Cleveland Clinic's staff treats more than 3,000 patients per year throughout the multidisciplinary subspecialties involved in the care of breast cancer. Cleveland Clinic Breast Center staff collaborate closely with the Department of Plastic Surgery for breast reconstructions.
For women who must face mastectomy, breast reconstruction offers a renewed sense of completeness. Improvements in plastic surgery techniques offer better breast reconstruction results than ever before, making breast reconstruction a favorable option following cancer surgery.
Why should I consider breast reconstruction?
After your mastectomy, you may choose to wear external breast forms or pads or make no attempt to alter your appearance. But if you are like many women, the option of breast reconstruction, using either breast implants or your own tissue, is appealing.
Breast reconstruction not only improves your physical appearance, but may also offer psychological benefits as well. It can help you feel whole again and promote a sense of wellness. Breast reconstruction can also make it easier to return to your normal routines and favorite activities.
At Cleveland Clinic, performing the two breast reconstruction procedures simultaneously is possible because of our unique team approach and the professional collaboration between the Clinic's breast surgeons, who perform the mastectomy, and the plastic surgeons, who perform the breast reconstruction.
It is also possible to have breast reconstruction months or years after a mastectomy. If any chemotherapy or radiation treatments have already been started, breast reconstruction is usually postponed until those are completed.
How is breast reconstruction achieved?
The main goal of breast reconstruction is to recreate a breast that closely matches the healthy, opposite side. If reconstruction on both breasts is necessary, this too can be accomplished. At Cleveland Clinic, breast reconstruction most often is performed at the same time as the mastectomy.
What area my options for breast reconstruction?
Either your own tissue or an implant can be used for breast reconstruction. To learn more about both breast reconstruction options, refer to the links at the right.
Nipple and areola reconstruction. Approximately one-third of mastectomy/breast reconstruction patients choose to have the nipple and the areola (dark-colored area of skin around the nipple) reconstructed. Reconstruction of the nipple and areola is done on an outpatient basis under local anesthesia. If the primary concern is to improve your appearance in clothing, you may choose not to have the nipple and areola reconstructed.
The nipple is made using a small flap of breast tissue at the site where the nipple should be located. It is no longer necessary to borrow tissue from elsewhere on the body. At a later date, the nipple and areola both are colored by medical tattooing.
Most doctors prefer to wait several weeks or months after the breast reconstruction to construct the nipple and areola. This allows the new breast tissue to heal and settle into place so minor adjustments in size and position can be carried out when the nipple and areola are reconstructed.
How long does breast reconstruction surgery take?
Depending on the specific procedure being performed, breast reconstruction can take between one and five hours.
What can I expect from recovery?
Expanding implant breast reconstruction performed at the time of the mastectomy generally does not increase the hospital stay. Flap procedures require a hospital stay of five to six days. Most women return to normal activities following flap breast reconstruction within six weeks following surgery.
What are the risks?
Breast reconstruction is a major surgical procedure, and both flap and implant procedures carry risks of complications, such as bleeding, infection or healing problems. Complications can delay recovery. With flap surgery, healing problems occasionally can result in partial or, rarely, total flap loss.
Breast implants have a limited lifetime and ultimately will wear out, leak or break, requiring replacement. "Capsules" or a firmness to the breast, occur in a small number of patients who undergo breast implant reconstruction. Risk of a capsule is significantly higher in patients who undergo radiation.
Undergoing breast reconstruction surgery neither will increase your risk of breast cancer recurrence nor interfere with the methods of detecting a breast cancer recurrence. In addition, according to available evidence, there is no reason to suspect that breast implants cause breast cancer.
When should I consider breast reconstruction?
Timing of breast reconstruction is based on a number of factors, including the patient's desires, the stage of breast cancer and the need (or lack thereof) for radiation and additional chemotherapy. The breast surgery and plastic surgery team is happy to discuss this with each individual patient in detail prior to the mastectomy surgery.
Will insurance cover the cost of surgery?
Breast reconstruction after mastectomy is part of the treatment of the disease and is not considered cosmetic surgery. Therefore, it has been mandated by the federal government that health insurance companies must cover breast reconstruction procedures, including surgery on the opposite breast if deemed necessary for best results. Contact your insurer about specific issues regarding your coverage.
