Breast Reconstruction: A Simple Guide
What Is the Aim of Breast Reconstruction?
Breast reconstruction is designed to help women who have had, or are planning to have, a mastectomy (surgery to remove the breast). The goal is to restore the breast’s shape and appearance to look as natural as possible.
Breast Reconstruction Options
There are three main options for breast reconstruction:
- External Breast Prosthesis:
- A removable breast form worn inside a bra.
- Implant Breast Reconstruction:
- Uses silicone or saline implants to recreate the breast shape.
- Autologous Tissue Reconstruction:
- Uses tissue from your own body (like the back, belly, or thighs) to rebuild the breast. This includes techniques like:
- Latissimus Dorsi Flap (LD Flap)
- Deep Inferior Epigastric Perforator Flap (DIEP Flap)
- Transverse Rectus Abdominis Muscle Flap (TRAM Flap)
Comparison of Breast Reconstruction Options
| Feature | External Breast Prosthesis | Implant Reconstruction | Autologous Tissue Reconstruction |
|---|---|---|---|
| Cost | $ | $$ | $$$ |
| Appearance (Look) | Good | Very Good | Excellent |
| Feel (Naturalness) | Fair | Good | Feels Most Natural |
| Surgery Complexity | None (non-surgical) | Moderate | Complex Surgery |
| Recovery Time | None | Moderate | Longer Recovery |
| Durability | 1-2 years | 10-15 years | Can Last a Lifetime |
Who Can Have Each Option?
1. External Breast Prosthesis:
- Who Can Use: Anyone
- Requirements: None
- Considerations: Needs replacement every 1-2 years
2. Implant Breast Reconstruction:
- Who Can Have It: People with good skin quality
- Not Recommended For:
- Smokers
- People with diabetes or obesity
- Those with prior chest radiation
- Risks:
- Implant rupture or shifting
- Rare risk of Breast Implant-Associated Large Cell Lymphoma (BIA-ALCL)
3. Autologous Tissue Reconstruction:
- Who Can Have It: People with enough tissue for transfer and good blood supply
- Not Recommended For:
- Smokers
- Those with diabetes, obesity, or prior chest radiation
- Athletes who rely heavily on upper body strength (for LD flap)
- People with hernia risk or weak core muscles (for DIEP/TRAM flaps)
- Risks:
- Scarring or complications at the donor site
- Longer recovery
Things to Keep in Mind:
- Touch-Up Procedures: You might need additional surgeries like scar revision or fat grafting (lipofilling) to improve the final result.
- Consultation: Always discuss the best option for your health, lifestyle, and personal preferences with your healthcare provider.
Helpful Resources:
External Breast Prosthesis:
- Breast Cancer Network Australia (BCNA) – Breast Prostheses
- External Breast Prostheses Reimbursement Program
Breast Reconstruction:
- BRECONDA – Breast Reconstruction Decision Aid
- Cancer Council – Breast Prostheses and Reconstruction Guide
Talk to your doctor or surgeon to find the best option for you.