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The diagnosis of breast cancer is devastating for any woman. At minimum, it represents a substantial threat to her health and femininity; at worst, it presents a serious risk to her life. There is no debating the imperative nature of treating the cancer, whether it is by some form of a mastectomy or a lumpectomy with subsequent radiation therapy. The cancer must be eradicated by some means.
What can be difficult in a brief window of time filled with severe anxiety, emotional stress, confusion and confronting one’s own mortality is deciding on whether or not to pursue breast reconstruction at that time or possibly at some later date. So many questions arise and making a decision for these women can be painfully difficult. Our experienced breast surgeon—Dr. Steven H. Turkeltaub—offers and can comprehensively explain breast reconstruction options both to women who have been just diagnosed with breast cancer as well as to those who have been treated sometime in the past.
- Benefits of Breast Reconstruction
- Breast Reconstruction Options
- Nipple-Areola Reconstruction
- Breast Reconstruction Before-and-After Photos
- Breast Reconstruction Patient Testimonial Videos
- Frequently Asked Questions
- Additional Information About Breast Reconstruction from Dr. Turkeltaub
Benefits of Breast Reconstruction
The treatment of breast cancer is not only physically deforming but is also mentally and emotionally stressful and for many, devastating. No matter which procedure is chosen, it exacts a high toll on a woman’s psyche and her sense of femininity.
Many women feel deficient, less feminine, unattractive and quite self-conscious about their appearance. Breast reconstruction, therefore, can serve not only to physically recreate or restore a facsimile of the breast that has been removed or deformed but it can also partially neutralize and reduce the emotional and mental impacts that are inevitable consequences.
Breast Reconstruction Options
No matter what technique is employed for reconstruction, the ultimate result is a representation and not a perfect replica or replacement of the original breast. It will never look, feel or respond the same but advances in plastic surgery have paved the way for results that can be quite outstanding.
The major options to consider include:
- Timing of reconstruction – immediate or late
- Reconstructive techniques on involved breast
- Procedures on the unaffected breast
Immediate Versus Late Reconstruction
Breast reconstruction can be performed concurrent with the mastectomy, providing advantages such as reducing the total number of separate surgical procedures needed for the final result, getting a head start on the reconstruction, and facilitating a shorter overall time for the reconstruction. Technological advancements like the incorporation of acellular dermal grafts (such as Alloderm®) in the reconstruction have resulted in superior outcomes with more precise and predictable results.
Breast reconstruction can also be performed at a later date – from months to even years later. There are many prudent reasons why women elect this course of action.
The pros and cons of each approach, when relevant, can be discussed with you at the time of your consultation with Dr. Turkeltaub.
There are many techniques that can be considered and employed for breast reconstruction. These can be categorized into three general groups.
- Placement of breast implants. A breast implant is inserted for the reconstruction without the need for any preparatory procedure such as usage of tissue expanders. Silicone implants generally provide results that are far superior to those that can be obtained from saline implants.
- Placement of tissue expanders. With this approach, temporary inflatable implants called tissue expanders are inserted initially. These are then inflated with saline over a period of time in order to stretch out the skin and promote new skin growth. Once the skin envelope has been expanded adequately, the permanent breast implants can then be used.
- Flaps. These techniques entail the transfer of tissue from other areas such as the abdomen (TRAM flap), back or buttocks to try and create a more realistic breast mound. Some of these flaps are designed to keep intact their main intrinsic blood supply whereas others require microsurgical techniques in order to facilitate the transfer and maintain tissue viability. As you might have assumed, these types of procedures have greater inherent risks including for failure and the frequent need for revisions.
Procedures on the Unaffected Breast
In order to obtain or at least offer the best possible breast reconstruction, the whole picture should be considered and not just the affected side. That is, one may be able to obtain a great looking reconstructed breast but it may be completely different in appearance compared to the contralateral side. The non-operative side could be far larger or much smaller and even very saggy. The best aesthetic results are obtained when both sides are closer in appearance.
Unless a woman has had a bilateral mastectomy and is undergoing reconstruction on both sides, the odds of the breasts being fairly similar are not great. Therefore, in order to acquire greater symmetry, an appropriate procedure can be considered on this unaffected side. It may involve the insertion of a breast implant with or without performing a breast lift. For a very large breast, a compensatory breast reduction would be beneficial.
It should be noted that many women do not want to have anything done on their uninvolved side which is their prerogative. This is, after all, an optional and not a mandatory component of reconstruction. Fortunately for those women who do want to pursue this symmetry procedure, your health insurance plan is required to cover it as part of the breast reconstruction.
Many women are quite satisfied with their reconstructed breast alone and have no desire to have an added nipple-areola complex. Others feel incomplete without it and elect to have one reconstructed.
There are many techniques that can facilitate the reconstruction of a relatively realistic appearing nipple-areola complex including with a projecting nipple. It can be performed as an isolated procedure, during the final stage of the breast reconstruction, or with a revision procedure. Tattooing can be employed later on for greater refinement and a customized outcome.
Breast Reconstruction Before-and-After Photos
Dr. Turkeltaub is an experienced plastic surgeon who has performed a large number of breast reconstructions in over 22 years of practice in Scottsdale and Phoenix, Arizona. The following are some examples of his results.
Breast Reconstruction Patient Testimonial Videos
Frequently Asked Questions
Q: I had a mastectomy 7 years ago but wasn’t mentally or emotionally ready at that time to consider breast reconstruction. Can I have it done now?
A: Absolutely! As long as you are healthy enough to undergo surgery, breast reconstruction can be considered. Some women are prepared to undergo an immediate breast reconstruction where the procedure is done concurrent with their mastectomy. Others, like you, choose to have it performed at a later date for whatever reason (delayed reconstruction).
Q: My left breast was reconstructed and I am happy with the result. However, there is a considerable difference between the two sides which makes it difficult to wear certain bras and clothes. What can I do?
A: It may be possible to obtain closer symmetry by performing an appropriate procedure on your right side. Depending on what the difference is, this may involve a breast enlargement with or without a breast lift or even a reduction. This compensatory surgery is considered to be reconstructive in nature and not cosmetic, and by law should be covered under your insurance policy.
Additional Information About Breast Reconstruction from Dr. Turkeltaub
Read more about breast reconstruction from Dr. Turkeltaub’s breast surgery blog.
Learn More About Breast Reconstruction Surgery
Dr. Turkeltaub offers comprehensive information and high-quality reconstructive surgery to women who are interested in breast reconstruction surgery. Please feel free to contact our practice today to schedule your consultation.