If you need surgery for breast cancer, you may be wondering about breast reconstruction. Choosing whether to restore your breast and selecting the method that’s right for you are very personal decisions.
At Seattle Cancer Care Alliance (SCCA), experienced breast reconstructive surgeons from UW Medicine are here to help. We specialize in breast reconstruction. After learning about your values, preferences, concerns, and wishes, we explain your options and guide you through the process.
- Our breast reconstructive surgeons, both men and women, are all highly skilled in natural-tissue reconstruction (restoring your breast using tissue from your own body) as well as implants (using synthetic materials).
- They partner with your breast surgeon (who performs the surgery to remove your cancer) and other members of your cancer care team so you receive coordinated care.
- We use a range of advanced surgical techniques to achieve the best possible results. This includes offering more complex procedures to meet the needs of women with different body types and health concerns and women who want breast reduction.
- To improve care for all women, we conduct research to study the results of reconstructive surgery, which means you benefit from the experience of women who have come before you.
Which type of breast reconstruction is right for me?
Your first step toward reconstruction will be to meet with a breast reconstructive surgeon to talk about your options.
Typically this happens after your cancer care team develops your overall treatment plan. This way you have a chance to consider their recommendations and think about the next step. We adjust the timing to be sensitive to your needs.
- SCCA surgeons offer both immediate breast reconstruction and later reconstruction after you complete breast cancer treatment (also called delayed reconstruction).
- The timing depends in part on the surgery you have to remove your tumor.
- It may also depend on other factors about your health or the other cancer treatment you need.
If you are having a lumpectomy
If you are having a lumpectomy to remove your cancer, your surgeon may be able to take out your tumor and reshape your breast in one procedure called donut mastopexy.
- In this option, your surgeon makes an incision around your areola (the darker colored skin around your nipple), where the scar can be well hidden.
- After taking out the cancerous lump, the surgeon shifts your healthy breast tissue over to restore the shape of your breast.
- Depending on how much tissue was removed, some women have their other breast reduced so their breasts are more balanced.
If you are having a mastectomy
If you are having a mastectomy, you may be able to have reconstruction right after your tumor is removed, while you are still under anesthesia, or your team may recommend waiting.
- Immediate reconstruction is often possible for women whose cancer has been detected early.
- Waiting may be best if you need other treatment, such as radiation and chemotherapy, or if you have health concerns, such as high blood pressure, that can complicate reconstruction.
SCCA breast reconstructive surgeons perform a high volume of natural-tissue reconstructions. We have the technical skills and extensive experience to provide an option that works for you.
Many women have their breast restored using skin and fat from their abdomen because it is the most natural match for breast tissue and the abdomen is the most common area to have extra tissue.
- The technical name for this procedure is deep inferior epigastric perforator (DIEP) flap. It’s also referred to as tummy-tuck reconstruction.
- Later, in a separate procedure, the surgeon can reconstruct a nipple.
- Some women have an additional surgery to improve balance with their other breast.
We also offer other techniques if the DIEP flap is not right for you—for example, if you have already had abdominal surgery or you do not have enough abdominal tissue to use in your breast. Other options include restoring your breast using:
- Tissue from your upper buttock (superior gluteal artery perforator, or SGAP, flap)
- Tissue from your lower buttock (inferior gluteal artery perforator, or IGAP, flap)
- Tissue from your inner thigh (transverse upper gracilis, or TUG, flap)
Restoring your breast with an implant
A saline or silicone implant is another option for restoring your breast.
Implants are better than they have ever been, and we can place them either under the pectoralis major muscle in your chest (subpectoral reconstruction) or over the muscle (prepectoral reconstruction).
To make room for an implant, most women need a temporary adjustable implant called a tissue expander.
- This balloon-like device is gradually filled with saline over several weeks to expand your skin (and, if needed, the muscle).
- The tissue expander can be put in place at the time of your mastectomy or weeks, months, or even years later. (Normally the surgeon will follow your mastectomy scar to avoid creating a new scar.)
- When the skin (and muscle) have stretched enough, the surgeon removes the expander and inserts your permanent implant.
If you’re considering an implant, your surgeon can explain the differences between saline and silicone options, as well as the different positions where implants can be placed, and they can show you samples of implants during your consultation.
Another option: Breast prostheses
Keep in mind that some women choose not to have reconstructive surgery; of these, some decide to wear a breast prosthesis, or breast form. The American Cancer Society has resources about breast prostheses.