Immediate Breast Reconstruction

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What is Immediate Breast Reconstruction Surgery?

Mastectomy patients have the option to reconstruct their breasts back to their original look and shape immediately after the procedure. Most women who have had a mastectomy can have reconstruction. Women who have had a lumpectomy usually do not need reconstruction.

Although breast reconstruction is a personal choice and is optional, the breasts are considered as a symbol of beauty, motherhood and vitality. Some women choose to undergo breast reconstruction to feel more like their former selves before mastectomy.

You can have your mastectomy and breast reconstruction at the same time with immediate breast reconstruction. Multiple surgeries and hospitalizations can be avoided, as well as the need to make additional decisions in the future.

Patients need to consult with their breast surgeon to find out which type of breast reconstruction surgery would work best for them.

Why should you opt for immediate breast reconstruction?

In general, women diagnosed with stage I or some stage II breast cancers, are less likely to need radiation or other treatments after a mastectomy. They are often suitable candidates for immediate reconstruction which offers several benefits to the patients such as:

Improved emotional and social wellbeing

Better cosmetic outcome

Fewer surgeries and lower surgery costs

Restore breasts without increasing breast cancer recurrence rate

Rebuild the feminine physique without jeopardising breast cancer detection

However, if there’s a good chance that radiation will be needed, delayed reconstruction may be suggested. It is also common in women diagnosed with stage III or stage IV cancers to require radiation therapy or other treatments after mastectomy due to the size of cancer or the number of lymph nodes involved.

How is immediate breast reconstruction done?

Immediate reconstruction is performed concurrently with a mastectomy which allows the surgeon to leave most of the natural breast skin envelope. This is known as a skin-sparing mastectomy. It leaves fewer scars than delayed reconstruction as less skin is removed.

The nipple, the areola (dark area around the nipple), and a small circle of skin around the areola are usually removed during this procedure.

It is sometimes possible to leave the nipple attached to the breast skin. This is known as a nipple-sparing mastectomy. The nipple is sometimes removed and then reattached to the reconstructed breast.

Factors affecting the timing of breast reconstruction

Radiation therapy

Radiation therapy can sometimes cause wound healing problems or infections in reconstructed breasts. However, because of improvements in surgical and radiation techniques, immediate reconstruction with an implant is usually still an option for women who will need radiation therapy.

Type of breast cancer

Women with inflammatory breast cancer usually require more extensive skin removal. This can make immediate reconstruction more challenging, so it may be recommended that reconstruction be delayed until after completion of adjuvant therapy.

Even if a woman is a candidate for immediate reconstruction, she still has the freedom to choose delayed reconstruction. For instance, some women prefer not to consider what type of reconstruction to have until after they have recovered from their mastectomy and subsequent adjuvant treatment. Women who delay reconstruction (or choose not to undergo the procedure at all) can use external breast prostheses, or breast forms, to give the appearance of breasts.

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