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PROCEDURES / BREAST RECONSTRUCTION
Double Mastectomy & Reconstruction Surgery
There are many reasons you might consider getting a double mastectomy and breast reconstruction surgery. These surgeries can be done at two separate times or together as a double mastectomy with immediate reconstruction. The decision to undergo this procedure can be both mentally and emotionally taxing. Getting any surgery is a big decision, but getting a double mastectomy and reconstruction surgery can be even more so, as many women feel deeply connected to having breasts as part of their identity as a woman. Having a great team in place to guide you and stand by you during these difficult decisions can make the process much easier and give you more confidence throughout your breast reconstruction journey.
The incredible team at Harris Plastic Surgery has an extensive history of helping women make these deeply personal decisions and delivering outcomes that match their lifestyle and goals for the procedure. Dr. Harris is a board-certified plastic surgeon with specific training in microsurgical techniques and cutting-edge breast reconstruction procedures. Your front office liaison, Joanne Parrinello, can help you navigate surgical scheduling and will help you get the most from your insurance coverage. Between these two, you will be fully supported and cared for during the entire process.
When To Choose a Double Mastectomy and Reconstruction Surgery
There are multiple reasons for someone to consider getting a double mastectomy. Still, most fall into two categories: you have/had breast cancer, or you are very likely to develop breast cancer. Reasons for choosing a double mastectomy (or preventative mastectomy) and reconstruction include:
- Genetic Predisposition – Most often, we think of BRCA1/2 mutations, but other genetic mutations are also linked to increased risk of breast cancer.
- Family History of Breast Cancer – If many women in your family have developed breast cancer, your risk for developing breast cancer also increases.
- Previous Breast Cancer Diagnosis – If you have previously been diagnosed with breast cancer, there is a risk of recurrence as long as you have breast tissue.
- Create Symmetry – If you have cancer in one breast, a double mastectomy and reconstruction can provide symmetry while eliminating the cancer and the risk of recurrence.
- Prevent Recurrence – Removing all breast tissue reduces the risk of breast cancer recurrence to near zero.
- Personal Empowerment – If you know you have a high risk of developing breast cancer, you can take control and feel empowered by choosing a prophylactic mastectomy, a procedure often covered by insurance.
- End Ongoing Surveillance – Women at high risk of breast cancer must perform ongoing cancer surveillance via mammograms and MRIs. These procedures and the wait for results can be unpleasant and stressful. You can remove this ongoing stress and surveillance if you have a double mastectomy and reconstruction surgery.
Once you have determined a double mastectomy is right for you, you will have several options for the reconstruction portion of your treatment.
After a double mastectomy, some women choose to wait and heal before undergoing a second surgery – especially if they have a cancer diagnosis and need to make sure all the cancerous tissue has been removed and they are in remission before rebuilding.
Other women, especially those who undergo prophylactic mastectomies, might choose to do an immediate reconstruction, so they never know a time without having breasts. The table below lists some reconstruction surgery options.
|Reconstruction Surgery Options
|A breast surgeon performs the mastectomy, and your plastic surgeon begins the reconstruction surgery immediately after.
|The breast surgeon conducts your mastectomy, and after a period of healing (months or years), your plastic surgeon will perform the reconstruction.
|Natural Tissue Flap Surgery
|Your own tissue is used to reconstruct the breast mound. There are several options for tissue donation sites: DIEP, SIEA, TRAM, and Latissimus.
|Implants are medical devices made of silicone and filled with saline or silicone gel. They can be placed either in front of the pectoralis chest muscle. Often, autologous fat grafting is used for better peripheral contour.
|Once your breasts are reconstructed, areola reconstruction can begin with tissue grafting or 3D tattooing if the nipple and areola could not be preserved
|Nipple reconstruction puts the finishing touch on your breast reconstruction through surgery to raise a piece of tissue into a new cylindrical nipple or 3D tattooing to create the appearance of a nipple without the actual projection.
Out of all these options, your decisions will depend on the overall goals for the double mastectomy and reconstruction surgery, along with your individual medical history and anatomy. Plastic surgeons have the knowledge and experience to guide your decision-making and provide the best treatment options and outcomes possible.
Benefits of a Plastic Surgeon-First Consult When Considering Prophylactic Double Mastectomy
Once you know you’ve decided on double mastectomy and reconstruction, the best course of action is to consult with a plastic surgeon who specializes in these procedures. A plastic surgeon can help you determine your overall reconstruction goals and connect you to a trustworthy breast surgeon. By meeting with a plastic surgeon first, you have the option of doing an immediate reconstruction after your mastectomy, meaning you only need to undergo surgery one time.
Consulting with a plastic surgeon before mastectomy allows you: