Plastic Surgeons are well trained in reconstructing breasts. While mastectomy is a traumatic experience for any woman, breast reconstruction is an alternative for women of any age whose health is good enough to tolerate a general anesthetic.

There are two basic ways of reconstructing a breast or both breasts:

1. Prosthetic implants
2. Using your own tissue

Talk to your plastic surgeon about the risks and benefits of implants versus using your own tissue to reconstruct your breast(s).

It is important to understand that a “normal” breast will never be obtained with either type of breast reconstruction operation. Realistic expectations are in order; however, patient satisfaction is generally high.

Prosthetic implants

Prosthetic implants usually consist of silicone shell implants enclosing saline (salt water) or silicone. Saline implants are the most common type used in Canada at this time.

The implants are usually placed underneath the muscle of the chest wall, which tends to be more convenient than wearing a prosthesis placed in a brassiere. However, the body’s reaction to an implant is to form a capsule or envelope around it, and in some people it can make the breast feel firm or even tender. In addition, implants will not have the same natural feel as your own tissue.

After mastectomy, your skin envelope may not be large enough to allow for an implant; skin expansion may be required before the “permanent” implant is inserted. Tissue is expanded by inserting an expandable silicone “balloon”, which your surgeon will inflate with salt water at weekly visits. When enough skin is available, usually after several months, a second operation is performed and the expander is exchanged for the implant.

Although implant surgery is usually simpler and shorter than using your own tissue, the complication rate and the need to re-operate at a later date is higher.

Furthermore, implants have a higher rate of complications for patients who have had radiation to the chest.

Talk to your surgeon about whether this a viable option for you.

Using your own tissue

Using your own tissue to reconstruct your breast(s) is called autologous reconstruction.

Autologous reconstruction involves transferring soft tissues (skin, fat) from other areas of your body to the chest area.

Tissue from the lower abdomen is often a preferred donor site for breast reconstruction). It is an area which commonly has excess fat and is conveniently located near the breast. Other, less common areas that can also be harvested include the buttock, thigh or back.

Complications can also occur with autogenous reconstruction and may include the small chance that the transplanted tissue will not survive or the risk of a hernia if the tissue is taken from the abdomen.

Additional information

Please also see the ASPS site for further information about Breast reconstruction: as well as:  and The UHN Breast Restoration Program, BRA Day (Breast Reconstruction Awareness Day)

Please click here for information from the American Food and Drug Administration (FDA) on ALCL (Anaplastic Large Cell Lymphoma) and breast implants.