Breast Reconstruction and Prosthesis

Body image is more about your physical self. It includes your overall sense of wholeness, how you feel about yourself and your appearance, and how you relate to others. For many women, the breasts are an important aspect of how they feel as a woman.

Breast cancer surgery by mastectomy leads to a significant change in physical appearance. If you have had a mastectomy, you may wish to discuss your options for breast reconstruction or prosthesis with your health care team.

You may also choose to take no action to restore or change the appearance of your breasts. Only you can decide which option is right for you.

Breast reconstruction

In breast reconstruction, a surgeon performs an operation to create a new breast(s).

There are several types of breast reconstruction, including the following:

• A silicone gel or saline implant is used to recreate the breast(s).
• Tissue from another part of your body is used to recreate the breast(s).
• An implant and tissue from another part of your body are used to recreate the breast(s).

If you decide to go for breast reconstruction, the type of surgery will be decided by you and your surgeon, based on your needs. Getting breast reconstruction will not affect your treatment or post-treatment follow-up care for breast cancer.

Surgery by implant

An implant is a sac that is filled with silicon or saline (a water-based liquid). Through an operation, the implant is placed under the chest muscles to create a breast that approximates the desired shape and size.

If needed, a tissue expander is used to stretch the skin before the implant is inserted. A tissue expander is an empty sac that is surgically inserted. Over the course of several weeks, the sac is injected with saline through a small tube. The sac expands with each injection until it reaches the desired shape and size. It may then be replaced with a more permanent implant.

Surgery with body tissue

In breast reconstruction using your own tissues, some skin and fat are taken from another part of your body, usually the abdomen, back or buttocks. There are different techniques for creating a new breast. This method does not require any silicon or saline-filled devices.

Reconstructing the nipple

Once your breast has been reconstructed, it is possible to undergo a procedure to reconstruct a nipple. A new nipple can be formed from a bit of skin from the breast or another part of the body. A tattoo procedure can be used to darken the reconstructed nipple and areola. The new nipple(s) will not have the sensation of a natural nipple.

Breast reconstruction is not an emergency surgery, so you can take time to make a decision about what action, if any, you wish to take. For some women, breast reconstruction enhances their confidence and self-image after a mastectomy. Others may not want to accept the risks of having more surgeries after breast cancer treatment. Speak to your health care provider about the benefits, limitations and side effects of breast reconstruction surgery. Consider other options too, including breast prosthesis—or taking no action.

Breast prosthesis

A breast prosthesis is an artificial breast form that looks like a breast and is worn either inside a bra or attached to the body with special adhesive. The choice to wear a prosthesis is yours. This decision usually takes place after the side effects from surgery and radiation therapy have passed.

Prostheses come in a range of sizes, shapes and materials that are designed to simulate the weight, feel and shape of a natural breast. If your entire breast has been removed, you may choose to wear a full prosthesis. If part of your breast was removed, you may choose to wear a partial prosthesis. You can also have a custom prosthesis made just for you.

A prosthesis may be the preferred option for women who do not want to have the surgeries that are required for breast reconstruction, or who want to take time to decide what is right for them.

Speak to your health care team for advice on when to obtain a prosthesis, where from and how to access funding to help pay for the cost of it.