Breast Reconstruction 101

Dr. Sewit Amde loves her job as a plastic and reconstructive surgeon for lots of reasons—including helping to comfort and empower women who’ve had mastectomies. 

She often meets women right after they’ve been diagnosed with cancer, when they’re fearful. Then she works alongside them throughout the breast reconstruction process, when they choose the size and shape of their new breasts. 

“My part of the process makes them feel better about the decisions they have to make in regard to their cancer. I think breast reconstruction is always a more positive part of what they have to go through,” Dr. Amde said. “We often get to laugh a little and not talk about cancer so much. By the time we finish, they feel whole and they’re just ready to leave all of that behind them. It’s a privilege going through that journey with our patients.”Dr. Amde, who is a double board-certified surgeon, performs two types of breast reconstruction procedures at Hancock Health.

Most of the breast reconstruction procedures in America—about 75%—are implant-based, said Dr. Amde.

The process usually requires two procedures, one at the same time as the mastectomy is performed, and another, placing the implants, a few months later. During the first procedure, your surgeon will place a tissue expander where your breasts were. The expander is then incrementally filled with saline, stretching your chest area and preparing it for the implants. Once the expanders are filled to your desired breast size, a second procedure is scheduled to place the breast implants.

The first procedure—the mastectomy and placement of the tissue expanders—is usually inpatient, requiring an overnight stay in the hospital. The second, when the implants are placed, is outpatient, allowing you to go home the same day. 

Once the second procedure is complete, recovery time is estimated at three to six weeks.

Another way to perform breast reconstruction is to relocate some of your own skin and tissue—either from your abdomen or back—to your chest, forming your new breast.

Dr. Amde uses this method when she needs tissue and skin from another part of the body to complete the procedure. Radiation treatments sometimes damage chest tissue and skin so it’s necessary to use another part of the body to build new breasts; women who delay their reconstruction months or years after their mastectomies usually use tissue from other parts of their body for their new breasts, too.

This type of reconstruction, which is similar to the breast implant procedure described above, is an inpatient procedure, so you’ll have a hospital stay of one or more days depending upon your individual circumstances. The recovery time is about six weeks.

Breast reconstruction patients can usually choose for their new breasts to be larger or smaller than their original breasts by one or two sizes. 

“We always take into account what the patient wants,” Dr. Amde said.

Tattoos are also available whenever a patient’s own nipple and areola can’t be preserved, but it’s better to try to use the original body parts. Medical tattooing hasn’t gotten good enough to replicate what areolas really look like, she said.

The answer is probably. Though you should consult with your insurance carrier before your procedures, most insurance plans cover the costs of breast reconstruction in medically necessary situations, including cancer diagnoses and mastectomies. (The procedures are different from breast augmentations, breast lifts, and breast reductions, which are considered cosmetic procedures and aren’t usually covered by insurance plans.)

“Even though it seems like a lot of what we’re doing is aesthetic, it’s qualified,” said Dr. Amde. 

Research has shown that women who have reconstruction following a mastectomy are more confident and have a more positive outlook on life, and that’s part of the reason insurance plans cover breast reconstruction.

“What I hear from my patients is that, after their reconstruction, they feel like they can go back to wearing whatever they did in the past,” said Dr. Amde. “They just don’t feel like they have to continually modify their lives because they’re missing a breast.”

More good news is that regardless of the method you choose, breast reconstruction is considered a safe procedure. If you want to know more about breast reconstruction or any of the other surgical procedures we perform, contact Dr. Amde at Hancock Plastic and Reconstructive Surgery and visit our surgical site at HancockSurgery.com.