Tips to Live By

Breast Reconstruction: 5 Things to Know If You Need Breast Cancer Surgery

Oct. 14, 2020 - Katie McCallum

A breast cancer diagnosis is frightening and overwhelming. Getting the cancer out of your body is, of course, your top priority, but if your treatment plan includes a lumpectomy or mastectomy, you're probably acutely aware that these procedures can change the way your breast looks and feels.

It's natural to be concerned about your femininity as soon as you hear the words "breast cancer" and "surgery" — and if you're left feeling afraid and full of questions, you're not alone.

Whether you're looking for information for yourself, your mother, your wife, your sister, your best friend or another loved one, Dr. Warren Ellsworth, breast reconstructive surgeon at Houston Methodist, is here to share five key things he thinks every woman needs to know about breast reconstruction.

Most women will have several breast reconstruction options to choose from

The type of surgery you need to remove your breast cancer is a large determining factor in the type(s) of breast reconstruction for which you're a candidate. But it's important to know that you have options and that you're not alone in your decision-making.

If you need a lumpectomy, which removes the tumor and only a small amount of healthy breast tissue, a reconstructive surgeon can reshape your breast so that the space where the breast tumor was removed from looks normal.

If you need a mastectomy, which removes your entire breast, a reconstructive surgeon can rebuild your breast using either an implant or your own tissue. Each option has its own unique advantages.

  • Breast implant – an implant is used to reshape and reform your breast. This option reduces your length of recovery by a few weeks, but studies show that many women will need the implant replaced after approximately 15 years.

  • Flap procedure – uses your own tissue, typically taken from your belly, to rebuild your breast. This is a more complex, specialized type of breast reconstruction, but it results in a more natural feeling and looking breast that works for life.

"The most important thing to know is that you have options, and it's my job is to match you with the procedure that's best for you based on your particular treatment plan and unique wants or needs," says Dr. Ellsworth. "It's also my job to educate you about your options so you feel comfortable and empowered while making your decision."

You can undergo breast reconstruction immediately, or months to years after your surgery

Most women have the option of undergoing breast reconstruction immediately after breast cancer surgery. But you can choose to delay reconstruction.

"One of the main advantages of undergoing reconstruction immediately is that we often can perform what's called a nipple-sparing mastectomy — which allows us to save your natural breast skin and nipple," explains Dr. Ellsworth. "This results in your breast looking more natural after reconstruction."

If you delay your reconstruction, or perhaps weren't ever offered the option as part of your treatment, Dr. Ellsworth still has good news.

"It's never too late to consider breast reconstruction," says Dr. Ellsworth. "Opting for an immediate breast reconstruction offers better aesthetic results, but a woman can always reconsider her option for an implant or a flap procedure."

You still have options if you need radiation after your breast cancer surgery

Radiation is sometimes a part of a woman's post-surgery breast cancer treatment plan, and this radiation can be damaging to an implant or your own tissue that's used to rebuild your breast.

But, needing this type of therapy doesn't mean you can't opt for immediate breast reconstruction to help ensure you have a more natural-looking breast at the end of your cancer treatment.

"For women who may need postoperative radiation, we can still spare your skin and sometimes your nipple at the time of your mastectomy. Rather than complete your reconstruction immediately, however, we use what's called a tissue expander to hold your breast in proper shape until we can complete the reconstruction after your radiation therapy."

And this is only one way in which our breast reconstruction experts are providing more options for more women than ever before.

Breast reconstruction techniques are continuously advancing

"In order to help every woman overcome her cancer while still maintaining her femininity, we're always looking towards the next frontier of breast reconstruction," says Dr. Ellsworth.

Over the years, our reconstructive surgeons have helped pioneer and become experts in:

  • The advanced microsurgical procedures that help spare muscle during flap procedures
  • Performing flap procedures using tissue from areas other than the belly, such as your inner thigh or buttocks, during a flap procedure
  • Surgical techniques that enhance recovery after surgery, helping a woman get back to her normal life sooner
  • Offering improved breast implant options, including those that are well-tested for safety and are less likely to leak

"One of the newer, more unique opportunities in breast reconstruction that we're helping pioneer at Houston Methodist is aimed at solving an unfortunate reality many breast cancer survivors have faced over the years: Reduced breast sensation," says Dr. Ellsworth.

A mastectomy can save a woman's life, but it removes all of her breast tissue — including the nerves. While a flap procedure uses her own belly skin, tissue, arteries and veins to rebuild a healthy breast that looks and feels natural, she may never regain full sensation in her breast.

"To help improve a woman's chance of regaining sensation, we're now dissecting nerves in the transplanted tissue and reconnecting these nerves as we rebuild the breast," explains Dr. Ellsworth. "This new technique requires an experienced reconstructive surgeon. It's currently only offered at 20 hospitals around the country as part of a clinical trial, but we've seen remarkable results using this technique here at Houston Methodist."

It's important that your care team include a breast reconstructive surgeon

Technique and technology aside, possibly one of the largest advances in breast reconstruction over the last 30 years is the increased collaboration between breast cancer surgeons and reconstructive surgeons.

"When it comes to treating your breast cancer and feeling confident and comfortable with your breast afterwards, you need a reconstructive surgeon as part of your care team from the get-go, at the very beginning of your diagnosis," says Dr. Ellsworth.

Early and frequent communication between experts is what enables them to plan not just the ideal lumpectomy or mastectomy, but also the ideal reconstruction — in tandem, leading to better results.

"At Houston Methodist, this team-based approach is what helps ensure that you wake up from your cancer surgery not only one step closer to being cancer-free, but also with a breast that looks and feels as normal as possible."


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