¿Considerando la reconstrucción mamaria? Lo que necesita saber

At some point after your breast cancer diagnosis, you should meet with your plastic surgeon to ensure you receive the best recommendation. As members of the breast team, Duke Health plastic and reconstructive surgeons can recommend the best surgical approach so that everything you need happens smoothly and efficiently.

The timing of your surgery depends on many factors. Sometimes breast reconstruction starts at the time of your mastectomy or lumpectomy. Published studies show that people often feel better emotionally when they wake up with something that resembles a breast. However, there are also times when reconstruction must be scheduled later. Or some women choose to delay reconstruction for months or years because they want to focus first on getting through their mastectomy and cancer treatment. The decision is often yours to make.

Getting breast reconstruction at a comprehensive cancer center with surgeons trained in microsurgery widens your choices beyond the limited options that may be offered elsewhere.

At Duke, our surgeons perform these advanced techniques and more:

• Direct-to-implant Reconstruction. Breast tissue is replaced with a silicone implant at the time of your mastectomy.
• Breast Reconstruction with Tissue Expander. During the mastectomy, a temporary tissue expander is placed to hold the breast shape. El expansor se llena con solución salina en el consultorio para incrementar su tamaño. This gives you flexibility to make decisions about how you want to proceed.
• Goldilocks. The skin, fat, and healthy tissue that remains after the mastectomy is reshaped into a small breast mound. While there is typically not enough to create a full breast, this approach retains some shape and definition and can be augmented later.
• Flap Surgery. This complex approach offers flexibility in timing the surgery. It requires a skilled microsurgeon who transfers tissues from another part of your body, like the abdomen, to create a breast mound that has a more natural look and feel than implants.

It’s important to know that the reconstruction option that’s right for you will depend on:

• La etapa de su cáncer.
• Whether your treatment includes radiation and chemotherapy.
• The presence of other medical conditions.
• Los objetivos individuales y los resultados deseados.

Nipple-sparing surgery can be part of your mastectomy if your doctors determine that it's safe to keep the tissue that comprises it. If the nipple must be removed, 3-D nipple and areola tattooing can create a realistic-looking nipple and surrounding area. Nipple reconstruction may also be an option. It's like "skin origami," said Dr. Knackstedt. "We make a small incision, ball up some skin to make a nipple." A 3-D tattoo often completes the procedure.

Dr. Knackstedt works closely with her patients, showing photos, explaining scar patterns, and what the breast might look like after surgery, including volume and symmetry. She encourages you to understand your options to ensure you are well-informed when choosing the option that is right for you.

Recovery after breast reconstruction depends on how healthy, fit, and emotionally prepared you are before surgery. The best way to bounce back faster is to spend time before surgery preparing your mind and body for what it's about to go through, just as you would for a marathon.

Some people get full sensation back but it’s more typical to experience little or no sensation after surgery.

Cancer support services, including therapy and counseling, for you and your whole family, go a long way toward helping everyone manage the demands of your cancer journey, from diagnosis and treatment through your recovery and survivorship. Duke has a wide array of support services to choose from.