Breast Reconstruction FAQs
It’s normal—and smart—to have a lot of questions when you’re considering breast reconstruction. While an experienced plastic surgeon can answer your specific questions in detail during a personal consultation, we’ve addressed some of the most common questions below to help you learn.
- Do I have to have breast reconstruction?
- What are the benefits of breast reconstruction using my own tissue?
- Am I a good candidate for tissue flap reconstruction?
- Should I have breast reconstruction if I will need chemotherapy or radiation?
- Can I have breast reconstruction after a lumpectomy?
- Can I choose the size of my reconstructed breast?
- What are the risks of breast reconstruction?
- Will breast reconstruction make it harder to detect cancer in the future?
- Does insurance cover breast reconstruction surgery?
- How do I make an appointment with Breast Reconstruction Specialists?
There is no medical requirement to have breast reconstruction after mastectomy. However, a number of studies have shown that breast reconstruction has positive emotional and psychological benefits and helps many women feel that their recovery is complete after overcoming breast cancer. Additionally, breast reconstruction eliminates the need to wear prostheses in order for clothing to fit properly and have a normal appearance.
While many women choose to have breast reconstruction with implants, there are several advantages to a tissue flap reconstruction, or a procedure that uses your own tissue, instead of an implant, to create a new breast mound:
- Tissue flaps can look and feel more natural than breast implants
- Implants are not considered permanent devices and may need to be replaced after a number of years
- There is no risk of capsular contracture after tissue-only procedures
- It is possible to achieve a tummy tuck, thigh or buttock lift at the same time as breast reconstruction with a tissue flap procedure
Many women do not want breast implants and would prefer a reconstructed breast made from their own natural tissue. Indeed using a “tissue flap” can often achieve a breast mound that looks, feels and moves more like a natural breast compared to an implant. However, tissue flap procedures are usually more complex procedures, involving two surgical sites (one at the donor site and one on the breast), and are not suitable for every patient. You need to have an excellent blood supply to keep the transplanted tissue alive and healthy, and you must have adequate tissue in the donor location to use to make an aesthetically pleasing breast.
Conditions such as diabetes, hypertension, heart disease, obesity, and blot clotting disorders, as well as lifestyle habits such as smoking, may prevent you from being a good candidate from DIEP Flap or another tissue-based breast reconstruction procedure.
Additional breast cancer treatments, such as chemotherapy and radiations, should not prevent you from having breast reconstruction, but your doctor may require you to delay reconstruction until other treatments are complete. Typically, it is safe to undergo chemotherapy before or after breast reconstruction. Radiation treatments should be completed before reconstruction, as radiation can damage the reconstructed breast. Your doctor and breast reconstruction surgeon will recommend the appropriate course of action for your needs.
While there are many advantages to undergoing a partial mastectomy (lumpectomy or quandrantectomy) vs. a full mastectomy, sometimes even these procedures leave the breast disfigured. In this case, breast reconstruction techniques can help restore an aesthetically pleasing breast shape. Options include:
- Remodeling surrounding tissue to create a smaller, but still aesthetically pleasing breast. This can be a great option for patients who desire a breast reduction, as the opposite breast is typically reduced and reshaped for symmetry.
- Transferring tissue via DIEP Flap or other free flap procedure. After more extensive lumpectomy, an autologous tissue transfer surgery can be performed to restore the affected breast to its previous shape and size for optimal symmetry.
Our surgeons at Breast Reconstruction Specialists are highly experienced in reconstruction after partial mastectomy, as well as opposite-breast reconstruction and can help you better understand your options during a complimentary consultation.
While your plastic surgeon will strive to achieve a breast size and shape that most closely matches your preferences, this may not always be possible, particularly after a tissue flap procedure. Several things factor into your new breast size, including:
- The amount and type of tissue removed during mastectomy
- The amount, type, and location of tissue available to recreate the breast mound
- The size of your natural, non-affected breast
- Whether or not you desire breast implants
- Your personal preferences
A skilled plastic surgeon can perform surgery on your opposite breast to achieve optimal size and symmetry. For example, if you would like smaller, lifted breasts, your plastic surgeon may perform a breast reduction and lift on your opposite breast and transfer the appropriate amount of tissue to create an even-sized reconstructed breast. If you would like larger breasts, your plastic surgeon may talk to you about breast implants for one or both breasts to achieve your desired size increase.
In the hands of an experienced board certified plastic surgeon who has specific training breast reconstruction, the risk for serious complications is low for an otherwise healthy patient. However, patients should be aware of the risks associated with autologous tissue breast reconstruction:
- Tissue flap failure. In a very small number of cases, the transferred tissue loses some or all of its blood supply following surgery. If not addressed immediately, the tissue flap can fail and need to be removed. In hospitals that regularly perform microsurgical procedures, the overall failure rate should be less than 5%.
- Fat necrosis. If blood supply to the transplanted tissues is compromised to a lesser degree, a portion of the transferred fat may not survive, which can result in a misshapen appearance to the breast. Depending on the degree of the issue, this can sometimes be corrected through fat grafting.
- Infection. With two surgical sites, is a risk of infection at both the donor site and the breast. This risk can be minimized by choosing a qualified breast reconstruction surgeon and closely following aftercare instructions. However, the risk for infection is higher if you smoke or have certain medical conditions.
- Loss of sensation in the breast skin. Certain procedures may result in loss of skin sensation in the breast. This is a big advantage of the DIEP Flap procedure—during immediate reconstruction, we are often able to retain some or all breast skin sensation by transferring nerves from the donor tissue and reconnecting them at the breast site.
- Cosmetic irregularities. A skilled plastic surgeon can usually achieve very good symmetry and an aesthetically pleasing appearance; however, this is not guaranteed and occasionally patients experience uneven breast size or shape, poor scarring, or other cosmetic problems. In most cases, a secondary breast reconstruction can significantly improve or correct the issue.
This issue has been thoroughly studied, and there is no evidence showing that breast reconstruction increases the risk of cancer returning, or makes cancer harder to detect. It is important to continue medical care and undergo screenings as recommended by your breast cancer doctors following breast reconstruction.
In the United States, health insurance policies that cover medically necessary mastectomy are required by law to also cover costs associated with breast reconstruction. However, insurance companies do not always cooperate easily from the beginning. In some cases, companies may initially deny coverage for breast reconstruction, requiring either the patient or her plastic surgeon’s office to resubmit the insurance claim with a letter explaining the details of her breast cancer diagnosis and necessary treatment. Additionally, the extent of benefits varies widely depending on the policy, and it is likely that you will be expected to pay some portion of the total costs.
It is best to find out before you have breast reconstruction surgery:
- Whether your policy will cover the specific breast reconstruction procedure technique you wish to have
- What costs the company will and will not pay for
- How your policy covers surgery on your breast that does not have cancer
It’s easy—just call us at 813-563-1144 or contact us online. Our helpful staff will help you set up a complimentary consultation at the Breast Reconstruction Specialists location that is most convenient for you. We currently have offices in Dallas, Houston, Nashville, and Memphis. If you live outside of one of these areas, please let us know and we will do our best to accommodate your needs. Our staff can provide resources to help you arrange transportation and accommodation if you plan to travel to us for your consultation or surgery.