It can be difficult to sift through the options to figure out what will work best for you. But the most important thing to know is that there are options, he says Michele Manahan, MD, professor of plastic and reconstructive surgery at Johns Hopkins Medicine. “Breast reconstruction is not for everyone. Now, more than ever, we have so many ways to get you back in shape and get you looking and feeling like yourself again.”
A new, less painful breast implant procedure
Manahan and her colleagues perform a state-of-the-art procedure called prethoracic breast reconstruction. It reduces pain and provides faster recovery compared to traditional reconstruction by placing implants or tissue expanders over the pectoral muscles. Since the muscles are not cut or stretched, you can return to your normal daily activities sooner. “Our patients are doing yoga and have full range of motion within the first month after the procedure,” says Manahan.
Prothoracic surgery is the most minimally invasive breast reconstruction option. Your doctor can perform a mastectomy by removing the breast tissue through a small incision under the breast. Through this incision, a tissue expander can be placed on top of the muscle to create a breast mound. Later, your doctor can remove the dilator through the same incision and place an implant.
A natural alternative to breast implants
Although using implants allows you to recover faster, not everyone likes the way they look or the prospect of needing future surgeries to replace them if they rupture. A natural alternative involves using fat and tissue from another area of your body to fill out your breasts.
In the past, doctors removed muscle, fat and skin from the abdominal wall, back, inner thighs or buttocks and moved it to the chest to form breasts. This procedure was painful and had a long recovery. But now an updated technique allows you to use your own tissue with less pain and faster healing. During this surgery, called a punch flap procedure, your surgeon only moves skin, fat, and tissue—not muscle—into your chest area. Not everyone is a candidate for this procedure, depending on anatomy and previous surgical history, but it is a good option for some women.
Using your own tissue creates a more natural look. And you can also have a tummy tuck, thigh lift, or buttock lift at the same time if you’ve had tissue removed from those areas.
What to consider before breast reconstruction
There are several things to consider when reviewing your breast cancer recovery options, Manahan says. Which procedure is best for you depends on many factors, including:
- General health
- ACTIVITY level
- What you do for a living
- Whether you want to have children after surgery
- If you have the extra tissue needed for a natural reconstruction
- How much downtime after surgery are you comfortable with?
If you are going to have a lumpectomy or mastectomy, consult a plastic surgeon in addition to your breast surgeon. A plastic surgeon can provide guidance on various breast reconstruction procedures and work with your breast surgeon to give you the look you want.
It’s okay to take your time making a decision, Manahan says. “You may not know if you want implants or if you want to use abdominal or thigh tissue or if you will need radiation. But you can still go ahead with the mastectomy. We can insert a tissue expander to keep a breast-like shape under your skin. Then, when you’re ready, we can remove the expander and reconstruct your breasts with either implants or your own tissue. What is important is to know that there are many options for breast reconstruction and to consult with your surgeon to find the best option for you.”
Everyone and every body is different, Manahan reminds, and every patient has different preferences and goals. “We hope that the many options we have to offer for breast reconstruction will allow us to tailor each reconstruction to each individual patient.”
To learn more about postponing your breast reconstruction, read on 7 things you may not know about delayed breast reconstruction.
