Breast reconstruction is an option for women who, as a result of cancer, injury, or congenital abnormalities, have missing or misshapen breasts. Reconstruction surgery usually uses saline or silicone implants to recreate the profile of the breast; if necessary or desired, the procedure can also include nipple reconstruction.

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If you are considering reconstruction prior to a mastectomy, ask your doctor if you’re a candidate for a nipple-sparing procedure, which reduces the potential need for nipple reconstruction.

Procedure

  • Anesthesia

There are a few options for anesthesia, including general and neuroleptic anesthesia. Discuss the advantages and disadvantages of the different types with your surgeon in order to determine what will be best for you and your unique needs.

  • Option A – A Flap Technique With Or Without an Implant

Women who have gone through radiation treatments may not have enough tissue in the chest area to add an implant without a flap or tissue expander. Transverse rectus abdominus myocutaneous (TRAM) flap procedures use skin, muscle, and fat from the woman’s abdominal region. Superior gluteal artery perforator (SGAP) and deep inferior epigastric perforator (DIEP) flap types do not use muscle, and employ tissue from the buttocks or abdomen. 

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A final flap option is the latissimus dorsi flap; this procedure brings tissues from the person’s back forward to the breast area.  An advantage of this flap is that it maintains the tissues’ original blood supplies. Depending on whether there is sufficient tissue for the entire breast, an implant may be used to adjust the profile.

  • Option B – Tissue Expander and Implant

With this option, the surgeon will add tissue expander under the patient’s skin during an initial procedure. Over a period of four to six months, the doctor will use a valve to gradually inflate the device, thereby expanding the skin in the chest area to eventually accommodate a silicone or saline implant. This option  (i.e., a second surgery would be required).

  • Nipple Reconstruction (Optional)

Some patients may choose to also have grafts taken from nipple-colored skin areas (such as the eyelid, the groin area, or the opposite nipple) to for reconstruction; others may elect to recreate the areolar coloration with tattooing.

Costs

Breast reconstruction for medical reasons are often covered at least partially by many insurance providers. This can reduce your out-of-pocket expenses. However, if you are completely paying out-of-pocket, expect this procedure to cost $3500-5000 on average, depending on many factors.

Risks

Breast reconstruction is a surgery; as such, it carries risks such as bleeding, pain, infection (at the incision site and in other areas of the body), prolonged incision healing, blood clots, accumulation of fluid, cardiac complications, or reactions to anesthesia. There are also complications specific to breast reconstruction surgery.

Disadvantages

  • Procedures that borrow skin, fat, or muscle from other areas of the body will leave scars at the other incision site.
  • No reconstruction techniques are able to restore the original breast’s sensations.