New Alternatives are Emerging for Breast Reconstruction

Currently about 250,000 women will face breast cancer each year. As our screening and detection have improved, our patients have become younger and fortunately, the breast cancers have become smaller. The early diagnosis with smaller cancers, many of which are noninvasive, has pushed the interest in reconstruction. The American Society of Plastic Surgeons (ASPS) data has shown that 96,000 seek breast reconstruction annually. Still, many who face the challenges of breast cancer diagnosis and treatment are not fully aware of all their options. Some states have even moved to ensuring women have the option to consult with a plastic surgeon before mastectomy.
In our own practice, we find patients are very active in pushing the discussion and taking an active role in understanding what their breast cancer journey will be like. Consider with early diagnosis at age forty, women have to look ahead to forty years of life without a breast, and today’s generation tells us they want to participate and make treatment decisions. They expect to have a full life and look as good as possible, and some wish to look even better than they did before mastectomy.
New alternatives our practice is investigating involve cohesive gel, or form stable implants which come in numerous shapes and sizes to match the natural breast shape. We began with the Allergan 153 implant trial which was a first evolution of a shaped implant. We found that mastectomy removed some the personality of the breast which was not as easily restored with current round breast implants, and the shaped implants gave us some very good results. This progressed into the current Allergan 410 or ‘gummy bear’ implant study which is still ongoing.
Tissue expanders may also take a new turn. A tissue expander is often needed to hold the space, and later expand the breast skin in preparation for an implant. The expander is filled over several office visits which can be time consuming for those eager to get back into a regular schedule. A newer expander being developed can be filled by the patient according to their own schedule and comfort level, and just might improve the whole process.
Finally, nipple reconstruction has always been the finishing touch to the perfect reconstruction, and something so simple can be a powerful and life changing event as the new breast comes to life. The nipple is so important to the essence of the normal breast that newer mastectomy techniques may be able to preserve the nipple for a fortunate group of patients. Sparing the nipple can allow an immediate implant placement and a one step process to restore a normal breast form and appearance.
Just as our ability to diagnose and cure breast cancer has greatly improved, so has our appreciation and ability to reconstruct the breast. Younger patients continue to push us beyond the pink ribbon as they demand the very best path to a full, active and beautiful life.