Open
14
Mar
2016

Can Breast Reconstruction Be Done After a Mastectomy?

Yes, breast reconstruction is possible after a mastectomy, and there are a variety of methods which address the different conditions that a breast may be in after it has been treated for breast cancer. Reconstruction after mastectomy is a path that many women have gone through before, so your surgeon will be going in with lots of knowledge to help restore the breast to its former condition.

Breast Reconstruction After Mastectomy

The timing of the mastectomy and reconstruction

Immediate reconstruction combines the mastectomy and reconstruction into one lengthened procedure. Not all cases are suited to this choice, such as when the breast tumor is very large. In those cases, the doctor focuses on the cancer treatment first, completes the mastectomy and adjuvant therapy, and then proceeds with reconstruction. Adjuvant therapy includes:

  • chemotherapy
  • hormonal therapy
  • radiation therapy
  • trastuzumab

It’s possible to have the reconstruction either before or after the adjuvant therapy, but if you’re going to wait until afterward, patients should wait 3-4 weeks after chemotherapy and 4-6 weeks after radiation therapy to have the procedure.

What if you’re thin or have large breasts?

Women who are thin face the issue of finding enough breast tissue to support the reconstruction. Likewise, women who are naturally large-chested but had a large tumor, meaning a sizable part of the breast had to be removed, will also face a similar issue since the affected breast has to be reconstructed to match the size of the other one. Other factors include the condition of the remaining tissue surrounding the site where the tumor was and other relevant health issues.

Still, with the existing procedures, there are ways to make the reconstruction work.

Restoring volume

The surgeon may choose to enlarge the breast with an implant that’s made from saline or silicone gel. Surgery is completed by first placing an expander which will gently stretch the tissue and form a pocket. Afterwards, the implant is inserted in the pocket where it will permanently stay. The other way to restore volume is using tissue from other parts of the body. The collected tissue includes fat and skin to be re-used in the breast. Common donor sites include the abdomen, back, and butt while the methods for removal and repositioning are:

  • free flap
  • DIEP flap
  • LATS flap
  • TRAM flap

Healing from breast reconstruction will require more time than a regular breast augmentation, but you will be able to lead an active life during the recovery period. For more information, consult your doctor or talk to us to learn more.





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Montreal Clinic

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Dr. Omar Fouda Neel, FRCSC, FACS
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