Breast Cancer Surgery and Reconstruction
Breast Reconstruction Surgery after Breast Cancer Surgery
Along with breast cancer surgery, you may choose to have breast reconstruction. This procedure can follow after a mastectomy in the same surgery. Breast reconstruction can also be done as a delayed procedure months to years after the initial breast cancer surgery.
Why should I consider a Breast Reconstruction Operation?
Losing one or both breasts to cancer is a very traumatic life experience. Cancer treatment may continue post-surgery in the form of chemotherapy or radiotherapy. Breast reconstruction helps to restore the shape of your breast. This may help you to better face the loss of your breast. It is important as post-surgery you will want to focus your time and energy on recovery as well as the other treatments that lie ahead.
Breast reconstruction also has benefit for daily function. It makes wearing a bra easier and prevents the bra from riding upwards. It also balances the weight of the opposite breast which is significant if you have large breasts.
Do take note that although breast reconstruction is able to restore the shape of your breast it will not be able to restore the sensation of your breast.
It is a larger operation compared to a mastectomy alone and there will be a longer recovery time for this surgery. Do discuss with your surgeon the pros and cons of this surgery to enable you to decide what will be best for you.
What are the various types of Breast Reconstruction Surgery available?
Generally the shape of your breast can be restored either with an implant or your own tissue, this is also known as a tissue flap. At times there may be a need to use both methods in the same surgery.
If your nipple has been removed during the cancer surgery it may be possible to reconstruct a new nipple from your own tissue as well. This usually takes place as another procedure about a year after the initial reconstructive surgery.
Again it is crucial to discuss these options with your surgeon as your cancer characteristics, the treatment needed as well as your breast size and shape, and your lifestyle, all impact the type of reconstruction that will be suitable for you.
1. Can breast reconstruction be done at the same time as cancer surgery?
Yes, breast reconstruction can often be performed immediately during your mastectomy. This is called immediate reconstruction. Dr. Melanie Seah works with a plastic surgeon who can reconstruct your breast right after removing the cancer tissue. This approach works especially well with skin-sparing or nipple-sparing mastectomy. However, not everyone is a candidate—factors like cancer stage, radiation needs, and overall health affect timing. Your surgical team will recommend the best approach for your situation.
2. Will I have sensation in my breast after reconstruction?
Most women experience some loss of sensation in the reconstructed breast, especially in the nipple area, because nerves are severed during mastectomy. Some women regain partial feeling over months to years, while others have minimal sensation. Nipple-sparing procedures may preserve slightly more feeling than those where the nipple is reconstructed. While aesthetic results can be excellent, it’s important to have realistic expectations about sensory changes.
3. How many surgeries are needed for breast reconstruction?
It depends on the method chosen. Implant reconstruction typically requires two stages: initial placement of a tissue expander, then replacement with a permanent implant 3-6 months later. Reconstruction using your own tissue may be completed in one surgery, though minor refinements might need an additional procedure. If you require radiation therapy, delayed reconstruction may be recommended. Your surgical team will outline the expected timeline during consultation.
4. How do surgeons maintain the natural appearance of the breast after surgery?
Dr. Seah uses oncoplastic techniques and offers skin-sparing and nipple-sparing mastectomy to achieve natural-looking results. Skin-sparing procedures preserve the breast skin envelope for better contour, while nipple-sparing also keeps the nipple-areola complex intact. For lumpectomy, oncoplastic techniques rearrange remaining tissue to prevent deformity. Surgeons also consider symmetry, sometimes adjusting the opposite breast to match. The goal is creating results that look natural while ensuring complete cancer removal.
5. What factors affect the choice of reconstruction method?
Several factors determine the best approach:
●Cancer factors: Tumor size/location, radiation needs, extent of tissue removal
●Surgical options: Type of mastectomy, whether skin-sparing or nipple-sparing is suitable
●Your health: Overall fitness, body shape, donor tissue availability, smoking status
●Personal preferences: Lifestyle, desired outcome, recovery time, comfort with different approaches
●Timing: Whether immediate or delayed reconstruction fits your treatment plan
Dr. Seah works with you and the plastic surgeon to evaluate these factors and recommend the best option for your individual needs.
