Breast Reconstruction

Breast reconstruction is an option for women who – as a result of illness (cancer), injury, or congenital abnormalities – have missing or misshapen breasts.  Most commonly, these procedures use saline or silicone implants to recreate the profile of the breast. In addition to reconstructing the shape of the breast or breasts, breast reconstruction surgery can also include the option of nipple reconstruction.  For women who are considering reconstruction prior to a mastectomy, ask your doctor if you would be a candidate for a nipple-sparing procedure, which would reduce the likelihood of a need for nipple reconstruction later.

What Occurs During a Breast Reconstruction Procedure?

Anesthesia

There are a few options for anesthesia that your surgeon will discuss during your consultations prior to surgery.

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.  TRAM flap procedures use skin, muscle, and fat from either the woman’s abdominal region (TRAM flap). SGAP and DIEP flap types do not use muscle and employ tissue from the buttocks or abdomen.  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 the 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 (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 reconstruct the nipple.  Others may elect to recreate the areolar coloration with tattooing.

How Expensive is Breast Reconstruction?

The good news about breast reconstruction for medical reasons is that many insurance providers are required to cover part of the cost by law.  This often reduces the out-of-pocket expenses for women substantially.  If paying out-of-pocket, you can expect this procedure to cost $3,500-5,000 on average, depending on many factors (Learn more about Costs).

What Are the Risks and Possible Complications of Reconstructive Procedures?

• Breast reconstruction is a surgery; as such, it carries the same potential for complications as any other.  These include bleeding, pain, infection (both 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.
• The need for additional surgeries should the implant leak or rupture.
• Short- or long-term (permanent) changes in nipple/breast sensation.
• Skin changes (e.g., wrinkling, dimpling, etc.) near the implant.
• Hardening of scar tissue by the implant (i.e., capsular contracture).

What Are the Disadvantages of Breast Reconstruction?

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