Breast reconstruction is a surgical procedure that is carried out to rebuild the shape of the breast after having undergone mastectomy. Mastectomy may have been carried out in patients to either reduce the risk of developing breast cancer in the first place or to treat others who may have been diagnosed with the condition.

The procedure can be performed at the time of the mastectomy known as immediate reconstruction or be postponed till a later time known as delayed breast reconstruction. Broadly speaking there are two types of procedures that are commonly practiced to achieve this.

The first is known as a breast implant where the skin and muscles of the breast area are filled with a silicone insert to reconstruct the shape of the breast. The insert is made up of either a silicone envelope or a shell containing silicone and provides a natural feel. Implants are available in two types where one is made of silicone gel and the other is its newer counterpart made of cohesive gel.

The silicone gel implant is the original type while the cohesive gel comes with the added advantage of holding its shape longer. This silicone implant method is typically recommended for women who do not need radiotherapy.

Another option to the silicone insert is the saline insert. Though initially used commonly, saline inserts are not that frequently used in such operations. In this type of insert, saltwater is contained inside a solid silicone envelope. In case the implant deflates over time, it will need to be replaced.

The most common concern with breast implants is that they may rupture or leak overtime. In such a case, the implant will need to be replaced, but most silicone implants can last for up to 15 years.

The second method is called a tissue flap breast reconstruction where skin, fat, tissue or even muscle is transferred to the breast area from another part of the body. The method is suitable for most women, especially those with a larger breast size, or others who may not have sufficient remaining skin after the mastectomy to cover the implant. In addition, women who have undergone radiotherapy can also have flap reconstruction done safely.

The various methods of flap reconstruction involve rotating, moving or detaching different muscles from the body and relocating them in the breast area. Each type of flap reconstruction is a different procedure and should be discussed fully with the health care practitioner prior to making any decisions.

The whole process of reconstruction can extend beyond a few weeks or months since breast reconstruction will likely involve multiple operations before the procedure is considered complete.

Patients may decide to opt for this operation for a number of reasons. For some women, having the breast recreated can help them lead a more physically and emotionally fulfilled life including having an improved body image, boosting confidence and reducing their stress levels.

On the other hand, women may choose not to have the operation done and prefer to live with their post mastectomy shape.

References:

1) Breast reconstruction: http://canceraustralia.gov.au/affected-cancer/cancer-types/breast-cancer/treatment/breast-reconstruction

2) Breast cancer network Australia- breast reconstruction: https://www.bcna.org.au/about-bcna/advocacy/position-statements/breast-reconstruction

3) Types of breast reconstruction: http://www.cancervic.org.au/about-cancer/types-treatments-trials/breast_reconstruction_1/types_of_breast_reconstruction.html