Breast Reconstruction: A breast reconstruction requires the surgeon to rebuild the breast using tissue taken from elsewhere on the body, prosthetic implants, or both. A patient may be able to undergo breast reconstruction surgery immediately following a mastectomy to remove a cancerous breast, depending on their risk factors, cancer recovery status, and the preferences of the surgeon. Breast reconstruction is optimally achieved through a series of surgeries.
Implants are commonly used in a breast reconstruction, but sometimes autologous tissue can be used in lieu of an implant. When implants are used, a tissue expanding pocket is inserted during the initial surgery and is subsequently injected with saline during a series of procedures over the coming weeks and months to stretch the overlying tissue before inserting a permanent implant. In flap reconstruction, autologous tissue is taken from parts of the body such as the buttocks, thigh, and abdomen and used to recreate the breast. Both procedures are followed by a separate surgery to reconstruct the nipple and areola.
Breast Augmentation: A breast augmentation may contain some of the same elements as a reconstruction and can even be done to correct certain cosmetic defects, but breast augmentation is largely an elective surgery performed for the purpose of making breasts larger and fuller. It is sometimes also performed to make asymmetrical breasts the same size and shape.
A breast augmentation usually requires the use of implants, although it is possible to use the flap reconstruction process described above. Silicone implants look and feel more like natural breast tissue, but saline implants are considered safer in the event of an implant leak or rupture. A breast lift is a related cosmetic procedure that makes sagging breasts perkier by removing excess skin, but it is not technically an augmentation because no tissue or implants are added to the breast.
Choosing a Surgeon: If you’re interested in a breast lift or augmentation, a plastic or cosmetic surgeon that’s a member of the American Society of Plastic Surgeons can answer your questions about saline versus silicone implants and the simple breast lift procedure.
For a breast reconstruction, you may be a candidate for immediate reconstruction following a mastectomy. If you qualify but the surgeon performing your mastectomy doesn’t do reconstructions, the plastic surgeon of your choice may be available to perform the procedure on site.
Thanks to the Women’s Health Care and Cancer Rights Act of 1998, insurance companies are required to pay for reconstructive surgeries and other procedures related to breast and nipple reconstruction in breast cancer patients.