Post-mastectomy breast reconstruction is a major component of the practice of plastic and reconstructive surgery. It offers women who must undergo a mastectomy options for restoring the female contour and appearance.

Breast reconstruction is a readily performed procedure that yields pleasing results for practically all women requiring mastectomy. A reconstruction can immediately follow a mastectomy procedure, or it may be done at a later time. The available techniques are many and varied. Selection of a technique depends on a thorough understanding of goals, alternatives, and risks by the patient and the physician alike. No single reconstruction technique is ideal for all patients, and the role played by the oncology surgeon significantly affects the ultimate selection of surgical reconstruction. The plastic surgeon must consider each of those factors when counseling a patient.

This chapter outlines the main aspects of breast and nipple – areola reconstruction. Its purpose is to guide the practitioner in counseling patients who have made a decision for surgical breast cancer treatment and breast reconstruction.

TIMING

Breast reconstruction can be immediate or delayed.

Immediate Reconstruction

Immediate breast reconstruction holds two main advantages for the patient:

• Tissue planes are more malleable when freshly dissected. Scarring has not yet developed, and the tissue is more elastic and flexible. Landmarks and anatomy are not distorted.

• […]