Breast Reconstruction

What Is Breast Reconstruction?

Breast reconstruction procedures are designed to re-create a feminine breast shape after a woman has had a mastectomy. Mastectomy procedures are performed to remove one or both breasts to treat or prevent breast cancer. The surgeons at Renaissance Plastic Surgery are proud to be considered top providers of breast reconstruction with implants and breast reconstruction without implants in the Detroit Metropolitan area.

In some instances, breast reconstruction can be completed in a single procedure. However, breast reconstruction often requires two surgeries: one to place a tissue expander and a second to replace the expander with tissue from another area of the patient’s body or with a breast implant.

Reasons to Undergo Breast Reconstruction

The decision to undergo this procedure is highly personal, and some women choose not to have breast reconstruction surgery. Women who opt for breast reconstruction often do so for the following reasons:

• To reclaim their femininity and feel comfortable and confident in their body again
• To alleviate self-consciousness about their appearance that causes emotional distress, negatively impacts their relationships, and/or otherwise holds them back from living a full life
• To avoid having to wear an external prosthesis to achieve a natural-looking breast profile
• To permanently restore a breast profile that allows for a flattering look in their favorite clothing, including swimsuits and bras

Who Is a Candidate for Breast Reconstruction?

Women who plan to have a mastectomy or have already had one or both breasts removed in a mastectomy procedure can be candidates for breast reconstruction surgery. Candidates must have reasonable expectations for the outcome of breast reconstruction surgery and must be committed to following all pre- and post-operative instructions their plastic surgeon provides.

Since breast reconstruction is a surgical procedure and requires the use of anesthesia, candidates must be in good health. They must be free of medical conditions that interfere with the body’s natural wound healing processes.

Ideal candidates are non-smokers, as smoking increases the risk of complications and slows healing. However, patients who smoke can also be candidates if they are willing and able to abstain for several weeks before and after breast reconstruction surgery.

Types of Breast Reconstruction

The most significant factors that differentiate reconstruction procedures are timing and whether a breast implant or the patient’s own (autologous) tissue is used to create the patient’s desired breast contours. Because every patient has different needs, preferences, and goals, our plastic surgeons offer multiple breast reconstruction treatment options, including:

• Immediate reconstruction with implants – The plastic surgeon places breast implants immediately after the breast cancer surgeon completes the mastectomy procedure.
• Immediate reconstruction without implants – The plastic surgeon removes autologous tissue from the abdomen or other area of the body and transfers it to the breast(s) immediately after the breast surgeon completes the mastectomy procedure.
• Delayed reconstruction with implants – Several weeks or months after the mastectomy, depending on the patient’s needs, a tissue expander is surgically placed. At the appropriate time, a second surgery will be performed to replace the expander with breast implants.
• Delayed reconstruction without implants – A tissue expander is surgically placed several weeks or months after the mastectomy, depending on the patient’s needs. At the appropriate time, a second surgery will be performed to remove autologous tissue from the abdomen or other area of the body and transfer it to the breasts to replace the expander.

What Is a Tissue Expander in Breast Reconstruction?

A tissue expander for breast reconstruction resembles a water balloon. Its purpose is to create and hold space for the placement of a breast implant or autologous tissue transfer. The tissue expander may be placed under the breast skin or beneath the chest wall muscle.

Tissue expansion takes time and is accomplished by gradually adding volume to the tissue expander over a series of appointments with our plastic surgeon. Once the desired size has been reached, the expander can be replaced with a breast implant or autologous tissue.

Breast Reconstruction with Implants

Our surgeons offer breast reconstruction with silicone gel implants and saline implants. Breast implants come in many sizes and shapes to accommodate a broad spectrum of aesthetic goals. Patients also have options when it comes to the texture, firmness, and profile of breast implants. Our surgeons will guide you through the process of selecting the ideal size and type of implant for achieving your breast reconstruction goals.

Breast Reconstruction without Implants

Autologous tissue flap reconstruction is a breast reconstruction technique in which tissue from another area of the body is transferred to the chest to restore the shape of the breast(s). Flap reconstruction procedures should only be performed by experienced surgeons who have the knowledge and training required to successfully connect the blood vessels in the transferred tissue to the blood vessels in the chest.

The donor site for flap breast reconstruction depends on a variety of factors, including the patient’s unique anatomy and desired results. Breast reconstruction with flap surgery most often involves removing tissue from the lower abdominal area. The back, thighs, and buttocks can also be donor sites for autologous breast reconstruction.

Some flap reconstruction techniques require the removal of muscle tissue, as well as fat and skin. Others, such as deep inferior epigastric perforator (DIEP) flap reconstruction, only transfer skin and fat.

DIEP flap surgery is an abdominal flap procedure that preserves the abdominal muscles while eliminating excess fat and skin. As a result, DIEP flap surgery can provide abdominal contouring benefits similar to that of a tummy tuck, as well as achieving the patient’s breast reconstruction goals.

What Is the Best Type of Reconstruction Surgery?

The best treatment option for you will depend on your medical history, the specifics of your breast cancer treatment plan, anatomical considerations, your aesthetic preferences, and other factors. You, your cancer treatment providers, and your plastic surgeon will need to work together to identify the safest, most advantageous breast reconstruction treatment approach for you.

Delayed vs. Immediate Breast Reconstruction

Delayed reconstruction is often recommended for patients whose cancer treatment plan includes radiation therapy after their mastectomy procedure. If you have a medical condition that increases the likelihood of complications during or after surgery, you will be advised to postpone breast reconstruction until your health issue has been resolved. Sometimes, even if a patient has their medical providers’ approval for immediate reconstruction, they will choose a delayed procedure for personal reasons.

Breast Implants vs. Autologous Tissue Reconstruction

Our surgeons can achieve incredible breast reconstruction results with or without implants, but some patients are better candidates for one option over the other. Women who are very lean usually do not have adequate donor site tissue for flap breast procedures. Breast implant reconstruction is the only viable option in such cases.

Breast implants allow patients to tailor their look in some ways that aren’t possible with tissue transfer. Implants have a distinct shape and are designed to hold that shape, so results are more predictable and precise than natural tissue. For instance, breast implants are a more effective way to create a round breast shape that provides ample cleavage.
Breast implants are not natural to the body and thus come with some distinct safety considerations that don’t apply to autologous tissue reconstruction. With breast implants, the need for removal or replacement surgery can arise for a number of reasons, such as scar tissue complications (capsular contraction), implant rotation, and rupturing.

Breast implants degrade over time, making them more susceptible to ruptures. On average, patients will need to have implant replacement surgery after 10-20 years.

While flap procedures can prevent the need for future breast surgery, they require an extra procedure initially to remove the donor tissue. Recovery from a flap procedure typically takes longer and involves more discomfort than implant-based reconstruction, as the body has to heal the breasts and the donor site.

How Much Does Breast Reconstruction Cost?

The cost of breast reconstruction varies in relation to the specifics of a patient’s procedure. During your consultation, detailed price information for your unique treatment plan will be provided.

Contact Us to Schedule a Consultation

The Renaissance Plastic Surgery team is dedicated to providing exceptional care and support at every stage of the breast reconstruction treatment process. If you are considering breast reconstruction surgery in Lapeer, Livingston, Macomb, Oakland, St. Clair, or Wayne County, contact our office to schedule a consultation.