Modern surgical technology makes it possible to construct a natural-looking breast after mastectomy (breast removal) for cancer or other diseases. The procedure is commonly begun at the conclusion of the mastectomy procedure, itself. Depending on the size of the patient, and the size she wishes to be, the procedure is sometimes done all in one stage and sometimes in several stages. Careful coordination is made with the mastectomy surgeon, the oncologist and radiiotherapist, if needed, so that the timing and procedure is optimized for every patient. When appropriate, it all may be completed on the day of the mastectomy. Alternatively, reconstruction may be performed years after mastectomy.
Women whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives.
The reconstruction itself consists of various options, from using implants to using the skin and fat from the lower abdomen, without implants at all. Sometimes, the permanent implant can be placed right at the time of the mastectomy. Sometimes, especially if a larger breast size is desired, a temporary “expander” is placed, which is gradually filled during sequential office visits over the following months. Once a pocket has been created large enough to accomodate the size and shape implant desired, a second procedure is necessary to remove the expander and place the final implant. The implants come in numerous sizes and shapes and every patient needs to be carefully measured so exactly the correct implant is chosen for her, according to her own desires. Dr. Reiffel will spend a great deal of time with you so that you clearly understand the various options and benefits of each.
Frequently, the nipple and areola will be removed as part of the mastectomy. If that is done, once the final breast shape, position and size have been achieved and healed, a new nipple and areola can be reconstructed, if desired.