The loss of a breast after mastectomy for most women is an emotionally disturbing event which causes much distress over a long period of time before the deformity can be accepted with equanimity and self-confidence. How each woman views her loss and solves her problems depends on her own needs. For some women, reconstruction of the breast by surgical means is a valuable alternative. Whether a woman should have a breast reconstruction depends primarily on her own needs but she should also consult with her primary surgeon, family physician and family to help her. A plastic surgeon should be available to assist her to make a reasonable decision.

Reconstruction of the breast can be done immediately or anytime after a mastectomy but usually a lapse of at least 3 months or more is typical. There are many methods utilized to reconstruct the breast. Factors will include age, weight, health of the patient and the status of the remaining breast or the occasional need to reconstruct both breasts. The particular surgical technique will depend upon the type of cancer surgery such as lumpectomy or modified mastectomy or skin-sparing mastectomy.

The simplest reconstruction method is to place a silicone breast implant directly beneath the skin of the chest and to form a new nipple utilizing a graft from the opposite breast or other areas. If there is inadequate skin at the mastectomy site or if radiation was a component of treatment then more complex reconstruction techniques must first bring new skin tissue into the area in the form of a skin flap. A Latissimus flap uses the tissue of the flank area to create a breast mound. A TRAM flap combines the tissue normally discarded in a "tummy tuck" operation to recreate a new breast at the same time.

Nipple reconstruction can be done afterwards either as an office procedure or a minor outpatient surgical procedure. The more complex breast reconstruction operations require general anesthesia and a short hospital stay. If the remaining breast is large and interferes with well being then improved breast symmetry can often be achieved by reducing the size of this breast with a reduction mammoplasty operation.

The results of breast reconstruction are usually gratifying and most women experience very positive feelings of self-image and well-being. In addition, the selection and wearing of clothing and general comfort is greatly facilitated. Breast reconstruction has no effect on the chance for the cancer to recur nor does it interfere with the detection of cancer should it recur. As with any surgery there are possible complications and these should be discussed before any reconstructive procedure is undertaken.