Robert R. Cawley, D.O.
Dover, NH 03802
By C. Wesley Bean, MD, Wentworth Health Partners Plastic Surgery Specialists
Twenty-five years ago, breast reconstruction was somewhat of a rarity. However, with more women being diagnosed with breast cancer and being diagnosed at much younger ages, it has now become the rule and not the exception. As such, most women now will seek out information about their breast reconstruction surgery options before a mastectomy.
There are two broad categories of breast reconstruction, but the most common procedure starts with a tissue expander that is placed beneath the muscle at the time of the mastectomy. Over a period of four to six weeks, the skin and muscle are stretched to allow for the placement of a permanent breast implant. During the period of tissue expansion, most patients carry on with their normal activities, and the placement of the permanent implants is usually done as a day surgery.
If a woman's breast cancer treatment requires radiation therapy, reconstruction is usually delayed until at least three months after the treatment is complete. Unfortunately, breast tissue that has been treated this way does not respond well to tissue expansion. Instead, a technique is employed that uses skin and muscle from other areas of the body to reconstruct the breast (usually from the back or the abdomen). This also may require a breast implant to achieve adequate breast size.
These are obviously much larger procedures with a commensurately longer recovery period, but they do work well after radiation therapy. If desired, nipple reconstructions are also a possibility for both reconstruction methods and are usually done in the office under local anesthesia.
Of course, many women choose not to have reconstruction. They may choose to go breast free or wear a breast form. Having reconstruction later on is also possible for women who are not ready to make the decision during their cancer treatments.
Deciding to have breast reconstruction is a very personal decision with a variety of deciding factors. Talking with other women who have had reconstruction can be helpful. Also, talk to all of your cancer doctors and your plastic surgeon about the best options for your unique situation. A plastic surgeon who is experienced in the options you're considering may offer you the most complete review of all of your choices.
For more information about breast reconstruction and the comprehensive services available at Wentworth Health Partners Plastic Surgery Specialists, call (603) 516-4268 or visit wentworthplasticsurgery.com.