Below are some of the most common questions we get about breast reconstruction. We encourage you to read through the questions and answers here, and if you have a question that isn’t addressed, please contact us online or call 949-759-0980 for more information.
What are the types of breast reconstruction?
In general, following a mastectomy, there is breast reconstruction using a breast implant/tissue expander only, reconstruction using your own body tissue (flap surgery), and reconstruction that combines flap surgery with the use of an implant. Breast conserving surgery involving a lumpectomy and immediate reconstruction (known as oncoplastic surgery) is also an option for many women.
Which type may be best for me?
Keep in mind that all reconstructive options following a mastectomy will require multiple surgeries and take time to achieve the final result. Oncoplastic surgery can offer many benefits over traditional reconstruction following mastectomy, including fewer surgical sessions and a better cosmetic outcome. The method you and your reconstructive surgeon choose will depend on factors such as the stage and location of the breast tumor, your current health, treatments you may need following surgery such as radiation or chemotherapy, and your personal preference.
Can I have a lumpectomy with breast conservation instead of a mastectomy?
Breast conservation surgery involves removing only a portion of the breast where a tumor is located, with either intraoperative or subsequent radiation therapy. Targeted removal of breast tissue will in most cases leave a visible indentation or dimple on the breast. This can be corrected using oncoplastic surgery techniques that reshape the remaining healthy tissue following a lumpectomy. Dr. Savalia can share more information with you about your candidacy after a review of your diagnosis and discussion of your reconstructive goals.
What are the steps in the traditional breast reconstruction process?
The exact steps that will need to be performed to complete a breast reconstruction will vary from patient to patient. Generally speaking, the traditional reconstruction process using either tissue expander/implant or flap surgery takes about 6 to 12 months. The initial surgery begins the process to create and shape a new breast mound. After waiting for healing (and for tissue expansion in the case of implant-based reconstruction), a secondary procedure is needed to refine the shape of the breast, place a final breast implant if needed, and perform any plastic surgery on the opposite breast for improved symmetry and balance. Additional surgeries may be needed for added improvement. As a final step, many women choose surgery to create a nipple/areola if it was removed at that time of the mastectomy.
What are the steps in oncoplastic breast conservation?
Oncoplastic breast conservation combines cancer surgery and breast reconstruction into a single-stage procedure. This eliminates the risk of performing multiple surgeries and helps women complete their physical and emotional recovery sooner. The procedure may include intraoperative radiation therapy (IORT), replacing the need for follow-up radiation treatments after surgery. During the initial surgery, a breast lift and/or breast reduction is usually performed on the opposite breast for better symmetry, though in some cases women will wait to have this component completed in a secondary procedure.
Is there insurance coverage for breast reconstruction?
The general rule is that if a health insurance company covers the cost of mastectomy surgery, they are obligated under Federal law to cover the cost of breast reconstruction as well. Covered costs must include reconstruction of the breast affected by cancer, reconstruction of the other breast to produce a symmetrical appearance, breast implant(s) if used, and treatment of any physical complications resulting from the mastectomy. More about insurance coverage for breast reconstruction.
What is the difference between immediate and delayed reconstruction?
Immediate breast reconstruction is initiated right after your mastectomy or lumpectomy in the same surgical session. Any reconstruction that is initiated after healing from the initial cancer surgery is called a delayed reconstruction. While reconstruction can be performed months or even years later, most women prefer immediate reconstruction. Learn more about immediate vs. delayed breast reconstruction.
I don’t live in Southern California. How do I arrange surgery and care through you?
We offer assistance in making your travel arrangements to Orange County. In most cases we can work with your primary care physician to arrange any testing needed prior to surgery. We are committed to making the trip and your time with us as comfortable and as easy as possible. Many of our oncoplastic patients find that traveling for care is actually easier than having care locally, where no specialist in oncoplastic surgery exists and mastectomy with multiple follow-up surgeries is the only option available.
What if I may need radiation?
Because radiation may damage the cosmetic results of a reconstruction, women who will need radiation after their cancer surgery may want to delay any reconstructive procedures. In particular, radiation can cause complications if an implant is used for reconstruction. Women who have oncoplastic breast conservation surgery may be candidates for intraoperative radiation therapy (IORT), meaning that their reconstruction and radiation can be completed at the same time as their cancer surgery.
Does choosing breast reconstruction impact when I can have chemotherapy?
If they are necessary, chemotherapy treatments generally are begun once a woman has healed from her mastectomy and reconstruction. This means that reconstruction does not in most cases significantly delay the start of chemotherapy, but complications such as wound healing problems or infection, should they occur, will need to be resolved before chemotherapy is begun.
Will I be more likely to have breast cancer again if I choose reconstruction?
Having breast cancer again (called recurrence) depends on many factors, but reconstruction has not been shown to increase the risk of recurrence.