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Breast Reconstruction

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I had reconstructive breast surgery. Read my story.

Kim Hagerich

Carol Hess

Laura Marblestone

Jill Scheetz

Tijuana Smith

Lael Swank

Breast reconstruction is surgery to rebuild and help restore the look of a natural breast. At Philadelphia's Fox Chase Cancer Center, we offer a full range of breast reconstruction options, giving you more choices following breast cancer surgery. This expertise includes microvascular and muscle-sparing procedures and advanced techniques using your own abdominal tissue.

More Choices + Expert Surgeons = Better Outcomes

Our reconstructive surgeons, including nationally-recognized expert Neal S. Topham, MD, and Sameer Patel, MD, FACS, are board-certified in plastic surgery and specialize in restoring appearance and function for patients with breast cancer and other types of cancers. Your reconstructive surgeon will work closely with your breast cancer surgeon and treatment team at Fox Chase to give you the best possible outcome.

Fox Chase Offers You the Latest Reconstructive Options

Flap procedures use your own tissue to create a natural looking breast. Fox Chase experts are skilled in performing several types of flap procedures, including the free TRAM flap and DIEP flap. Both use abdominal tissue.

For women who choose breast reconstruction with implants, Fox Chase offers both saline and silicone gel implants. Implants are inserted with a tissue expander. A new technique using AlloDerm, a processed skin product, allows for faster expansion and stable implant coverage, which shortens the reconstruction process for implants.

Fox Chase has surgeons who have extensive experience with TRAM (transverse rectus abdominus myocutaneous) flap procedures, either pedicled TRAM or free tissue transfer, as well as other types of tissue reconstructions tailored to suit a patient's specific body habitus (or body build).

The Breast Reconstruction Process

Reconstruction usually is completed in multiple stages. The first stage involves creation of the breast mound and is usually done in a hospital. Follow-up procedures are commonly done on an outpatient basis, but may also take place in the hospital. This decision depends on the extent of surgery needed and the preference of your surgeon.

Follow-up procedures usually include exchanging expanders for implants and reconstruction of the nipple and areola (the darker area surrounding the nipple). Less common are procedures to reshape the remaining breast to make it symmetrical with the reconstructed one or to address complications that may result after surgery. Years later, it may be necessary to replace implants. Breast implants usually don't last a lifetime as there can be scarring around them.

Is Breast Reconstruction Right for Me?

The choice to have breast reconstruction is a personal one. Some women choose reconstructive surgery to re-establish breast symmetry, to regain normal breast contour or to eliminate the need for a breast prosthesis (artificial breast form).

Most women who have had a mastectomy (removal of the entire breast) are candidates for breast reconstruction. Women who have had a lumpectomy, in which only a segment of the breast is removed, usually do not need reconstructive surgery.

After considering your overall health and other personal factors such as the stage of your breast cancer, age, lifestyle, body type and goals of the surgery, your surgeon will discuss the risks and benefits of your reconstructive options.

Health insurance policies often cover most or all of the cost of reconstruction after a mastectomy. Check your policy to make sure you are covered. Also, see if there are any limits on what types of reconstruction are covered.

When to Have Breast Reconstruction

Breast reconstruction can be done either at the time of the mastectomy (immediate reconstruction) or the surgery can be delayed for months or years (delayed reconstruction) depending on your preference and treatment options.

In general, reconstruction results are better when done at the time of the mastectomy. This is because the skin and other soft tissues surrounding the area haven't tightened and scarred. Delaying surgery may be recommended, however, when radiation therapy is necessary after a mastectomy.

Discuss breast reconstruction with your doctor

The results of surgery vary. The desired result with breast reconstruction is improvement, not perfection. You should openly discuss your expectations and all possible outcomes with your doctor when considering breast reconstruction. Questions for your doctor

  • While breast reconstruction restores the shape of the breast, it does not restore normal breast or nipple sensation.

  • The ability to heal may be affected by previous surgeries, chemotherapy or radiation treatments, smoking, alcohol, diabetes and various medications.

  • It may be recommended to have surgery on the remaining breast to reshape it to match the reconstructed breast. (For women with a breast cancer diagnosis, reconstructive surgery on the opposite breast is covered by insurance as mandated by federal law.)

  • There is no known effect on breast cancer recurrence (the cancer coming back) if a woman has had breast reconstruction.

  • Women who've had a unilateral mastectomy (one breast removed) should continue to have regular mammograms on the opposite breast. Generally, there is no radiographic follow-up for a reconstructed breast because there is no remaining breast tissue. If there is a recurrence of cancer, it would be palpated, or felt, on the chest wall.

For more information about breast cancer treatment and prevention at Fox Chase Cancer Center or to make an appointment, call 1-888-FOX CHASE (1-888-369-2427). The breast cancer scheduling department can be reached at 215-728-3001.