Breast Reconstruction
Breast reconstruction surgery is an option for every woman who has had partial or complete mastectomies for cancer or other reasons, but at the least, every woman should be informed of this option. If you are thinking about having reconstructive surgery, it is wise to talk about it with your surgeon and a plastic surgeon experienced in breast reconstruction before your mastectomy so that you are informed, aware, and educated about the various options. This lets the surgical teams plan the treatment that is best for you, even if you decide to wait and have reconstructive surgery later. The goal of breast reconstruction is to provide symmetry, and to match, as closely as possible, the appearance and feel of a natural breast. In general, there are implant-based breast recosntructions and autologous flap-based (using your own tissue) for breast reconstruction. Examples of flap-based reconstructions are the newest and most-innovative today such as the microsurgical perforator flaps (e.g. DIEP, SIEA, TAP, SGAP, etc) and the latissimus dorsi flap.
According to published reports, although there has been a steady increase in the amount of breast reconstructive procedures performed annually, nearly 60% of women who are eligible for reconstruction are not informed of the reconstructive options available to them. Statistics reported by the American Society of Plastic Surgeons (ASPS) shows that ~79,000 breast reconstruction procedures were performed in 2008 alone – a 39% increase from the previous year. Unbelievably, current research shows that most breast cancer patients are not even involved in a key discussion that should take place at the time of their initial diagnosis. The Plastic Surgery Society has been working diligently to get legislation to educate women of this option. In 1998, a law was passed (The Women’s Health and Cancer Rights Act), that allows for treatment of cancer on the affected breast as well as reconstruction for absence following the mastectomy along with any contralateral procedure for symmetry.
Women who choose to undergo breast reconstruction report improved self-esteem, self-confidence, femininity, comfort, and wholeness with their bodies. Your plastic & reconstructive surgeon should personalize your consultation to provide an informed discussion about the procedures that are offered (both implant-based and flap-based, which utilizes your own tissue) and assist you in determining which procedure would be the most suitable for you. Be sure to discuss the best timing and type of reconstruction for you, taking into account your cancer type, tumor size, nodal involvement, the need for pre/postoperative chemotherapy or radiation therapy, your overall medical health and comorbidities, along with your own personal preferences. There are several options for breast reconstruction and it is important that you know and understand as well as are offered each of these options. It is wise to discuss with a plastic surgeon who is well-skilled and trained in breast reconstruction – as they will be able to offer all of the techniques and likely have optimal results for your breast reconstruction. The discussion should involve you in the decision-making process, as the final reconstruction will ultimately become part of you.