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Breast Reconstruction Surgery: Options, Considerations, and Recovery



Breast reconstruction surgery plays a vital role in the physical and emotional recovery for many individuals who have undergone mastectomy or breast-conserving surgery. Understanding the options, considerations, and recovery aspects of breast reconstruction is crucial for making informed decisions and promoting post-surgical well-being. There are many different reconstruction techniques available. Take the time to learn about the breast reconstruction options and consider talking to others who have had that procedure before you make a decision.

Types of Breast Reconstruction

Implant-Based Reconstruction: Implant-based breast reconstruction may be possible if the mastectomy or radiation therapy have left sufficient tissue on the chest wall to cover and support a breast implant. Involves using saline or silicone implants to reconstruct the breast mound. It may require multiple surgeries to achieve the desired size and shape.

Autologous (Flap) Reconstruction: For patients with insufficient tissue on the chest wall, or for those who don't desire implants, breast reconstruction will require a flap technique (also known as autologous reconstruction). This uses the patient's own tissue, often from the abdomen, back, or thighs, to reconstruct the breast. It results in a more natural-looking and feeling breast but is a longer and more complex surgery.

Combination Reconstruction: Utilizes a combination of implants and autologous tissue to reconstruct the breast.

Implants above or under the muscle

Immediate breast reconstruction above the pectoral muscle

This procedure is performed in combination with the mastectomy and results in an immediate breast mound. After the mastectomy has been performed by the breast surgeon, the plastic surgeon will place the breast implant, wrapped in a biological mesh known as acellular dermal matrix (ADM), to help the implant maintain correct anatomic position, above the pectoralis muscle.

With this procedure, recuperation may be more rapid because the muscle in the chest has not been elevated. Further, the breast implant itself is not influenced by the contraction of the muscle.

Immediate breast reconstruction under the pectoral muscle

This procedure is also performed as a combination with the mastectomy and results in an immediate breast mound. The incision generally is performed through the mastectomy site. Once the mastectomy is completed, the plastic surgeon will elevate the pectoralis major muscle. This will allow the muscle to retract upward and allow a pocket to be developed underneath the muscle and at the bottom of the normal breast position.