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Breast reconstruction is a surgical procedure that rebuilds the breast mound after mastectomy for breast cancer treatment or risk reduction. The Women’s Health and Cancer Rights Act (1998) requires health insurance plans to cover breast reconstruction after mastectomy. MetroDerm’s Center for Plastic Surgery in Atlanta offers comprehensive breast reconstruction options, from implant-based reconstruction to autologous (your own tissue) flap procedures, with a compassionate, patient-centered approach.
Types of Breast Reconstruction
Implant-Based Reconstruction
The most common approach. A tissue expander is placed at the time of mastectomy and gradually inflated over several months to stretch the skin, followed by an exchange procedure to place a permanent implant. Alternatively, direct-to-implant reconstruction can be performed in select patients, eliminating the expander stage.
Autologous (Flap) Reconstruction
Uses the patient’s own tissue — transferred from the abdomen, back, thigh, or buttocks — to create a new breast mound. Common flap procedures include the TRAM flap (transverse rectus abdominis myocutaneous), DIEP flap (deep inferior epigastric perforator — microsurgical, muscle-sparing), and latissimus dorsi flap. Autologous reconstruction provides a more natural, long-lasting result but involves a longer initial recovery and additional donor site scarring.
Timing of Breast Reconstruction
Immediate Reconstruction
Performed at the time of mastectomy, in coordination with the breast surgical oncologist. The most common approach when oncologically appropriate. Allows the patient to wake from mastectomy with a breast mound in place.
Delayed Reconstruction
Performed after mastectomy healing is complete — sometimes after radiation therapy is completed. Preferred when radiation is planned, as radiation can significantly affect implant-based reconstruction outcomes.
Nipple-Areola Reconstruction
The final stage of breast reconstruction is optional nipple-areola reconstruction, typically performed 3-6 months after the breast mound is complete. Techniques include local flap reconstruction (creates a three-dimensional nipple from local skin) and tattooing (creates a realistic two-dimensional nipple-areola appearance without further surgery).
Frequently Asked Questions
Q: Is breast reconstruction covered by insurance?
A: Yes. The Women’s Health and Cancer Rights Act (WHCRA) of 1998 requires all insurance plans that cover mastectomy to also cover breast reconstruction — including the unaffected contralateral breast (to achieve symmetry) and prostheses. Contact MetroDerm’s Center for Plastic Surgery to discuss your coverage before your mastectomy.
Q: When should I consult a plastic surgeon before mastectomy?
A: Ideally, consult a plastic surgeon before your mastectomy so that reconstruction can be planned and coordinated with your breast surgical oncologist. Immediate reconstruction often produces better aesthetic outcomes and is more convenient for the patient. Early consultation also allows time for insurance pre-authorization.
Q: How long does breast reconstruction take?
A: The timeline depends on the chosen technique and whether radiation is involved. Implant-based reconstruction with tissue expander typically takes 6-12 months from mastectomy to final implant exchange. Autologous flap reconstruction has a longer initial surgery (4-8 hours) but fewer staged procedures. Your MetroDerm plastic surgeon will outline the full timeline at consultation.
Procedures & Treatments
