Breast cancer is an all-too-common disease that affects thousands of Canadian women every year. The Breast Cancer Society of Canada estimates that in 2015, 25 000 Canadian women will be diagnosed with breast cancer. The life-altering fight to overcome this disease often involves the removal of the affected breast(s) with a surgical process known as a mastectomy. Despite the widespread nature of breast cancer and its treatment, many women are unaware of the options for breast reconstruction that are available to them.

Dr. Nancy de Kleer is a dedicated plastic surgeon with a special interest in reconstructive surgery, and is passionate about educating women on breast health and empowering them to seek the best possible medical care. In honour of Breast Cancer Awareness Month and BRA Day 2015, Oakville Plastic Surgery and Advanced Skincare is sharing everything you need to know about breast reconstruction.

When can breast reconstruction be performed?

Breast reconstruction surgery can be performed immediately following a mastectomy procedure. The benefit of this option is that it entails only one recovery period, which can reduce stress on your body. Should further chemotherapy be required, the breast reconstruction will not interfere with the progress of the treatments.

In some cases where ongoing radiation therapy is required, your surgeon may recommend delayed reconstruction: there is a chance that implants can compromise the radiation treatment, and radiation therapy can cause unfavourable changes to implants.

Another option is delayed-immediate reconstruction, whereby a tissue expander or breast implant is inserted under the chest muscle and preserved breast skin after the breast is removed. This method helps to preserve the shape of the breast and breast skin. Once radiation is complete and tissues have recovered (4-6 months), the expander/implant that was used to maintain the shape of the breast is removed. In the case of an autologous or “flap” reconstruction, tissues transplanted from another part of the body are then used to form the breast.

The surgical options for breast reconstruction.

There are two primary methods for reconstructing the breast: autologous reconstruction and implant reconstruction.

Each of these methods has its pros and cons.

• In the case of implant reconstruction, it is a simpler procedure with less complications and faster recovery.
• However over time, problems can arise with implants that require maintenance, whereas flap reconstruction should not require further attention once the recovery and follow-up period is complete.

Your surgeon will make recommendations, as your particular situation will influence which type of reconstruction is best suited to you.

Corrections post-reconstruction.

The reconstructed breast takes a minimum of 4-6 months to heal. At this point, small differences in the shape, balance, or position of the reconstructed breast in comparison to the other breast may be evaluated and corrected. Your surgeon will make the appropriate recommendations to correct these minor flaws.

Nipple Reconstruction.

There are two main options for nipple reconstruction: tissue reconstruction and a tattoo nipple.

Tissue reconstruction uses the surrounding skin at the desired site to form and shape a living tissue projection that mimics the natural nipple. The new nipple can then be tattooed to add color and create the areola around the nipple.

A tattoo nipple is a recreation of a nipple with no physical dimension. A tattoo artist can create a 3-D representation of a natural nipple that can look quite realistic.

Whichever option that is chosen, reconstructing the nipple is an important step for many women in the process of achieving a familiar look and form for their breast(s).

There is more to learn.

We hope this introductory article about breast reconstruction has given you some clarity on this surgical procedure that plays such an invaluable role in the breast cancer recovery process. Reconstructive surgery is still in its infancy, and great emphasis in the field of plastic surgery is placed on continued research and innovation for enhanced safety and outcomes. Dr. Nancy de Kleer constantly updates and develops her skills, and provides her patients with the most advanced methods in breast reconstruction. To learn more about breast reconstruction options, we welcome you to book in for a surgical consultation. Call 905.901.9545 or email [email protected] to request an appointment.