One in eight women will get breast cancer in her lifetime. Chances are, a significant number of these women will choose to undergo breast reconstruction. By restoring a breast that has been lost due to cancer or other causes, a patient may find improvement in her quality of life and emotional wellbeing.
WHAT IS BREAST RECONSTRUCTION?
Breast reconstruction involves restoring the breast’s shape and size after it has been removed following a mastectomy or a lumpectomy. This is done primarily in the following ways:
- Breast implants, silicone or saline
- Flaps, i.e. skin, fat and/or muscle is taken from one part of the body and moved to the chest
Most breast reconstruction in the United States is done with breast implants. About 82% of women who choose breast reconstruction will undergo an implant-based procedure, whereas 18% of women will choose autologous reconstruction, or reconstruction using their own body tissues.
The most common forms of autologous reconstruction are the DIEP flap or the TRAM flap, which is when the skin and fat from the lower abdomen (the part that is typically removed during a tummy tuck), is transplanted, along with its blood supply, to the chest to restore the breast’s shape and volume.
IS BREAST RECONSTRUCTION RIGHT FOR ME?
Breast reconstruction is a deeply personal decision. The most important thing to know is that it can take more than one procedure to reach your best result. Patients most often will need two to three procedures to create their final breast shape. Breast reconstruction is a good option if:
- You can cope well with your diagnosis and treatment
- You do not have additional medical conditions that may impair healing
- You have realistic expectations for restoring your breast and body image
Breast reconstruction typically involves several procedures performed in multiple stages. Reconstruction can:
- Begin at the same time as mastectomy, or
- Be delayed until you heal from your mastectomy and recover from any additional cancer treatments
WHAT IS RECOVERY LIKE?
Breast reconstruction that is done at the same time as a mastectomy usually will require an overnight hospital stay. Breast reconstruction that is done in a delayed fashion can be done as an outpatient. If you are undergoing a DIEP flap or other type of autologous reconstruction, you may be in the hospital for three to five days.
Generally, it will take three to four weeks to heal. Your activity restrictions will be in place during this time. You will wear a special surgical bra, and wound care often is not extensive. Most patients will return to work after 10 to 14 days.
WILL MY INSURANCE COVER BREAST RECONSTRUCTION?
In the U.S., the Women’s Health and Cancer Rights Act of 1998 requires group health insurance plans that cover mastectomy to also cover reconstruction, regardless of whether reconstruction happens at the same time or months, or even years, later. Insurance also is required to cover revision procedures and procedures on the non-cancer side to create symmetry.
Check that your surgeon is in-network with your health insurance. Most plastic surgery offices have a financial advisor or health insurance specialist to help patients navigate the requirements, obtain preauthorization and calculate their out-of-pocket costs.
