Breast reconstruction can help restore the look and feel of breasts after the mastectomy (breast removal for cancer), and can make
patients feel more comfortable about their looks. There are a number of options and techniques available, depending on a variety of factors including the extent of tissue removal during mastectomy and radiation therapy.

Breast reconstruction may begin at the time of breast removal or at a later date, after the mastectomy and tissue expansion. Some patients are candidates for immediate reconstruction. Even patients who have had breast removal in the past may be able to have reconstruction.

Tissue Expansion
After a mastectomy,  a tissue expansion procedure is used to allow the body to ‘grow’ enough skin for use in the reconstruction process. Typically, a silicone balloon
expander is inserted under the skin and gradually filled with saline or carbon dioxide during multiple office visits over a 2-6 month period. This causes the skin to gradually stretch and grow. The expander can be filled even while the patient undergoes chemotherapy or radiation therapy. The expander is then removed and a permanent implant placed.

Types of Reconstruction: Implants or Tissue Flaps
Breast reconstruction is done using saline or silicone breast implants or natural tissue flaps (using skin and fat from other parts of the body including the abdomen, back, thighs, or buttocks).

Tissue Flap Reconstruction
Breast reconstruction can also be done using the patient’s own tissue to rebuild the shape of the breast after mastectomy and/or radiation therapy. There are a number of types of tissue
reconstruction surgeries, depending on which part of the body is used for the donor tissue. Some of these procedures require the skills of highly trained microvascular surgeons.

Reconstruction with Implants
Another option is to use permanent implants for breast reconstruction. In this outpatient procedure, the surgeon removes the tissue expander and replaces it with a permanent silicone or saline implant. Reconstruction with implants requires shorter recovery period than tissue flap reconstruction, and leaves fewer scars.

Immediate Breast Reconstruction with Implants
In some cases, where a mastectomy leaves enough tissue on the chest wall to cover and support an implant, a saline or silicone implant may be inserted at the time of mastectomy. Typically this option is available to women who have moderate-sized breasts or excess natural breast skin. Direct implant insertion is done by a plastic surgeon immediately after a breast surgeon has performed the mastectomy.

Drs. Thayer, Zonca, and Ter Louw are all Board Certified Plastic and Reconstructive Surgeons who can help you navigate your breast reconstruction options. Contact us or
call 231-739-1933 to learn more.

Sources:
https://www.plasticsurgery.org/reconstructive-procedures/breast-reconstruction/techniques
https://www.cancer.org/cancer/breast-cancer/reconstruction-surgery/breast-reconstruction-options/breast-reconstruction-using-implants.html
https://ww5.komen.org/BreastCancer/BreastReconstruction.html