For many women diagnosed with breast cancer, mastectomy, or breast removal, is an unfortunate and inescapable option. Women who have undergone this surgery can choose to have breast reconstruction. This procedure recreates the size and shape of the patient's natural breast and can renew a woman's sense of beauty and femininity.

The Surgery

The most common breast reconstruction technique combines skin expansion with a breast implant (a silicone shell filled with a saline solution). The surgeon makes an incision in the crease of the armpit, and inserts a balloon expander under the chest muscle. The incision is then stitched. Over a period of weeks, the surgeon injects saline solution into the expander through a tiny valve that lies just below the skin's surface. Once the skin has stretched sufficiently, the doctor removes the expander and replaces it with a permanent implant. A final operation reconstructs the nipple and areola (the dark skin surrounding the nipple). In some cases, no tissue expansion is required and the permanent implant can be inserted during the initial surgery.

Alternative Approach

Breast reconstruction can also be accomplished through a technique called flap reconstruction. In one approach, the surgeon creates a flap of chest tissue (skin, fat, and muscle still attached to its blood supply) that serves as a pocket for an implant or as the chest mound itself. The surgeon may decide to create flap tissue from the abdomen, thigh, or buttocks and relocate it to the chest area. Breast reconstruction generally involves multiple procedures, and is almost always performed under general anesthesia. The initial surgery is performed in a hospital, while follow up procedures are often outpatient based.

After Surgery

Following the surgery, patients experience some fatigue and soreness for several weeks. Postoperative conditions such as bruising, swelling, and discomfort are typically reduced through medication. Patients can expect to return home in two to five days.

Health Concerns

As with any cosmetic surgical procedure, complications are rare, but include implant leaks, infection, fluid loss or gain, bleeding, and a reaction to the anesthesia. Fortunately, new advances in technology have minimized the impact of these potential post-surgical complications. For example, new implants are filled with saline water solution, so in the rare instance of a leak, only water is escaping from the implant. The most common complication is capsular contracture (a tightening of the scar or capsule surrounding the implant). If this should occur, the surgeon will either remove the scar tissue, or remove and replace the implant. If you smoke, your surgeon will probably ask that you quit two weeks prior to and following the treatment. To maximize the success of surgery and minimize the risk of complication, always follow your doctor's instructions for surgical preparation and postoperative care.