Type of Surgery
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Last updated: 02/17/2009
Breast surgery, including reconstruction, is the second most commonly performed cosmetic surgical procedure practiced on women in the United States. It increased by 306% between 1992 and 1998. According to the American Society of Plastic and Reconstructive...
Surgeons, more than 125,000 breast augmentation or reconstruction procedures are performed each year.
Presently, more than two million, or approximately 8%, of women in the United States have breast implants. The majority of breast implant recipients are Caucasian women (95%), followed by African-American women (4%). The remaining women that have breast implants are Asian (0.5%) and other non-specified races (0.5%).
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Breast reconstruction is the rebuilding of a breast, usually in women. It involves using autologous tissue or prosthetic material to construct a natural-looking breast. Often this includes the reformation of a natural-looking areola and nipple. This procedure involves the use of implants or relocated flaps of the patient's own tissue.
The primary part of the procedure can often be carried out immediately following the mastectomy. As with many other surgeries, patients with significant medical comorbidities (high blood pressure, obesity, diabetes) and smokers are higher-risk candidates. Surgeons may choose to perform delayed reconstruction to decrease this risk. Patients expected to receive external beam radiation as part of their adjuvant treatment are also commonly considered for delayed autologous reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients.
Breast reconstruction is a large undertaking that usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revisional surgeries.
In 1998, the Women's Health and Cancer Rights Act was passed mandating insurance coverage for breast reconstruction in the United States. Prior to this, many insurance carriers did not cover breast reconstructive surgery as they considered it cosmetic in nature. The act mandates insurance coverage for the surgery of the affected breast and also the contralateral side for purposes of symmetry1, 2
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