Breast Reconstruction Surgery: You Have Options

Patients at our Eugene, Oregon plastic surgery practice are sometimes surprised to learn that Dr. Jewell is a world-class breast surgeon with more than 35 years of experience in performing both cosmetic and reconstructive breast surgery, with more than 2,400 surgeries performed. That’s reassuring to know for women diagnosed with breast cancer who are seeking his expertise about their breast reconstruction options.

In honor of Breast Cancer Awareness month and Breast Reconstruction Awareness (BRA) Day, we want to discuss the different options for breast reconstruction surgery following a mastectomy. Studies have shown that the range of options available often aren’t explained to women getting mastectomies. These statistics underscore the need for BRA Day:

  • Less than 50% of women who require mastectomy are offered breast reconstruction surgery.
  • Only 23% know the wide range of reconstruction options available.
  • Fewer than 20% of women choose to undergo immediate reconstruction (at the time of their mastectomy).

There are 3 primary surgical paths offered (along with the option of not having reconstructive surgery). Dr. Jewell works closely with your primary breast surgeon and customizes the procedure based on your body type and the status of your cancer treatments.

Implant Reconstruction After Tissue Expansion

This type of reconstruction is the least invasive and requires less recovery time compared to flap reconstruction with a patient’s own tissue. Dr. Jewell performs the procedure at the same time that a breast surgery oncologist performs a mastectomy.

Dr. Jewell begins the reconstruction process by inserting an expander beneath the chest muscle. This is similar to an implant, but it has a valve that allows more saline to be added (with a simple injection through the skin into the valve) after surgery. Over the course of about 2 to 6 months — Dr. Jewell gradually fills the expander with a sterile, saline solution. This process will usually begin 3 to 4 weeks after your mastectomy and slowly creates healthy tissue to cover the breast mound.

Eventually, the expander is replaced with a breast implant. This is a relatively straightforward procedure that’s usually performed as outpatient surgery. Then after a few months, Dr. Jewell can reconstruct a nipple and perform surgery on the opposite breast, if necessary, to help match the new reconstructed breast. A tattoo artist can add color to the areola.

The other 2 options include:

Flap Reconstruction with the Patient’s Own Tissue

These procedures use tissue from other parts of your body, such as the back, thighs, or buttocks to rebuild the breast shape. In general, flap reconstruction procedures require more surgery and a longer recovery than other breast implant procedures. Dr. Jewell explains the details of this option during the consultation.

Combination Flap and Implant Reconstruction

Combining the 2 approaches may be best-suited for patients in limited situations. For example, if a patient prefers an implant reconstruction, but the chest tissue will not be able to provide a healthy cover. Also, some patients might want greater fullness than a flap can provide alone, so an implant can be used.

Before deciding which type of reconstruction you want, there needs to be open dialogue between your breast surgeon, your oncologist, your plastic surgeon, and you.  Being diagnosed with breast cancer and having to undergo a mastectomy does not mean a woman must settle for being unhappy with her new breasts.

After a tough and demanding journey, breast reconstruction surgery can be physically and emotionally rewarding for breast cancer survivors. Dr. Jewell’s main priority is safety during breast surgery, so patients can have peace of mind in his care.

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