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Restoring Wholeness After a Mastectomy: What Are My Breast Reconstruction Options?

Posted November 15, 2022 in Breast Reconstruction

3 Minute Read:

If you have been diagnosed with breast cancer, reconstruction can often help restore a sense of wholeness by restoring a more natural appearance.

A hand holds a pink breast cancer awareness ribbon.

Breast reconstruction should be considered when a mastectomy is the only way to ensure cancer has been eliminated or when a mastectomy is performed as a preventative measure for those at high-risk for breast cancer. 

The plastic surgeon typically begins breast reconstruction during the mastectomy surgery after the breast surgeon has removed the cancerous tissue.

Cohn Plastic Surgery Offers Several Breast Reconstruction Options

Most breast cancer patients choose to begin breast reconstruction at the time of the mastectomy. 

Tissue expander(s) are inserted during the mastectomy to prepare the breast area for the next stage of reconstruction. The expander stretches the remaining tissues, creating a pocket that can accommodate breast implant(s). 

The following breast reconstruction techniques are most often used to restore a natural-looking feminine chest and bustline:

Implant-Based Reconstruction

Implant reconstruction is a common breast reconstruction option that relies on a synthetic implant to create the breast mound. Fat grafting may accompany this implant to provide greater coverage and help conceal the implant’s edges.

Implant reconstruction is a staged process that requires multiple visits to your reconstructive surgeon. With this technique, a tissue expander is placed and gradually filled over the following months to gently stretch the tissue and skin. 

Once the skin and tissue have been stretched to the appropriate amount, the expander is replaced with a permanent implant.

You have a few options regarding implant-based reconstruction and one non-implant based option. 

Nipple Sparing Implant Reconstruction (Implant Based)

Sometimes the nipple and areola are left intact during a mastectomy; in this case, the surgeon doesn’t need to recreate these breast components. This option is not as common since the nipple and areola are often removed during treatment.

Once the expander has done its job, it is removed and replaced with permanent breast implants. 

Non-Nipple Sparing Implant Reconstruction (Implant Based)

Nipples are often removed during the mastectomy to ensure that all traces of cancer are eliminated. If desired, you can have your nipples reconstructed. Nipple reconstruction generally occurs in the second stage of breast reconstruction. Often, a patient also decides to have nipple tattooing to restore the areola’s color for a more natural appearance.Tattooing can begin around 90 days after your permanent implants have been placed.

Non-Nipple Sparing Latissimus Flap Reconstruction (Implant-Based)

The latissimus flap comes from the latissimus muscle on your back. During this technique, Dr. Cohn may redirect the latissimus muscle in your back by moving it under your arm and to the front of your chest. 

This technique is commonly combined with breast implants for a fuller appearance. Tissue expander(s) are then placed beneath the relocated latissimus muscle. Typically, 90 days later, the expanders are removed and replaced with implants. At this time, fat grafting may also be performed and nipple reconstruction.

Non-Nipple Sparing TRAM Flap Reconstruction

TRAM stands for transverse rectus abdominis myocutaneous and refers to tissue in your lower abdomen. This technique utilizes skin, fat, and the blood supply from your lower abdomen to reconstruct the breast(s) and nipple(s). This procedure is typically performed without the use of implants.

This technique is often not appropriate for women who have undergone prior abdominal surgery.

Besides giving the surgically treated tissue time to heal and expanders to work, insurance providers generally require a 90-day waiting period after each phase of


What if Only One Breast Was Removed?

Symmetrical results are easier to accomplish when reconstruction is performed on both breasts. 

If you’ve undergone a unilateral mastectomy (removal of only one breast), you can opt for an implant to be placed on just one side of the chest. An experienced breast reconstruction surgeon will do their best to make your breasts look as even as possible. 

You can also choose to have implants placed on both sides for a better chance of achieving symmetry.

Searching for a Breast Reconstruction Expert in Birmingham, AL?

If you’re looking for an experienced breast reconstruction surgeon near Birmingham, or South Birmingham, Alabama, call Cohn Plastic Surgery in Vestavia Hills at (205) 590-9900 today!

Learn More About Breast Reconstruction Here