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Reconstruction with quickest recovery?

Page last modified on: October 15, 2008

Question from SarahL: I am contemplating a mastectomy and ovary removal after having gone through chemo and radiation, and after discovering I carry a BRCA2 mutation. I am just feeling like myself and I find planning this difficult. What of the many choices is the quickest recovery? I should say I am only 40 and several of my doctors believe I will be most happy with some kind of implant or reconstruction.: Answers —Jennifer Sabol, M.D., F.A.C.S.: I think it's fair to say this is a very difficult decision to make when you are finally feeling like a healthy individual again. But it's important to look at the long-term outcome. Many patients who have already received treatments for their breast cancer and find out that they are BRCA positive, ultimately continue to choose only very close observation and screening, unless they have another recurrence. If, however, this makes you very anxious, as it will in a number of young women, it's very important not to look for the quick fix, but to look for the best long term outcome, looking at several factors, some of which are your overall body shape, your expectations for a good cosmetic outcome, your athletic ability, and your overall health. These are just a few of the important issues, and I think Dr. Serletti will agree that while implants may seem like a quick short-term fix, they do require ongoing maintenance and may require several revisions to maintain an optimal cosmetic result. Maybe, Dr. Serletti, you can comment further about some of the types of reconstruction and what you would take into consideration when you see these patients.; Joseph Serletti, M.D., F.A.C.S.: Any patient, whether they're young or old, really needs to look at the long-term results. Obviously, it's more important for a younger patient like you are to look at the long-term results also. As with most patients, there are two options for breast reconstruction. Those are implant reconstruction, and then using the patient's own tissue, such as a TRAM flap, a DIEP flap, SIEP flap, or a gluteal flap. Most of us feel that in the proper patient, a reconstruction using the patient's own tissue will give the best long-term results over many years. Further, the recovery from most complex breast reconstructions using the patient's own tissue is typically about six weeks. In a patient who has had previous radiation, using the patient's own tissue is really the method of choice.

On Wednesday, May 16, 2007, the Ask-the-Expert Online Conference was called Reconstruction Updates. Joseph Serletti, M.D. and moderator Jennifer Sabol, M.D. answered your questions about breast reconstruction.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Joseph M. Serletti, M.D., F.A.C.S. is professor of surgery and chief of the Division of Plastic Surgery at the University of Pennsylvania. He is a pioneer in the field of free flap autologous breast reconstruction.

Jennifer Sabol, M.D., F.A.C.S. is a breast surgeon who directs the newly developed Breast Care Center at Lankenau Hospital in Wynnewood, Pa. Among her many interests, Dr. Sabol spearheads several research initiatives to advance the care for women with breast cancer and improve methods of breast cancer detection and treatment.