New surgical techniques and insurance changes have made it easier for many women to have breast reconstruction. Breast Cancer Surgery has emotional and physical challenges. Breast reconstruction is an important option after mastectomy and lumpectomy. The team at UPMC Breast Care Center provides the latest approaches for breast reconstruction. Your individual treatment plan may include reconstruction at a time that is right for you.
Breast reconstruction can usually be done right after your mastectomy. There are times when reconstruction is delayed. It may be delayed due to the patient’s personal preference. Some women are not good candidates for medical reasons. Your UPMC Breast Care team will review your breast reconstruction options with you as part of your treatment planning.
UPMC Breast Care Center offers three approaches to breast reconstruction: implant reconstruction, autologous tissue reconstruction, and oncoplastic breast reconstruction. Each of these options can provide a more balanced and normal look after breast cancer surgery. Women may have fewer physical and emotional burdens as a result.
Some women have micropigmentation after breast cancer treatment. This is a type of tattoo that can restore a natural look to breasts and eyebrows.
Implant reconstruction is usually a two-stage procedure. The surgeon first places a tissue expander under the skin below or above the chest wall muscles at the time of mastectomy. An expander is similar to a balloon. The expander is gradually filled. This slowly expands and stretches the skin over time in preparation for the implant.
The second stage involves the placement of the breast implant. Implants come in a variety of forms, shapes and materials, including saline and silicone. Your surgeon will discuss timing of reconstruction if you need radiation after your mastectomy.
Infection, changes in the size or shape of the breast, dimples or rippling of the implant can occur after implant reconstruction. Radiation can cause hardness or changes in the size or shape of the reconstructed breast. Arm and chest muscle stretching and exercise, using lotion and massaging the implants in the first months following radiation can sometimes help minimize these effects. Certain complications may cause the need to remove the implant. This situation is rare.
This approach allows the surgeon to use your own (autologous) tissue to reconstruct your breast(s). Skin, fat and muscle from the abdomen (TRAM, D.I.E.P flap), side(latissimus dorsi flap) or other body sites are used. Autologous tissue reconstruction takes longer and is more extensive than implant reconstruction. Some women may not be candidates for tissue reconstruction. They may not have enough tissue available to build a breast to match the healthy breast. Or they may have a history of prior abdominal operations.
Delayed wound healing, insufficient blood supply to parts of the reconstruction, infection or the development of small, hard nodules of fat inside the breast can be complications. Insufficient blood supply can affect healing or cosmetic results. Some women may experience delayed healing of lower abdominal wounds. Radiation may cause changes in the overall size and shape of the reconstructed breast. It may also cause hard nodules of fat inside the breast. These nodules are called fat necrosis.
Oncoplastic reconstruction means the surgeon first performs the lumpectomy to remove the cancer then reconstructs the breast by moving tissue during the same surgery to provide a more natural look.
Not all patients who undergo a lumpectomy will require oncoplastic breast reconstruction. Your UPMC Breast Care team will review your case and determine if you are a candidate.
Micropigmentation is a type of tattoo that can create natural looking areolas, nipples and eyebrows. It uses a mix of pigments that are placed beneath the skin. This creates a 3D effect. Women will often have micropigmentation after a mastectomy or breast reconstruction. Some women will have micropigmentation to replace eyebrows that have fallen out after chemotherapy.
Micropigmentation is done in the UPMC Breast Care Center. It is permanent and can be completed in a single visit. The area usually heals within 7-10 days. There may be some scabbing or flaking. Vigorous exercise should be avoided for the first 24 hours after the tattoo is done. Bathtubs and Jacuzzis should be avoided for a week. Swimming should be avoided for two weeks. Learn more about micropigmentation.
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