Breast Reconstruction

Choosing Breast Reconstruction

The first thing every woman should know about breast reconstruction is that it’s a choice. Some patients decide they are not ready for reconstruction or do not want to undergo any further surgeries. Some decide to wear a breast form or prosthesis under their clothing. Some decide to “go natural” as a symbol of their triumph over breast cancer. As long as you are a candidate for breast reconstruction, whether or not you move forward with the procedure is up to you. This is an intensely personal decision that each woman must make for herself.

With over twenty years of service to the Lake Forest and surrounding communities of Illinoisan southern Wisconsin, Dr. Terrasse has found that many women who undergo mastectomy elect to have breast reconstruction surgery. Most patients choose this path because it makes them feel more comfortable with their body, more confident and complete. Dr. Terrasse and his team at Terrasse Aesthetic Surgery are here to offer support and guidance through this decision-making process.

Options for Breast Reconstruction 

Plastic surgeons utilize two general techniques for breast reconstruction. The technique you choose will influence whether you have immediate surgery or whether it will be done in stages. Your health and current treatment plan are also considerations, which is another reason we work with your oncologist and other doctors. There are two main ways to go about the reconstruction procedure:

• Autologous (Flap) Reconstruction – Autologous (meaning “involving one person as both donor and recipient”) reconstruction is a procedure that uses tissue from a donor site on your body to create a breast shape. This tissue – which can include skin, fat and occasionally muscle – is typically taken from your abdomen, back or thigh and used to form a new breast. You can have implants put in at this time as well, but depending on what your desired results are, autologous reconstruction on its own may be satisfactory.
• Implant Reconstruction – Implant reconstruction is similar to a regular breast augmentation procedure, in which Dr. Terrasse places silicone or saline implants in your chest to restore the shape and volume of your breasts. The process can sometimes be completed in one step. In other cases, Dr. Terrasse takes a staged approach that first involves the placement of temporary devices called expanders to help make the most desirable breast shape and size for your body proportions and goals. The implant is then placed in a second surgery.

The technique that is most suitable for you will be based on several factors, including your body type, where you are in your treatment and your end goals. For example, slender women without a lot of body fat may not be good candidates for autologous reconstruction, as they may not have enough excess tissue at the donor sites to use for flap surgery. On the other hand, implant reconstruction may not be the best choice if you must have radiation, because as helpful as radiation is in treating cancer, it also causes the skin to be tougher and more resistant to stretching.

• Nipple Reconstruction – After autologous reconstruction or implant reconstruction, you can decide if you would also like to have your nipple reconstructed. Nipple reconstruction is not usually performed at the same time as breast reconstruction — it is done after the reconstructed breast has healed, typically at least three to four months after reconstruction. The nipple can be reconstructed from tissue surrounding the site desired for nipple placement. The tissue is elevated into position and shaped to mimic a natural nipple. Tattooing can then be used to add color and recreate the appearance of the areola around the reconstructed nipple. If you elect not to have nipple reconstruction, you can still have a three dimensional appearing nipple tattoo or wear a nipple prosthesis.

Breast Reconstruction Recovery

Your recovery process and timeline will be determined by which method of reconstruction you choose and whether you have surgery on your opposite breast to maximize symmetry. Expect some pain and discomfort after surgery and do not be afraid to ask for assistance from a trusted caregiver as you heal. You will feel fatigued and your movements will be limited at first. Drains may be placed temporarily under your skin to remove any excess fluid and you may be instructed to wear a special garment to support your reconstructed breast and minimize swelling.

Recovery takes longer for an autologous reconstruction than for an implant reconstruction because it involves two surgical sites that must heal. In general, you can expect your recovery to last for several weeks while postoperative swelling subsides and the shape and position of your reconstructed breast settles. Most women start to feel better in a couple of weeks and can resume their daily activities, including work, within a couple of months. 

Breast Reconstruction Results 

Breast reconstruction is a highly rewarding procedure. The creation of a new breast can not only restore your physical body, it can offer a renewed sense of confidence and enhance your quality of life. Women who undergo breast reconstruction report feeling more feminine, feeling comfortable in a wider variety of clothing and having an improved self-image. Seeing your body look similar to how it looked before breast cancer can help you move on from a challenging period of your life.

It is important that you have realistic expectations of your reconstructed breasts. Reconstruction is not the end of an emotional journey; it is an emotional journey of its own. The ideal outcome of your surgery is that you look and feel balanced and symmetrical. You may not think your breasts feel as natural as they should, or it may take a while to become accustomed to the lack of sensation. A reconstructed breast may never match a natural breast perfectly and there will always be some amount of scarring. For some women, it takes time to see a reconstructed breast as part of their own body. One of the best ways you can plan for life after breast reconstruction is to ask your team of medical providers lots of questions about what to expect.

You might also find it helpful to speak with a mental health professional or other women who have had the same type of reconstruction you are considering.

Results of breast reconstruction are affected by other treatments you may receive, genetics, weight gain or loss, and other factors. You may experience some drooping and sagging, or even firmness, as time passes but that is an unavoidable part of the natural aging process. Dr. Terrasse is well-versed in each of the options available for revising breast shape and size. If there are noticeable changes, you can undergo revision surgery at a later date to address any issues. Your relationship with Terrasse Aesthetic Surgery is ongoing to ensure you remain happy with your body well beyond your treatment for breast cancer.