Dealing with breast cancer is a painful and challenging ordeal for any woman that normally results in the removal of one or both breasts to prevent the spread of cancerous cells to other parts of the body. With swift and proper medical treatment and some luck, the risks to a patient’s health can be abated, but the loss of a breast may have lasting damage to her self-esteem and self-image, not to mention serve as a horrific reminder of her struggle with cancer. There are other conditions or illnesses that may require the removal of a breast, with similar crippling effects on a woman’s confidence due to the negative changes in her physical appearance. For such women, breast reconstruction surgery can be most rewarding in both the aesthetic and the emotional sense, restoring not only one’s breast, but also one’s quality of life.

Good candidates for the procedure are women who have responded well to their treatment and are not in danger due to complications or other factors that may affect the healing process, or create additional risks during the surgery itself. In addition, women who opt for this surgery must maintain realistic expectations, as the reconstructed breast will not have the same sensation or functions as a normal breast.

The process itself involves several surgical procedures, that may be performed during the mastectomy or some time afterwards, to reduce stress on the body. The first step is the reconstruction of the breast mound itself, which is done in a number of ways. The most popular method is to use a tissue expander, inserting it beneath a pocket under the main pectoral muscle that supported the former breast. Gradually, in a process that takes anywhere from weeks to months, saline solution is progressively injected to expand the covering tissue. Once the expander has reached a satisfactory size, it may be removed and replaced with a permanent breast implant.

Another method is to use donor muscle, fat and skin from the woman’s abdomen or the latissimus dorsi back muscle to make a flap, which is then used to reconstruct the breast. The tissues are either detached completely and formed into a breast mound, or tunneled up to the area of reconstruction so that blood supply to the new breast area remains intact. In all such cases, the muscles that are utilized can be removed from their harvest area without significant loss of function, but in the case of abdominal flap removal, some torso weakening is expected. The size of the breast to be reconstructed determines the origin of the flap. Small breasts can be restored with a flap from the latissimus dorsi, while an abdominal flap will be required for larger breast restoration.

Reconstruction of the breast mound is usually followed by restoring the nipple and areola area, which is also performed in several ways. If only one breast has been removed and the other breast has a sufficiently large nipple and areola, some of that tissue may be taken and grafted onto the reconstructed breast. In other instances, a raised mound of skin is crafted from tissue either in the area or from a donor location, and then tattooed to match the color of the old breast. A significant challenge is attaining symmetry between the reconstructed breast and the existing intact breast, which may necessitate adjusting the normal breast through augmentation or reduction.

Recovery after a breast reconstruction will take anywhere between three to six weeks, and patients should refrain from sexual activity, heavy lifting and other strenuous physical movement during this period. The results of the surgery will not be apparent until several weeks after its completion, during which time the breast tissue will settle into shape and the scarring will begin to fade.