Related Procedures to Breast Reconstruction
Breast reconstruction surgery in connection with mastectomy is part of the protections signed into law on October 21, 1998 under the U.S. Women’s Health and Cancer Rights Act (WHCRA). Women can have the surgery to rebuild the breast so that it will be much as it was before the mastectomy. National health care programs in most countries provide similar prearrangements for this type of coverage.
Research on the psychosocial benefits and improvements of the quality of life associated with breast and nipple reconstruction have resulted in the mandated health care for procedures pertaining to achieving symmetry. Breast reconstruction, or the rebuilding of a breast, is either performed using the patient’s own tissue or prosthetic material, such as implants, resulting in the construction of a natural looking breast.
Achieving Symmetry: Mastopexy or Mammaplasty
The goal in contralateral breast reconstruction is to closely match the mature breast on the other side. This may require a lift or mastoplexy, or mammaplasty, either a reduction or augmentation, to help achieve symmetry between your natural and reconstructed breast. In achieving symmetry, sometimes the decision is made to enhance the unaffected breast which may have become saggy over time or due to pregnancy and child birth. Prior discussion with the plastic surgeon of any preferences will help in the decision of which procedures will produce the best results.
This procedure is basically a breast lift and is intended to tighten up the skin around the breast that has been stretched. Incisions are made below and around the nipple in preparation for repositioning the nipple and areola complex (NAC) to a higher position. The closing of the incisions in this procedure after tissue removal is what allows for lifting and tightening.
Breast reduction surgery is sometimes suggested for the unaffected breast that is large and pendulous to best achieve symmetry. This is performed by excising fat, skin, any breast implant, and glandular tissue and may include liposuction. It may also include a procedure to counteract drooping of the breast. It is similar to mastoplexy in that is uses the same incision pattern and the NAC is also repositioned.
The procedure to enlarge the breast is augmentation mammaplasty and may be an option to consider helping improve symmetry between your natural and reconstructed breasts. Primarily, there are two types of implants: saline and silicone. Saline implants have sterile saline solution inside a silicone elastomer shell whereas viscous silicone gel is contained in a silicone implant. The implants are either subglandular, placed underneath the breast tissue or submuscular, placed underneath the pectoralis muscle.
Most often, nipple reconstruction is necessary as removal of this tissue is surgically necessary. This procedure is usually delayed following the mound reconstruction in order to plan precise positioning. There are options with reconstructing the NAC including:
Nipple-Areolar Composite Graft (sharing) – harvesting tissue from the unaffected breast
Local Tissue Flaps – producing a raised mound of skin by creating a small flap in the target area and later using tattoo to color match the contralateral breast
Local Tissue Flaps with use of AlloDerm – as with local tissue flaps only using AlloDerm or cadaveric dermis inserted into the new nipple to perform like a “strut” to help maintain nipple projection over a longer period of time. This option may also then be tattooed later.
Breast Reconstruction – General Information
Breast Reconstruction – Most Common Risks
The Timing of your Breast Reconstruction
Who is a Candidate for Breast Implant Reconstruction
Reconstruction With Tissue Flaps
Choices in Reconstructive Procedures
Questions You Should ask your Surgeon about Breast Reconstruction
Warranty for Implants
Breast Reconstruction Considerations