Breast Cancer Reconstruction Options

In some cases, a breast cancer patient will opt to have one or both breasts reshaped or recreated following a lumpectomy (where a tumor and a margin of surrounding healthy tissue are removed) or a mastectomy (where the entire breast is removed). This is known as breast cancer reconstruction surgery.

Patients who choose to undergo this procedure have numerous options available to them, including immediate (oncoplastic) reconstruction, delayed reconstruction, implant reconstruction and tissue (flap) reconstruction. The board-certified breast surgeons at Tampa General Hospital’s Cancer Institute and world-renowned Breast Cancer Center have extensive experience with all of these techniques and can recommend the approach that’s right for you.

Immediate (Oncoplastic) Reconstruction

Also referred to as oncoplastic reconstruction, immediate reconstruction takes place directly after a lumpectomy or mastectomy. Once the initial procedure is complete, the surgeon immediately begins reconstructing the breast. Immediate reconstruction is especially common among patients who are proactively undergoing a mastectomy to reduce their risk of developing breast cancer.

Immediate reconstruction offers some advantages over delaying reconstruction efforts. For example, an immediate reconstruction reduces the number of surgeries that a patient must undergo, which can in turn potentially lead to lower medical costs. This approach also produces immediate cosmetic results, which can decrease the chances of the patient developing emotional or social issues related to the loss of a breast.

Delayed Reconstruction

With a delayed reconstruction, the reconstruction procedure takes place weeks, months or even years after the lumpectomy or mastectomy. Once the initial procedure is complete, the surgeon will close the incision. Then, during the subsequent reconstruction, the surgeon will reopen the original incision and proceed accordingly.

Like immediate reconstruction, delayed reconstruction offers its own set of benefits. For instance, a patient who undergoes delayed reconstruction will likely spend less time in the hospital and in recovery for the initial lumpectomy or mastectomy procedure (although a second round of hospitalization and recovery period will be necessary for the subsequent reconstruction). Plus, if a patient needs to undergo further breast cancer treatment—such as chemotherapy or radiation therapy—a delayed reconstruction will typically allow them to start those treatments sooner, and those treatments will be less likely to affect the reconstruction.

Implant Reconstruction

As its name suggests, an implant reconstruction requires the use of a saline or silicone breast implant. The surgeon may insert the implant either on top of or beneath the patient’s chest muscle.

In some cases, the surgeon will elect to use a tissue expander before placing the implant. Once the expander has been inserted, either the patient or a medical provider will fill it with saline once a week to gradually stretch the surrounding skin until it can accommodate an implant.

Implant reconstructions tend to be more common among patients with small- to medium-sized breasts. Patients with larger breasts can also elect to receive implants, but if only one of their breasts was removed during a mastectomy, the remaining natural breast may need to be reduced in size to match the implant.

Tissue (Flap) Reconstruction

When a patient opts for a tissue reconstruction (also known as a flap reconstruction), the surgeon uses a “flap” of tissue from another area of the patient’s body—rather than an implant—to create the new breast. The surgeon may take this tissue from the patient’s:

  • Lower abdomen – If the surgeon moves skin, fat and blood vessels from the lower abdomen—but not muscle—it’s referred to as a DIEP flap. If they also transfer abdominal muscle, it’s known as a TRAM flap.
  • Back – When the surgeon transplants tissue and muscle from the patient’s back, it’s called an LD flap.
  • Buttocks – If the surgeon takes tissue from the patient’s buttocks, it may be referred to as either an IGAP flap or an SGAP flap, depending on the specific group of blood vessels used. Neither of these procedures involve moving muscle from the buttocks.
  • Thigh – If the surgeon transfers non-muscular tissue from the patient’s thigh, it’s known as a PAP flap. But if they also transplant muscle from the thigh, it’s referred to as a TUG flap.

In some cases, the surgeon will move the tissue through the patient’s body—under their skin—allowing it to remain connected to its original blood supply while being transferred to the chest (this is known as a pedicle flap). In other instances, the surgeon will disconnect the tissue from its original blood supply, move it to the chest and then reconnect it to the blood vessels within the chest (this is referred to as a free flap).

Which Breast Reconstruction Option Is Right for You?

Surgeons take numerous factors into account when determining which approach to use during a breast cancer reconstruction. For example, they may consider the patient’s:

  • Age
  • Breast cancer type, location and stage
  • Overall health
  • Medical history
  • Lifestyle
  • Personal preferences

The surgeon will also consider the type of lumpectomy or mastectomy that the patient underwent, the results of that surgery (for example, how much breast tissue remains) and whether the patient still needs to undergo chemotherapy, radiation therapy or another type of breast cancer treatment.

It’s important to note that breast cancer reconstruction can involve a combination of techniques—for example, a surgeon may use an implant along with natural tissue to reconstruct a breast. And in some instances, a reconstruction may require multiple surgeries to complete.

Partner With TGH for Your Breast Cancer Reconstruction

If you’re interested in undergoing breast cancer reconstruction, you can entrust your care to the skilled team at Tampa General Hospital. U.S. News & World Report has repeatedly ranked us as the No. 1 hospital in Tampa Bay, and our Breast Cancer Center is among the highest volume programs in Florida for treating breast cancer patients who require a hospital stay. Our multidisciplinary team can tell you about our various breast cancer reconstruction options in greater detail and recommend the approach that’s best suited to your specific needs.

Contact Tampa General Hospital at (800) 844-4554 to learn more about our world-class breast cancer treatment and to schedule a consultation at a date and time that’s convenient for you.