Breast reconstruction is a surgical procedure used to recreate the breast mound after mastectomy or lumpectomy. You can have reconstruction at the same time as breast cancer surgery (immediate reconstruction), or months or years later (delayed reconstruction). If both breasts are being reconstructed, the aim is to recreate breasts that match and are in proportion to the body shape. The goal of breast reconstruction is to create a breast shape that looks as natural as possible and to try to match the breast on the other side in size, shape and position. However, even with the best outcome, there will be differences between the remaining breast and the reconstructed one, and sometimes surgery on the other side can help. This can be done at the same time as the reconstruction, but waiting for the reconstruction to heal and settle into position may give a better outcome.

After the breast tissue has been removed, most times, it is necessary to use donor tissue, dermal matrix, to create a pocket in which an implant can be placed at a later date. A tissue expander, a glorified implant, will be placed in the pocket to stretch the tissue. Weekly appointments to fill the expander, increase volume, and stretch remaining tissue are required. Depending on the patient’s plan of care, the expander may be in place for several months. Ultimately, a permanent prothesis (breast implant) will be placed. 

If you require radiation therapy, this may affect the options and the timing of breast reconstruction. Radiation can increase the risk of hard scar tissue forming around an implant. This is known as capsular contracture. Capsular contracture can also affect a reconstruction that uses your own tissue, making the breast feel firmer, reducing its size, and possibly altering its shape. Breast reconstruction often involves several surgeries. Discussing reconstruction with your surgeon before making a decision is important. Dr Pflueger will want to make sure that you fully understand the reconstruction process and have realistic expectations of how your reconstructed breast will look and feel.