertise, training and experience. Before choosing a surgeon, ask about his or her surgical results and capabilities.

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