Women’s Cancer Communication Project
Coordinated by the European Institute of Women’s Health
Many women have their breast reconstructed either at the time of their mastectomy or months or years later.
Many women will wear an external breast prosthesis in place of the breast that has been removed,while awaiting reconstruction. Breast reconstruction means making a new breast using:
- An implant of either silicone or saline (salty water) is positioned under the skin and muscle of the chest
- Skin and muscle from another part of the body
- A combination of both.
Breast reconstruction is possible for most women who have had all or part of their breast removed.
TYPES OF BREAST RECONSTRUCTION
The decision on what type of reconstruction is chosen for a particular woman is dependant on
- the size of the breast required,
- the amount and condition of the skin on the chest wall following the mastectomy and
- whether or not a permanent implant is acceptable to the woman.
In general breast reconstruction can be performed by one of the following methods:
1. Implant alone
This involves placing a silicone or saline implant under the skin and muscle of the chest wall. Sufficient skin must be present and normally only a small breast can be reconstructed by this method.
2. Tissue Expansion plus Implant
This is a 2 stage procedure:
Stage 1 A tissue expander (an inflatable silicone bag) is placed under the skin and muscle of the chest. It is gradually filled with saline until judged to be large enough. This filling is done on a regular basis as an outpatient and may take 3-4 months to complete.
Stage 2 At a second operation, approximately 3 months after the expansion is complete the tissue expander is removed and a permanent implant of either silicone or saline is put in. Tissue expansion does take time and there may be some discomfort at the time of expansion. It is not suitable on its own or if Radiotherapy has been part of the treatment of the breast cancer.
3. Tissue from back plus Implant
Some women have insufficient skin or have had Radiotherapy and require new skin to be brought in for reconstruction. Some of the skin from the back with its muscle can be brought to the chest. An implant is placed under this skin in order to make a new breast. This is a bigger operation and will result in a scar on your back as well, but has very acceptable results.
4. Tissue from Abdomen
Some women are not happy to have an implant and request a form of reconstruction that does not require one. Skin and fat from the lower abdomen can be brought up to the chest in order to make a new breast. This is suitable for women who have excess lower abdominal skin (e.g. after pregnancy). It is a big operation and has a higher complication rate than other procedures, especially in smokers and those who are overweight.
WHAT SHOULD YOU DO?
For your own peace of mind, find out as much as you can about breast reconstruction before you have surgery or any treatment you are about to have for breast cancer. TALK TO YOUR DOCTOR OR CONSULTANT Ask your questions before you decide on a course of treatment.
A breast prosthesis is a breast form worn either inside a bra or attached to the body. Its purpose is to simulate the weight, bounce, feel, movement and especially the shape of the natural female breast. It is very important that a breast form should look good and be the same size and weight as the woman’s own breast. This helps keep your natural posture. Breast prostheses are made of lightweight foam.
Many modern external prostheses are weighted with silicone encased in a clear matte textured film. Silicone absorbs body heat and maintains the same temperature as the body. It is designed to be comfortable to wear. Remember, the more supportive the bra, the better the prostheses will fit.