Possible Breast Reconstruction Options

There are two options to consider for breast reconstruction.

Skin Expansion

The most common reconstructive technique combines skin expansion and the eventual insertion of an implant. Following the mastectomy, your surgeon inserts a balloon expander beneath your skin and chest muscle. Through a tiny valve mechanism buried beneath the skin, your surgeon will periodically inject salt-water solution to gradually fill the expander over several weeks or months. After the skin in the breast area has stretched enough, the expander is removed and a more permanent implant is inserted in a second operation. Some expanders are designed to remain in place as the final implant; these obviously do not require a second operation. In either case, however, the nipple and areola must still be reconstructed in a subsequent procedure. Some patients do not require preliminary tissue expansion before receiving an implant. For these women, the surgeon will proceed with inserting an implant as the first step.

Flap Reconstruction

An alternative approach to implant reconstruction involves the creation of a skin flap using tissue taken from other parts of your body—such as your back, abdomen, or buttocks. Flap surgery consists of the tissue remaining attached to its original site, retaining its blood supply. The flap—consisting of skin, fat, and muscle with its blood supply—is tunneled beneath the skin to the chest. This creates the pocket for an implant or, in some cases, creating the breast mount itself without the need for an implant. Another flap reconstruction technique uses tissue that is surgically removed from other parts of the body and then transplanted to your chest by reconnecting the blood vessels to new ones in your chest. This procedure requires the skills of a plastic surgeon who is experienced in microvascular surgery as well. The flap procedures are more complex than the expander technique. If you opt for a flap technique, you will be left with scars at both the tissue donor site and the reconstructed site.