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Breast reconstruction is surgery to recreate breasts after mastectomy. Choosing whether or not to have reconstruction after mastectomy and deciding on the type of reconstruction is very personal and can be challenging. Each procedure has advantages and disadvantages and no one type of reconstruction is perfect for everyone. Not all surgeons perform all procedures, and often, surgeons recommend only the techniques they perform. The most important actions a woman considering reconstruction can take is to learn about her options, decide which is best for her, then consult with and choose a surgeon who is experienced and expert in the technique she prefers.
The Breast Reconstruction Guidebook by Kathy Steligo is an outstanding resource to help women understand all their options in order to make an informed decision about reconstruction. FORCE's post-mastectomy photo gallery has pictures submitted by women and FORCE's Show & Tell book are two great resources with post mastectomy photos of women with and without reconstruction.
There are two major categories of reconstruction With "tissue flap reconstruction" surgeons use fat, and/or muscle and skin from other areas of the body to recreate a breast. For "implant reconstruction" surgeons use breast implants filled with silicone or saline to reconstruct breasts.
Most reconstruction involves two or more operations over several months. The initial surgery forms the breast mounds, breasts without nipples. Depending on the procedure used, a shorter revision surgery refines the shape and size of the new breasts and add nipples. With unilateral reconstruction, the opposite healthy breast may be modified at this time for better symmetry. Tattooing the area around the nipples simulates the areolas and completes the process. As nipple-sparing surgery becomes more common - reducing the need for a second surgery to reconstruct the nipple - some surgeons offer women the option for reconstruction in one surgery.
Women who choose to undergo reconstruction after mastectomy have many options.
There are several types of reconstruction. It is helpful to learn about all the different options before choosing a type of reconstruction or surgeon.
Tissue flap vs. implant reconstruction
Types of flaps
Types of implants
Breast implant reconstruction can be categorized by the type of implant used. All implants have a silicone exterior.
Breast implants can also be categorized by the shape and profile of the implant.
Expander-implants vs. direct-to-implant
Implant reconstruction can be done as a one-step or a two-step surgical process.
Immediate vs. delayed reconstruction
Reconstruction can be done almost anytime after mastectomy.