5 Things to Know About Breast Reconstruction After Cancer

If you have had or are planning to have a mastectomy following a breast cancer diagnosis, you may decide to have reconstructive surgery to restore the shape of your breasts. To make the best choices for your body, mind, and lifestyle, you need information. Here are five things you should know about breast reconstruction.

1. Surgical reconstruction is just one choice you could make.

When it comes to your body, you’re the boss. Some women choose breast reconstruction surgery after a mastectomy, and some do not. You may not be sure at first whether you want to undergo reconstructive surgery, and that’s okay. Your choice should be the one that best supports your overall physical and mental health. Ask all the questions you have, and take the time you need to feel confident that whatever choice you make is the right one for you.

If you forego surgery, you can get a prosthesis to replace the shape of your breasts, wear a padded bra, or choose to embrace your new, streamlined profile. Breast prostheses come in a variety of shapes and weights to fit a wide range of body types.

In Iowa, Unity Point Health hosts Women’s Health Boutiques in Clive, Fort Dodge, and Sioux City. At these sites, certified prosthetic fitters are available to help patients select quality products that fit well, feel comfortable, and appeal to their sense of style. They can also help select products that are covered by insurance.

2. You may be able to have reconstructive surgery during the same appointment as your mastectomy.

If you’re considering reconstruction, it’s best to talk with your surgeon about it before your mastectomy, even if you’re not sure or if you’re planning to do it later on. Different plastic surgeons have expertise in different techniques, so starting the conversation early will give you more time to select the best provider to perform the best procedure for you. If you do end up having both procedures done at the same time, you’ll need to select a plastic surgeon who is able to work side by side with your breast surgeon.

3. Surgeons can reconstruct breasts using either implants or the patient’s own tissue.

Breast implants are well known, but some women instead undergo what’s known as a “flap” surgery to reconstruct their breasts. This can be done in several different ways. Whether a flap surgery is the best choice, and if so, which type of flap procedure should be used depends on the patient’s body type, medical needs, and personal preferences.

If you decide to move forward with reconstruction, talk with your surgeon about the pros and cons of various procedures. Expect clear and accessible communication. If you have trouble getting answers you understand from your surgeon’s office, a different provider may be able to serve you better. Be honest and thorough with your health history so they can make the very best recommendations for you.

4. Breast implants can be filled with either silicone or saline.

All artificial breast implants have a silicone shell. The first implants to come on the market in the 1960s were filled with silicone. Soon after, saline-filled implants came into use. The silicone filling in breast implants is a gel substance, and saline is a liquid (salt water). As a result, the look at feel of a silicone implant is different from a saline implant.

Saline implants tend to be less expensive but are more easily seen beneath the skin and can make it more difficult to attain the feel of natural breast tissue. Silicone gel better approximates the texture of human body fat. Additionally, while either type of artificial implant can rupture, saline implants, because they are filled with liquid, tend to deflate when they rupture. Routine MRI screening is often recommended to detect rupture of silicone implants.

5. All surgeries involve risk. Breast reconstruction is no exception.

Whether and what type of reconstructive surgery to have is probably not the biggest health decision you’re making right now, but it is important to appreciate the risks involved. In this brief overview, we will only highlight some of the more prominent risks of breast reconstruction. Be sure to thoroughly discuss with your surgeon all complications associated with the surgery you’re considering and how to minimize your risks.

• The risk of infection is present in any surgery.
• Silicone or saline implants can rupture, causing the gel or liquid to leak into the surrounding tissue.
• Scar tissue can form around the implant, creating a capsular contracture. This can cause pain and change the shape of the breast.
• Fluid can collect around the implant, creating a seroma. If they become large, seromas may need to be drained. Seromas can also result from the mastectomy procedure.
• “Breast implant illness” is used to describe a collection of systemic symptoms, including memory loss, fatigue, and rash, that women have described in association with breast implants.
• Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a cancer of the immune system that can develop following breast implant surgery. It is unclear how many patients suffer this complication, and the FDA is actively studying the issue. Some types of implants are associated with a higher risk of this complication than others.

Smoking, obesity, radiation treatment, and other health factors can increase your risk of complications following reconstructive surgery. By thoroughly discussing your risks and health history with your surgeon, you will be able to choose the procedure that best supports your health and minimize the risks involved.

When making decisions about your health, you need all the reliable information you can get. At Iowa Radiology, we strive to be a trusted resource for health information. To stay up to date on our latest articles, subscribe to our blog.

Resources

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Magnetic Resonance Imaging (MRI)—Body. Radiologyinfo.com. https://www.radiologyinfo.org/en/info/bodymr. Reviewed June 18, 2018. Accessed July 29, 2021.

Magnetic Resonance Imaging (MRI). NIH.gov. https://www.nibib.nih.gov/science-education/science-topics/magnetic-resonance-imaging-mri. Published May 4, 2013. Accessed July 29, 2021.

MRI. MayoClinic.org. https://www.mayoclinic.org/tests-procedures/mri/about/pac-20384768. Updated August 23, 2019. Accessed July 29, 2021.