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Breast reconstruction: Compare options

Legacy Cancer Institute surgeons have years of experience with all types of breast reconstruction, including microsurgical procedures using your own tissue to rebuild your breast (like the DIEP flap) and nipple-sparing mastectomy. Your breast surgical oncologist and your reconstructive plastic surgeon will help you decide which option is best for you and will coordinate your cancer care with your reconstruction.

Type of surgery

Description

 Best for:

Pros and cons

Legacy surgeons

Oncoplastic surgery: Breast reduction and lift on both sides in combination with lumpectomy. Tumor removal combined with cosmetic breast reshaping to restore a natural appearance. The opposite breast is reduced, so both sides match.

Women like the "lifting" effect. 


Women who undergo breast-conserving surgery or radiation therapy that will leave the breast distorted.

Best for women with large or very large breasts.
Only one surgery.

Maintains breast shape after cancer treatment.

Reduces risk of complications from radiation therapy.

May lose feeling in the nipple.

Surgical oncologists:
Alivia Cetas, MD
Jennifer Garreau, MD
Nathalie Johnson, MD, FACS
Plastic surgeons: 
Elisa Burgess, MD, FACS
Emily Hu, MD
Shane C. Kim, MD
Hema Thakar, MD

Nipple-sparing mastectomy The nipple and/or areola are left in place while the breast tissue under them is removed.

Reconstruction may be done at the same time or at a later time.
Women who have a small, early stage cancer near the outer part of the breast, with no signs of cancer in the skin or near the nipple. Spares the nipple, for a more natural looking breast after reconstruction.

Little or no feeling left in the nipple.
Alivia Cetas, MD

Jennifer Garreau, MD

Nathalie Johnson, MD, FACS
DIEP flap (deep inferior epigastric perforators) An advanced microsurgical technique which uses excess fat and skin from the lower abdomen to reconstruct the breast after a mastectomy,

No muscle tissue is used.
Women with excess fat on their lower abdomen.

If women do not have enough abdominal fat, tissue may sometimes be used from another part of the body.

It may not be possible for women who smoke, are obese or have diabetes.
Natural-looking results.

A “tummy tuck” effect, while preserving abdominal muscles and strength.

Scar at the bikini line.

Minor surgery may be required on the opposite breast so they match.

6-8 week recovery 

Shane C. Kim, MD

Hema Thakar, MD

Implant-based breast reconstruction
A breast implant is used to recreate the breast, using a silicone shell filled with either silicone gel or a salt water solution (saline), including the new teardrop shape. 

Immediate or staged reconstruction is possible, depending on the circumstances. Delayed reconstruction is also possible. 
Women without excess fatty tissue and who do not need radiation treatment.

Not generally recommended if radiation is required.

For women having a mastectomy on only one breast, exactly matching the other natural breast with an implant can be difficult.
No additional scars on the body other than those on the breasts.

3-4 week recovery. However, at least two surgeries and multiple visits to the plastic surgeon’s office are usually required.

Risk of complications requiring surgery to correct.
Elisa Burgess, MD

Emily Hu, MD

Shane C. Kim, MD

Hema Thakar, MD
Tattoos of the nipple areola
The finishing touch to breast reconstruction
Women who have had breast reconstruction with or without reconstruction of the nipple
Can be done in the doctor’s office.

More than one procedure may be required for a color match.
Hema Thakar, MD