Toronto Plastic Surgery

Reconstruction of a breast that has been removed due to cancer or other disease is one of the most rewarding surgical procedures available today. By utilizing a variety of medical techniques and devices, it is possible for surgeons to create a breast that closely matches the form and appearance of a natural breast.

Surgery
Immediate breast reconstruction is performed at the same time as breast removal (mastectomy). This approach provides the patient with a new breast mound, and spares her from waking up post-surgery with the sight of having only one breast.

Immediate breast reconstruction is usually reserved for women who are unlikely to require further treatment after their mastectomy, such as chemotherapy or radiation therapy. For patients who are not candidates for immediate breast reconstruction or choose not to undergo reconstruction at the time of their mastectomy, breast reconstruction can be performed at any time in the future (delayed breast reconstruction). The best time to conduct the procedure will be discussed with you at your initial consultation.

Most breast reconstruction involves a series of procedures occurring over time. The initial operation is usually the most complex, and involves the reconstruction of a new breast mound. Typically, a second operation is performed 3-6 months later, at which time final shaping of the breast mound is achieved, as is the reconstruction of the nipple and the areola. At the same time, patients often undergo surgery to enlarge, reduce or lift the natural breast to match the reconstructed breast.

Options for Breast Reconstruction
Skin Expansion
Following mastectomy, a balloon expander is inserted beneath the skin and chest muscle. This balloon expander is very much like a deflated breast implant. Following the surgery, the patient makes periodic visits to the office where a salt-water solution is injected through a tiny valve mechanism in the balloon, which is enlarged to gradually fill the expander over several weeks or months. After the skin over the breast area has stretched enough, the balloon expander is removed and a more permanent implant is inserted.

Flap Reconstruction
As an alternative to using an implant, the breast can be reconstructed using the patient’s own skin and fat taken from other parts of the body, such as the back or abdomen. The tissue usually remains attached to its original site, retaining its blood supply. The flap, which consists of the skin, fat and muscle, has its blood supply tunneled beneath the skin to the chest, creating the breast mound itself. In general, flap reconstruction is more complex than balloon expansion, but has the advantage of reconstructing the breast entirely with the patient’s own tissue. In some cases, there may also be the added benefit of an improved abdominal contour.