There are many techniques for post-mastectomy breast reconstruction. Some of the more complicated procedures involve the transfer of tissue from the lower abdomen or back to the chest in order to develop a breast mound. Since these procedures require an extensive hospitalization/recovery period (three to seven days hospitalization for patients who choose the tissue flap” type of surgery), most of my patients choose to undergo less complicated, but highly effective, alternative reconstruction processes.
In my Hinsdale Illinois practice, the most common technique employed is the use of a tissue expander. By utilizing this procedure, the breast mound can be developed gradually over a period of time to match the volume of the opposite breast closely. The period required to properly develop a soft, natural-looking breast- mound is approximately four to six months. At that time, the tissue expander is replaced with a permanent implant, If the patient so desires, nipple reconstruction can also be performed.
To obtain the best possible symmetry, surgery of the uninvolved breast (in the form of reduction, augmentation or lift) may be necessary. The patient remains fully active during the development of the breast mound, all of the procedures involving tissue expanders are done on an outpatient basis.
Insurance companies generally cover breast reconstruction, but usually will not cover procedures completed on the opposite breast. However, some insurance companies are beginning to realize the importance of opposite breast procedures. and many consider covering it in some cases.
Breast reconstruction can usually be accomplished at the time of the mastectomy, or it may be deferred until three or four months later. I prefer to put off the reconstruction until a later date since the tissue will have developed a much healthier blood supply. At that time, the surgeon has much more control over determining the shape and position of the breast mound.
Breast reconstruction is a complex (but well-mastered) procedure. It requires a significant amount of discussion between the patient and the physician. There also a number of support groups for women with mastectomies, including Reach to Recovery and Y-Me. I am happy to provide my patients with information about these groups.