What are the Choices in Breast Reconstructive Procedures?

The type of breast reconstruction procedure available to you depends on your medical situation, breast shape and size, general health, lifestyle, and goals. Women with small or medium-sized breasts are the best candidates for breast reconstruction.

Breast reconstruction can be accomplished by the use of a prosthesis (a breast implant, either silicone gel or saline-filled), your own tissues (a tissue flap), or a combination of the two. A tissue flap is a section of skin, fat, and/or muscle which is moved from your stomach, back, or other area of your body to the chest area, and shaped into a new breast.

Whether or not you have reconstruction with or without breast implants, you will probably undergo additional surgeries to improve symmetry and appearance. For example, because the nipple is often removed with the breast tissue in mastectomy, the nipple is often reconstructed by using a skin graft from the opposite breast or by tattooing the area. Nipple reconstruction is usually done as a separate outpatient procedure after the initial reconstruction surgery is complete.

The Timing of Your Breast Implant Reconstruction

The following description applies to reconstruction following mastectomy, but similar considerations apply to reconstruction following breast trauma or reconstruction for congenital defects. The breast reconstruction process may begin at the time of your mastectomy (immediate reconstruction) or weeks to years afterwards (delayed reconstruction). Immediate reconstruction may involve placement of a breast implant, an expander/mammary implant, or a tissue expander, which will eventually be replaced with a breast implant. It is important to know that any type of surgical breast reconstruction may take several steps to complete.