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Spring 2007

Choices Offered for Breast Reconstruction After Cancer

New surgical techniques have dramatically improved the results of breast reconstruction following mastectomy. For patients who are appropriate candidates, microvascular surgery makes it possible to transfer tissue from the lower abdomen or buttocks to reconstruct the breast at the time of the mastectomy. This procedure has become the predominant technique for breast reconstruction at the Revlon/UCLA Breast Center. Under the magnification of a microscope, tissue from elsewhere on the body is connected to a blood supply in the breast.

Prior to the advent of microvascular surgery, breast reconstruction using the patient’s own tissue (autologous tissue transfer) was significantly more invasive. “When we were moving tissue around, we sometimes had to take a small piece of muscle,” explains Andrew Da Lio, M.D., UCLA plastic surgeon. “Now that it’s almost solely fat and skin, the functional downside has been reduced dramatically, to the point where patients rarely notice any difference.” In most cases, the reconstruction can be done in conjunction with the breast removal, improving the cosmetic outcome, Dr. Da Lio says. 

Implants still represent an attractive option for many patients. “Our results are getting better not only with autologous tissue transfers, but also with the use of implants,” Dr. Da Lio says. There are now multiple types of implants, using both saline and silicon, with a variety of shapes and textures. Women for whom mastectomy is the best choice should fully understand the pros and cons of microvasuclar surgery or implants for breast reconstruction, says Helena Chang, M.D., director of the Revlon/UCLA Breast Center.

“It comes down to individual choice, the ability to tolerate the surgery, and whether the patient will need radiation as a subsequent breast cancer treatment,” Dr. Chang notes.

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