Breast reconstruction following mastectomy is a real option for most women who will face this decision. And today, millions more are aware of it because of the actions of one of the most well-known celebrities on the planet.
The headlines, blogs, and television news stories have been filled recently with the image of Angelina Jolie. She announced to the world that she had chosen to have double mastectomies and breast reconstruction, because her genetic makeup put her at high risk for someday developing breast cancer.
Telling the world her personal story, was a moment of great courage, and Ms. Jolie says she wanted to share her choice with everyone in hopes of spreading knowledge. And that’s what we’re doing here. We’ll try to explain the type of breast reconstruction she has had.
CAN ANY WOMAN HAVE THE TYPE OF RECONSTRUCTION ANGELINA HAS?
Almost any woman will be a candidate for some type of reconstruction following Mastectomy. But there may be differences and limitations, depending on the patient’s situation.
HOW WAS HER SURGERY PERFORMED?
- In Ms. Jolie’s case, the mastectomies were preventive, so there was no cancerous tissue to remove. That allowed her surgeon to leave a good amount of healthy skin, which would later be “filled” with an implant.
- Sparing the nipple Nipple-sparing mastectomies have become very common in recent years. It is what it sounds like. After various tests have been done, doctors determine whether a patient’s own nipple and areola, with its blood supply, can be saved, allowing her a more natural appearance.
- Surgeons will sometimes perform what is known as a nipple delay procedure to increase the chances that the nipple will survive. Several weeks before the mastectomies, surgeons may take a small amount of tissue from directly beneath the nipple, to test for any trace of disease. The surgery in itself, may produce the advantage of adding another avenue of blood flow to the nipple, increasing its chance of survival.
- According the account her doctor was given permission to make public, Ms. Jolie had the nipple delay procedure, as well as nipple-sparing mastectomies.
- Her surgical incisions were made beneath the breast, in the inframammary fold. Following mastectomy, she chose to have her reconstruction performed in stages, the first being insertion of tissue expanders in the “hollowed out” breast tissue created by the mastectomy. The expanders are empty implants that are placed under the chest muscle, and then filled with saline during periodic injections over the next several months, until the volume chosen by patient and doctor is reached.
- In the final stage, a separate surgery, the expanders are removed, and the permanent breast implants are put in place. In Ms. Jolie’s case, according to her doctor, teardrop shaped anatomic implants were used, along with allograft, a graft of processed skin material, to provide additional coverage for a more natural look.
WHAT ABOUT RECONSTRUCTION WHEN A WOMAN HAS HAD CANCER?
As mentioned earlier, it is certainly possible. In my practice, I have performed breast reconstruction in San Jose and Palo Alto, on hundreds of patients, using implants, expanders, and microsurgical (flap) techniques. Most of these patients have had cancer. Determining which type of surgery is best for an individual patient, is based on their anatomy, health, and the type and location of a breast tumor.
Please know that reconstruction is a process, and a very personal journey. You and your board-certified Plastic Surgeon will have a number of discussions about what might be possible and best for you.
It’s true that most women facing mastectomy and reconstruction, do not have the lifestyle, and advantages of one of the world’s most famous women. Fortunately, you do have many of the same options available to you. We encourage you to learn more about them.