Dr. Stacey June, Plastic & Reconstructive Surgeon at Advanced Specialty Care, shares what mastectomy & breast reconstruction options may be available to help improve breast symmetry, breast size & shape and restore self confidence.
The type of mastectomy you have could change your reconstruction options. Mastectomy options include:
- Skin Sparing: Most women today qualify for skin sparing mastectomy, which leaves some skin for the plastic surgeon to use in the reconstructive surgery.
- Nipple Sparing: The breast surgeon shells out the breast tissue while leaving the skin, nipple & areola for the plastic surgeon to use in the reconstructive surgery.
- Reduction Patterned: This surgery can help reduce the size & elevate the breast in a mastectomy patient who is starting with large, droopy breasts.
Be sure to discuss your options with your breast surgeon or breast oncologist.
Is radiation therapy necessary?
Depending on the type & stage of cancer, type of excision (lumpectomy vs mastectomy), and surgical margins, your oncologist may recommend radiation therapy. Radiation therapy may decrease your recurrence rate or increase your survival rate. Indications for needing radiation therapy in mastectomy patients continue to grow.
Unfortunately, radiation therapy also causes more scarring & tightening of the breast. This could cause complications like poor wound healing, infection, capsular contracture (hard distorted implant), fat necrosis, implant exposure & loss.
Who is a candidate for breast reconstruction?
Mastectomy, Lumpectomy & Partial Mastectomy patients can be candidates for breast reconstruction. Whenever breast cancer has the potential to leave you with an asymmetry between your breasts, or when you are unhappy with the size or shape of your breasts, you should meet with a plastic surgeon to discuss your options.
Breast reconstruction options at time of or after mastectomy:
- Implant Reconstruction: This is very popular due to the ability to reconstruct the breast with an implant & avoid the need for surgery on another part of the body. Newer silicone gel implants are safe & feel natural. This surgery often requires a staged procedure, starting first with a tissue expander, then a smaller procedure to exchange tissue expander for permanent implant. This surgery will typically leave you with a fuller & more youthful reconstructed breast & you may have more choices in your final size.
- Autologous Tissue: Utilizes tissue from another part of the body, most commonly the abdomen, to reconstruct the breast. This entails a longer operation & recovery process. It occasionally requires a surgeon proficient in microvascular techniques. Because it’s your own tissue, it will likely change with you as you age, gain & lose weight.
Can I have breast reconstruction at the same time as a lumpectomy or partial mastectomy?
Yes! The following reconstructive options may be performed at the same time as a lumpectomy or partial mastectomy.
Breast Reduction: Reduces the overall volume & lifts a larger breast.
- Mastopexy: Breast lift for a droopy breast.
- Soft Tissue Rearrangements: Improves the final overall shape of the breast.
What breast reconstruction options are available if I’m unhappy with my results after my lumpectomy or radiation?
- Breast Implants: Increase breast volume & improve cleavage.
- Fat Transfer: Can improve volume & correct indentations, scarring & other contour irregularities.
Nipple and Areola Reconstruction:
Once you have completed the reconstruction of the breast mound, your plastic surgeon will discuss nipple & areola reconstruction. Nipple & areola reconstruction options include:
- Projecting Nipple: Made using local soft tissue, grafts from another part of your body, and/or implanted material. Color can also be added with tattoo.
- 3D Tattoo: The appearance of a nipple & areola can be made with a 3D tattoo.
Is breast reconstruction covered by insurance?
All topics discussed here are covered by insurance companies. It is federally mandated that once an insurance company pays for your mastectomy, they must not only pay to reconstruct that breast, but they will also pay for symmetry procedures. So, if your reconstructed breast is different than your other (natural) breast, your insurance company will pay for an operation on the natural breast (to make it bigger, smaller, more lifted, etc.)
Your consultation with a plastic surgeon for breast reconstruction is covered by insurance and should be scheduled early so your plastic surgeon can coordinate care with your breast surgeon.
Whichever procedure you & your surgeon choose, the office will contact your insurance company to assure coverage & define any out of pocket costs prior to said procedure.
ALCL & Breast Implant Recall: Certain breast implants were recalled for causing ALCL (Anaplastic Large Cell Lymphoma). This is an extremely rare & highly treatable cancer of the immune system & was found to be slightly higher in certain textured implants. For that reason, these implants were removed from the market. To date, there is no correlation between smooth implants & ALCL.
Dr. Stacey June is an accomplished Plastic & Reconstructive Surgeon & Hand Surgeon & is highly skilled in breast reconstruction as well as other facial and body surgery and non-surgical cosmetic procedures. She practices in Danbury & Ridgefield, CT at Advanced Specialty Care. To book an appointment, please call (203) 830-4700 or click here.