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Breast Reconstruction: Your Common Questions

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October is Breast Cancer Awareness month, and as a plastic surgeon here in Honolulu, I’m acutely aware of the effects–both physical emotional–that breast cancer can have on a woman. In this blog post, I’d like to address some of the most common questions I hear about breast reconstruction. I was the first plastic surgeon in the state of Hawaii to perform single-stage reconstruction–an approach that creates attractive, natural-looking results in fewer surgeries. I want to help demystify the reconstruction process by providing answers to frequently asked questions.

1. What is a mastectomy?

Mastectomy is the surgical removal of one or both breasts. While breast cancer is the most common reason for mastectomy, some women may opt to undergo the surgery to treat precancerous conditions or as a prophylactic measure if they’re at a higher risk of developing cancer in the future. According to U.S. breast cancer statistics, 1 in 8 American women will develop invasive breast cancer sometime during the course of her lifetime. Although this figure is alarming, by preparing ourselves with knowledge and resources, we can feel more confident about the odds.

2. What is breast reconstruction?

“Breast reconstruction” is a general term that refers to the process of surgically rebuilding a breast after mastectomy, lumpectomy, or trauma. Breast reconstruction can be “delayed,” which means it’s performed months or even years after mastectomy, or “immediate,” which means it’s performed at the same time as mastectomy. Reconstruction can be performed at any point after mastectomy, and the decision regarding when or even if to pursue reconstruction is largely personal. Reconstruction can be achieved with implants or with the patient’s own skin and fat, taken from another area of the body. In my photo gallery, you can see images the results created by various techniques.

3. Can the nipple be reconstructed?

Yes, the nipple can be re-created using the skin of the breast, but reconstructed nipples will not have the sensation or functionality of natural nipples. Specially trained tattoo artists can also re-create areolas and improve the color of the new nipple.

4. Is breast reconstruction only performed after mastectomy?

No. In some cases, patients with deformities such as severe asymmetry or tuberous breasts may also benefit from reconstructive procedures.

In the United States, health insurance carriers are required by law to cover breast reconstruction after mastectomy. If only one breast is reconstructed, insurance must also cover procedures on the unaffected breast if they are needed to create symmetry.

I hope you never need breast reconstruction, but if you do, it helps to be informed and knowledgeable about your rights and your options.

Shim Ching, MD