Breast Reconstruction Myths Debunked

Facts vs Myth

There are a lot of misconceptions about breast reconstruction after cancer.

In honor of the annual Breast Reconstruction Awareness Day (BRA Day) — a worldwide day dedicated to promote education for those considering breast reconstruction, Dr. Saïd C. Azoury from Penn Plastic Surgery clarifies five myths about breast reconstruction options.

Myth #1: Reconstructive surgery is a one-and-done procedure.

Fact: It may take a number of surgeries to achieve the look that you want.

Your plastic surgeon reconstructs your breast after a mastectomy by taking a woman's muscle in her chest, which is not removed during the mastectomy, and moving that muscle directly underneath the skin.

Then, a breast implant is placed under the muscle. A normal breast has breast tissue on top of the muscle.

The first surgery would be the mastectomy and placement of tissue expanders underneath the muscles of the chest. Then, the patient undergoes a series of expansions to stretch the skin and muscle to create a pocket.

Expanders are balloon-like sacs that slowly expand to the desired size of a reconstructed breast.

The second surgery involves removing the expanders and putting the breast implants in, while the third surgery is the nipple reconstruction phase. Nipple reconstruction is when a plastic surgeon builds a new nipple using tissue from your body or donor skin.

Not every woman needs every stage done.

Myth #2: Once an implant is in, it's a lifelong device.

Fact: Over time all implants will eventually break (rupture). There is a lifespan for breast implants; typically, 10 to 15 years.

Implant rupture rates are approximately one percent per year but go up after 10 years. One can expect your implant to last approximately 10 to 15 years. Since a woman may not always feel or see when a rupture in her implants has occurred, magnetic resonance imaging (MRIs) may be needed every few years to monitor for any sign of trouble.

It is also imperative that you follow with your plastic surgeon regarding your implant based breast reconstruction. Other than rupture, there can be other potential complications like infection, capsular contracture, or even a rare lymphoma associate with implants, that should be assessed periodically by your surgeon.

Myth #3: If you have a breast reconstruction, it will be hard to detect breast cancer in the future.

Fact: There's no evidence that shows breast reconstruction of any kind will deter cancer detection. Patients have to continuously undergo surveillance for the rest of their lives, even though they've had a mastectomy.

At Penn Medicine, cancer treatment is our first priority, your provider would not delay treatment for reconstruction. Breast reconstruction should never take precedence over breast cancer treatment.

Myth #4: Not every woman is a candidate for breast reconstruction.

Fact: Most women are candidates for breast reconstruction no matter the stage of treatment.

Even if you're not ready to get your reconstruction, you should still meet with a plastic surgeon to review your options. It can be done at the same time as a mastectomy or delayed afterwards. And if you've had a mastectomy, it will be covered by insurance.

Breast reconstruction is a healing process.

Myth #5: Implants are the only option for reconstruction.

Fact: There are other treatment methods that exist other than breast implants.

An option besides implants is getting tissue from other parts of your body — such as the abdomen, buttocks, or back — and using that to create a new breast.

There are various different options available for breast reconstruction. Each has a different length of surgery, different recovery times, different outcomes; discuss with your doctor which may be best for you.

Myth #6: I am not a candidate for using my own tissue for breast reconstruction because I do not have much belly fat.

Fact: Oftentimes when reconstructing one breast (unilateral reconstruction), both sides of the abdomen can be combined for that one side, which doubles the amount of fat used for reconstructing the breast.

This makes it possible to still use the abdomen as the donor site in less overweight women. Also, some women may not have adequate donor site at the abdomen, but the thighs fat (gracilis, profunda artery perforator flap) and back (latissimus) are also used to reconstruct breasts, depending on the scenario.

Dr. Azoury is a plastic and reconstructive surgeon who is board-certified in general surgery, board-eligible in plastic surgery and fellowship-trained in surgical oncology and reconstructive microsurgery. He completed his residency in Plastic and Reconstructive Surgery at the University of Pennsylvania. He then completed fellowship in Reconstructive Microsurgery at Memorial Sloan Kettering Cancer Center in New York, NY.

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The Focus on Cancer blog discusses a variety of cancer-related topics, including treatment advances, research efforts and clinical trials, nutrition, support groups, survivorship and patient stories.

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