Breast cancer will strike one of every seven women. Modern medicine has several technologies to diagnose and treat breast cancer at an early stage, but some women will require a mastectomy (breast removal) for the best chance at a cure. The good news is that virtually any woman who must lose her breast to cancer can have it rebuilt through reconstructive surgery. Women who have had lumpectomy usually do not need reconstruction, although the breast may shrink or become distorted after radiation.
Reconstruction of a breast that has been removed due to cancer or other disease is one of the most rewarding surgical procedures available today. New medical techniques and devices have made it possible for surgeons to create a breast that can come close in form and appearance to matching a natural breast. Breast reconstruction may be performed simultaneously to mastectomy for immediate restoration of volume and shape or at a delayed time if radiation is planned following mastectomy. The benefit of immediate reconstruction is that it allows for a skin sparing mastectomy in those who are appropriate candidates.
You should begin talking about reconstruction as soon as you’re diagnosed with cancer. Ideally, you’ll want your breast surgeon and Dr. Paul LoVerme to work together to develop a strategy that will put you in the best possible condition for reconstruction. Although an individual choice, breast reconstruction attempts to restore the beauty inherent to the female form, symmetry with the opposite breast, and most importantly, a renewed sense of self and body to each woman individually.
Breast Reconstruction Options
There are several ways to reconstruct the breast, both with and without implants and/or flaps (TRAM, Latissimus Dorsi, or DIEP). Form-stable shaped implants have many advantages for breast reconstruction that Dr. LoVerme will discuss with you. Implant reconstruction may be accomplished in a single stage or it may be better for you to have a tissue expander followed by a second procedure to insert the permanent implant. In some instances, Dr. LoVerme will suggest using an acellular dermal implant (Alloderm, Flex HD) or Siri surgical scaffold to reinforce the tissue over the implant. Dr LoVerme will work together with you in deciding which is the best for you. After evaluating your health, he will explain which reconstructive options are most appropriate for your age, health, anatomy, tissues, goals and lifestyle. Be sure to discuss your expectations frankly with your surgeons (both Dr. LoVerme and your breast surgeon). They will be equally frank with you, describing your options and the advantages, risks and limitations of each. Post-mastectomy reconstruction can improve your appearance and renew your self-confidence — but keep in mind that the desired result is improvement, not perfection.
Although modern surgical technology has improved the possibility of creating a natural-looking breast after mastectomy for cancer or other diseases, the difference between the reconstructed breast and the remaining breast can often be seen when you are nude. The breasts in a bra should be close enough to one another in size and shape so you feel comfortable about how you look in most types of clothing or swimwear. Your body image and self-esteem may improve after your reconstruction surgery.
Breast reconstruction may fix things you were unhappy about before your surgery. You may have always wanted a larger, or smaller, breast, or you may have been unhappy with sagging or asymmetry. Insurance accompanies are required by law to pay for breast reconstruction at any time after removal of your breast tissue, including surgery to the other breast for symmetry if needed. This may require a reduction, lift or augmentation of the normal breast so that it most closely matches the reconstructed side.
- Consult with a plastic surgeon soon after the diagnosis of cancer is made.
- Ask questions. Be specific and demand frank answers.
- Investigate the pros and cons of each procedure. You should make an informed choice.
- Be sure that your plastic surgeon performs a variety of procedures, both with implants and flaps.
- Discuss the benefits of round or form-stable silicone gel implants when appropriate.
- You and those close to you must be realistic about what to expect from reconstruction.
For more information, contact Dr. LoVerme.