If you or a loved one has just entered the world of breast cancer, mastectomy and breast reconstruction, I hope this page will help you understand a few key terms. At the bottom of the page you will find links to some websites with more detailed information.
TYPES OF MASTECTOMY
A unilateral (sometimes referred to as single) mastectomy removes the tissue of a single breast.
A bilateral (sometimes referred to as double) mastectomy removes the tissue of both breasts.
A prophylactic mastectomy is when a woman chooses to undergo the surgery prior to diagnosis. Mastectomies are often performed after a breast cancer diagnosis, but are also a treatment option for women who are cancer-free, but have tested positive for the genetic mutation for the disease on their BRCA1 or BRCA2 gene. The genetic mutation greatly increases the risk of a future breast cancer diagnosis. A woman who undergoes a prophylactic mastectomy is called a previvor.
BREAST RECONSTRUCTION VS. BREAST AUGMENTATION
Breast reconstruction is done to restore breasts after a mastectomy. Though in some cases the woman’s nipple is spared during mastectomy, the goal of the surgery is to remove all the breast tissue. Depending on how advanced the cancer, sometimes some or all of the chest muscle is removed as well. The surgeon is tasked with creating something out of nothing, and the nature of the surgery generally necessitates long incisions that leave prominent scars. Reconstruction comes from a place of sadness and loss. It’s something women undergo to regain a sense of normalcy after one of the key feminine parts of their body is removed.
Breast augmentation (boob job), on the other hand, utilizes implants or fat to enhance the size and shape of already existing breasts. The woman’s natural breast tissue remains intact, and an implant is added to the breast tissue for aesthetic reasons. This procedure is completed using a small incision in an inconspicuous area like the armpit or the underside of the areola. It’s something women do to improve their look. I consider this a “happy procedure.”
In flap reconstruction, tissue is taken from another part of the woman’s body and reassigned to the breast. Skin, muscle and fat tissue can all be used. There are several places on the body that can be used as the donor sites for flap reconstruction. The two most common sites are the abdomen and the upper back. (There are a variety of flap procedures that are commonly performed.)(American Cancer Society)
In implant reconstruction, the breast is rebuilt using a silicone or saline implant instead of tissue from a different part of the woman’s body. This is sometimes immediately follows mastectomy – immediate reconstruction. It’s sometimes done in phases – immediate/delayed reconstruction.(This is what I did.) And it is sometimes done months or even years after mastectomy – delayed reconstruction.
COMMON IMPLANT TYPES
Saline implants are filled with saline, a substance similar to salt water. The most appealing part of saline implants is that if they puncture or break, the body naturally absorbs the saline. A common complaint about saline implants, however, is that they don’t feel natural. They tend to be harder and less malleable than silicone implants. Though saline implants have been in use the longest, silicone implants are a more popular choice.
Silicone implants are the most common type today. A regular silicone implant is filled with silicone gel. If the implant breaks or leaks, the gel has the possibility of seeping out into the pocket that was created for the implant. Fears about the silicone leaking into the body in the event of a puncture led the FDA to research the safety of these implants in the 1990s. (They were deemed safe and have been in use ever since the completion of that study.)
Gummy bear implants ulitize a semi-solid silicone gel that holds its form even if the implant breaks. Because of the thicker gel, these implants feel less like natural breast tissue than regular silicone, but they don’t risk leaking if the implant is punctured.