Cancer treatments sometimes damage a body part’s function or appearance. Reconstructive surgery helps to repair that damage.
This differs from cosmetic surgery done without a medical reason. Most insurance companies cover reconstructive surgery that is needed after cancer treatment.
Reconstructive surgery is most commonly needed after some types of surgery to remove the cancer. For example, a patient may choose to have reconstructive surgery after a mastectomy. A mastectomy is the surgical removal of the breast. It is a type of treatment for breast cancer. Another example is when a surgeon may replace tissue or nerves removed during treatment for head and neck cancer or skin cancer.
Some types of reconstructive surgery are performed in a doctor's office, clinic, or surgery center. This is called outpatient surgery. For other types of surgery, the doctor admits the patient to the hospital. This is called inpatient surgery.
The medical team
The doctor who leads your medical team depends on when you are having reconstructive surgery. A surgical oncologist may lead the team if you have reconstructive surgery at the same time as surgery to remove the cancer. A reconstructive surgeon may lead your surgical team if the reconstructive surgery is done at a later time. A reconstructive surgeon then works closely with your oncologist and other members of your health care team.
It’s important that the surgeon performing your reconstructive surgery has expertise in reconstructive and plastic surgery. This may be a reconstructive/plastic surgeon but many surgeons who remove cancer also regularly perform certain types of reconstructive surgery.
How reconstructive surgery works
Many reconstructive surgeries use microvascular techniques. Microvascular surgery is often called “free flap surgery.”
In this type of surgery, tissue and blood vessels are taken from one part of the patient’s body. They are moved to the damaged body part. This is called transplantation.
The surgeon uses small stitches that are only visible under a microscope to connect blood vessels. The stitches connect the tissue and blood vessels to those at the new site.
For example, sometimes, head and neck surgery changes the jawbone shape. A reconstructive surgeon then may transplant bone from the leg to the face. This restores the jawbone’s shape and often its function as well.
Types of reconstructive surgery
Here are several types of reconstructive surgeries:
Skin, tendon, and bone grafts. The surgeon transplants healthy skin, tendon, or bone to a new place in or on the body. The transplanted tissue does not have its own blood supply. This means that new blood vessels must grow.
Local flap surgery. This approach uses nearby body tissue to cover the area affected by cancer surgery. The tissue is not disconnected from the body or blood supply but moved while still attached to the nearby area.
Artificial implants. Sometimes, an artificial implant replaces a damaged body part. Examples include breast, testicular, and penile implants.
Scar revisions. These surgeries help minimize the appearance of scars from an earlier surgery.
Making decisions about reconstructive surgery
Talk with your surgeon about your options. The type of reconstructive surgery that is right for you depends on several factors:
- The location and severity of the damage
- Prior surgeries
- Your personal preferences
- Need for further cancer treatment
- Your overall health and other medical conditions
Often, reconstruction is done right after removing the tumor. However, sometimes, you may need to wait until you complete other cancer treatments. These may include chemotherapy or radiation therapy.
Recovery from reconstructive surgery
The time to recover from reconstructive surgery depends on the surgery type. Before surgery, ask your surgeon about these recovery topics:
- Your expected recovery time
- How to manage any pain or discomfort you may have
- Limitations to your daily routine and how long they will last
Sometimes, a patient may have permanent lifestyle adjustments. For example, if the bladder is removed, a bag on the outside of the body will collect urine.
Emotional side effects of reconstructive surgery
Talk with your reconstructive surgeon about how surgery will change the way you look and feel. Then, seek support for managing your emotions related to those changes.
It’s normal for changes to your body to affect your self-image. Consider joining a support group for people who have experienced similar changes. You can learn from others’ experiences and share your own. Or seek professional help through counseling. Ask a member of your health care team for a referral to a mental health professional.
Questions to ask your reconstructive surgeon
- Are you board-certified? Is reconstruction or plastic surgery your specialty?
- How many reconstruction or plastic surgeries of this type do you perform in a year?
- What reconstruction options do I have?
- What are the advantages and disadvantages of each type?
- When can I have my reconstruction?
- What are the costs involved with this type of surgery? What does my insurance cover?
- How long will the surgery take?
- How should I prepare for the surgery?
- Is this an inpatient or outpatient surgery? If it is inpatient surgery, how long will I be in the hospital?
- What are possible complications for this type of surgery?
- How long will it take for me to recover? When can I resume my normal activities, including exercise?
- Will I have stitches, staples, and/or bandages?
- Will there be a scar or other permanent effects from the surgery?
- What type of results can I expect?
- Can I look at photographs of similar reconstructions?
- What changes to the reconstructed area can I expect over time?
- Will I need to have another surgery in the future?
- Do I need any follow-up appointments or tests after reconstruction?
American Society of Plastic Surgeons: Find a Surgeon
American Society of Plastic Surgeons: Reconstructive Procedures