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Reconstruction or Prosthesis

Reviewed 2015

Surgical reconstruction of the breast is an insured benefit for breast cancer patients under the BC provincial medical plan.

Vancouver Coastal Health’s Breast Reconstruction Program has very good information on this procedure. BC Cancer recommends that patients visit this site for in-depth information.

The goal of breast reconstruction is to create a breast mound. This restores a more normal looking body when clothed. This is usually very successful but the appearance of the naked breast is not completely natural in most cases. This operation is about giving women a normal look with clothes on.

It is usually performed by a plastic surgeon rather than the surgeon who did the mastectomy.

Reconstructive surgery can be done either immediately or be delayed. Immediate reconstruction requires that the patient visit the mastectomy surgeon and the plastic surgeon before the surgery is booked. It is essential that both surgeons are present during the surgery.

There are two kinds of reconstruction. 

  • One kind is to place an implant (also called a prosthesis) into the chest wall. 
  • The other kind is to create the breast-shaped mound using tissue from your own body.

Implants

An implant can be made of saline or silicone. It is placed between the chest wall (ribs) and pectoral muscle. There are different methods the plastic surgeon can use to introduce the implants into the body. The two surgeons work together during the surgery to give the best cancer outcome and the best looking result.

Breast implants are not hazardous as long as the silicone is sealed in a bag, or the prosthesis is the type that is filled with saline (salt water).

In 1992, silicone implants were voluntarily taken off the market in Canada because of safety concerns. In 2006, silicone implants were approved for use in Canada. For further information, see Health Canada’s Licensing Decision on Silicone Gel-filled Breast Implants (2006).

Patient's tissue

Another way to reconstruct a breast is to use the patient’s own tissue to create a new breast mound. There is more than one way to do this, and the patient and plastic surgeon will decide which is best together.

The most common is TRAM flap (Transverse Rectus Abdominus Muscle). This involves moving tissue from one part of the body (the belly) to another (the chest wall). The surgeon creates a flap using the skin, fat and one of the abdominal muscles or muscles of the lower abdomen. This tissue is transferred from the abdomen to the breast area.

Another type of flap reconstruction is the latissimus dorsi flap which involves moving tissue from the back to the chest wall. The surgeon transfers skin, muscle (the triangular muscle from the back), fat and the blood vessels that nourish them, from the back to the breast area.

A large breasted woman may require reduction of the opposite breast to create a balanced look.

Mammograms after breast implant

  • Women with breast implants should get regular mammograms.
  • MRI: This test may be helpful in assessing the implant and may help diagnose any rips, tears or disruption of the implant.

Financial assistance 

For information on financial help or any assistance regarding related breast cancer expenses – external prosthetics, bras and wigs, please consult the booklet: Financial Information for Cancer Patients, which is produced by BC Cancer’s Patient and Family Counselling.

SOURCE: Reconstruction or Prosthesis ( )
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