Breast Reconstruction

Latest update: April 19, 2024
Medically reviewed by: Jordan Frey MD

Details

Breast reconstruction is for patients who have undergone a mastectomy or lumpectomy. A reconstruction procedure can restore just one or both breasts and make them proportional depending on the case.

Surgeons most commonly perform reconstruction simultaneously with the mastectomy. The decision on which technique to opt for is taken on a case-by-case basis with theuniqueness of each patient being the key component. The surgeon will choose between the implant-based technique and the autologous reconstruction method.

The first approach uses silicone or saline implants. This procedure is most suitable for patients with enough tissue to support the implant. Downsides include an increased risk of infection, capsular contracture, and implant loss, especially in patients requiring radiation. 

Another option is autologous reconstruction in which surgeons use tissue, skin, fat and muscles from other body parts and graft them into the breast with their own blood supply. In some cases, both techniques can be used in one operation.

There are different types of implant-based breast construction techniques.
Immediate implant breast reconstruction is performed at the same time as a mastectomy using either a tissue expander or a permanent implant. A tissue expander is used when a  patient desires a larger post-operative breast size or the quality of the breast skin is poor. This tissue expander is slowly filled over time in the office after which a second procedure is required to remove the tissue expander and place a permanent implant. 

A permanent implant can be used in patients desiring a similar size breast with healthy breast skin. The implant may be wrapped in a unique material called acellular dermal matrix that helps secure the implant in the correct position above the pectoralis muscle. This technique usually encourages faster recovery compared to an under-the-muscle technique which may be required in cases of poor breast skin quality.

Patients can expect swelling and soreness after the procedure. They need to wear a support bra that should help in recovery. Patients must also avoid strenuous activity and lifting. Most women can return to their normal activities after 6 to 8 weeks.
Anesthesia
general
Operation Time
Inpatient Period
1-2 days
Number of Appointments
Recovery Period
6-8 weeks
Invasiveness
yes

Delayed Breast Reconstruction

Dr. Jeffrey Ascherman, a plastic surgeon at Columbia University Medical Center, describes delayed breast reconstruction. He explains the procedure and talks about the risks and benefits associated with it. He explains who is considered a good candidate for the procedure. He gives advice on what to expect afterwards.