The results after breast reconstruction can vary dramatically. The proper choice of breast reconstruction and the surgeon’s attention to detail will make a significant impact on the overall look and feel of a new breast.
Many people wonder if there is a way to recognize a good breast reconstruction. Photographs are a basic way to describe the aesthetic appearance. However, the critical items of feel, touch and patient comfort simply cannot be seen on one or two pre or postoperative photographs. The long-term complication rates of different types of reconstruction also differ significantly.
For a truly aesthetic breast reconstruction, all of the following factors are very important: Type of breast reconstruction (own tissue vs. expander/implant); a surgeon’s experience and attention to detail during the breast reconstruction first stage (“the reconstruction part”); a surgeon’s time spent in attention to detail and during the second procedure, or “touch-up” stage. This is the time when the breast “reconstruction” procedure is transformed into an “aesthetic” procedure by a meticulous surgeon.
Studies in medial literature have repeatedly shown that breast reconstructions performed using a patient’s own tissue results in a reconstruction which will look better and feel better in the long run than breast reconstructions performed with tissue expanders and implants. Breast reconstruction from a patient’s own tissue will appear more natural and tend to gain and lose weight with that patient.
Long term rates of complication using a patient’s own tissue also tend to be significantly lower than with the expanders and implants. This is especially true with patients who have undergone radiation in the treatment of the breast cancer.
The patient’s own tissue brings in blood supply, nutrients and oxygen which contribute to and support, not only the breast reconstruction itself, but also the surrounding tissues. In contrast, reconstruction or an implant will cause the body to form a capsule, or shell of connective tissue, around the implant in all cases. The reconstruction may remain soft but has the propensity to form a contracture, or hardening of the shell over time. This risk of contracture and hardening is present throughout the life of the patient.
The surgeon’s experience and attention to detail in determining the choice of reconstruction and the way it is performed during the first operation is important. Again, use of a patient’s own tissue will overall have a higher chance of having a natural-appearing result than that with tissue expanders and implants, especially in the face of radiation.