Breast Reconstruction

At the time of a breast cancer diagnosis, many women understandably feel completely overwhelmed by the amount of information they are presented with by many different health care providers (breast surgeon, oncologist, radiation oncologist). It is important to remember that unlike many other elective plastic surgery procedures, breast reconstruction is rarely performed in a single operation, and typically requires multiple procedures with multiple surgical follow-ups, over many months (or in some cases, over a year) to complete. Throughout this reconstructive “journey”, patients will have frequent contact with Dr. Gougoutas who will explain, in detail, the next steps of the reconstructive process as it evolves.

Breast reconstruction is generally performed in one of two ways:

Implant-Based (Alloplastic) Reconstruction

Implant-based reconstruction is exactly what it sounds- using a breast implant (whether silicone or saline) to replace the breast tissue that was removed and restore the breast form. This type of reconstruction is typically performed in 2 stages, the first of which is insertion of an adjustable implant called a “tissue expander”. This temporary breast implant is slowly filled with a salt solution (generally once a week) until the desired volume is reached. In a second operation, the tissue is then removed and replaced with a permanent implant.

Tissue -Based (Autologous) Reconstruction

This method of reconstruction uses tissue from another area of a patient’s body, such as the abdomen or back, to reconstruct the breast form. These operations generally take longer to complete and involve a much longer hospitalization and recovery than implant-based reconstructions. Patients who choose to make this larger reconstructive “investment” up-front, however, are left with a natural reconstruction without any prosthetic devices or materials and the maintenance that frequently accompanies such devices.

In rare instances, a “hybrid” reconstruction may be performed consisting of one’s own tissue and an implant.

It should be stressed that surgical decision making for breast reconstruction is inherently quite complex and must take into consideration a variety of factors including, but not limited to:

• Required therapies for treating the underlying breast cancer
• Timing of reconstruction relative to cancer therapies (mastectomy, chemotherapy, radiation therapy)
• A patient’s anatomy, desires, lifestyle, occupation, support network, and ability to take required time off work for recovery from reconstructive procedures.