Breast Reconstructive Surgery

More choices and better technology

Women who want to consider breast reconstruction surgery following a mastectomy or lumpectomy have more choices than ever with advances in technology that lead to better early detection as well as improved surgery options.

These options depend on a number of factors, such as what stage the cancer is in when discovered, what treatments are chosen, and the patient’s overall condition and size of the breasts. How to approach reconstruction also depends on the type of surgery that was performed to remove the tumor.

We sit down with each patient to discuss all the options and formulate a plan together. We take differing approaches to a lumpectomy—a breast-conserving surgery that removes only the tumor and some surrounding tissue —than to a mastectomy, which removes all tissue in the affected breast.

In breast reconstruction, we create a breast shape using an artificial implant, a flap of tissue from another place on the patient’s body, or sometimes a combination of both. Implants are filled with saline, silicone gel, or a combination of the two. Flap, or autologous, reconstruction uses tissue transplanted from the stomach, leg, or back.

Beyond reconstruction, some patients choose to also reconstruct the nipple if the original one isn’t preserved. We can tattoo match color to the opposite breast, or you can have a 3-D tattoo that looks like a nipple. There are several options.

Reconstruction has progressed to the point of being more refined, and patient satisfaction is markedly better than in years past when patients had concerns about a possible defect in the implant. The silicone implants used decades ago no longer exist. Now it’s a cohesive gel that has a more natural feel and look.

Some women know as soon as they have a mastectomy or lumpectomy that they want reconstructive surgery immediately. Others might decide to go down the surgery path years after breast removal. There is no right or wrong way, only the way that works best for you.

All women considering breast reconstruction must remember tumor removal is first priority. Talk to your surgical oncologist as well as your plastic surgeon to come to an agreement on the best approach for both tumor removal and breast reconstruction.

I’ve been asked if we have a typical patient. In medicine generally, and plastic surgery specifically, there isn’t one general type of patient. If we start treating everyone the same, then we’ve missed the boat.

Some people don’t want reconstruction, and that’s perfectly fine. Some people may want a size reduction, or one breast made smaller and the reconstructed side made to match. We want every woman to understand that we’re here to work with you.

Now, sometimes there are limitations. Radiation therapy, for example, changes muscle and skin and affects how we approach our options. But don’t get discouraged if you’ve received radiation therapy. Many implant-based breast reconstructions after radiation therapy are successful, and in some situations, the patient’s own tissue is used.

It’s an exciting time for what we can offer women. We’re here to provide the best options for breast reconstruction surgery.

Dr. William L. Hickerson a is board certified by the American Board of Surgery and the American Board of Plastic Surgery. He is medical director of Regional One Health’s Firefighters Burn Center, the only full-service burn center of its kind within a 150-mile radius of Memphis. His expertise in skin substitutes and reconstructive surgery has earned him global recognition. He has performed countless plastic surgeries for more than 30 years. To schedule a consultation or appointment, please call 901-515-5665 or visit RegionalOneHealth.org/cosmetics for more information.

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