Each reconstruction technique will be tailored according to the patient’s physical health, aesthetic goals, and personal preferences. There are many factors playing into the approach that will be taken. The ultimate goal is to ensure the patient is healthy and happy with their final breast results.
There are two primary categories of breast reconstruction techniques:
RECONSTRUCTION WITH IMPLANTS
Breast reconstruction using silicone or saline implants is a common approach that often starts with the use of a tissue expander to help form a suitable pocket for an implant. The expander may be inserted after the mastectomy procedure or during the same operative session. Over the course of several months, the expander will slowly be enlarged using a sterile solution injected through a port residing under the skin. During the scheduled reconstruction surgery, the expanders are removed and replaced with implants.
AUTOLOGOUS RECONSTRUCTION
If there is limited tissue inside the breast, or limited skin on the outside, tissue may be used from another part of the patient’s body to supplement this loss. The most common areas to support this process are the buttocks, thigh or abdomen. This is an autologous approach to breast reconstruction. The TRAM flap (Transverse Rectus Abdominus Myocutaneous), the DIEP flap and SIEA flap techniques involve taking skin and fat from the abdomen and relocating it to the breast. The Latissimus Dorsi Flap is another common method using tissue from the patient’s back.
NIPPLE/AREOLA RESTORATION
During a mastectomy, the nipple and areola often cannot be saved. The loss of one’s nipple and areola can be as unnerving as the removal of the breast itself. However, reconstruction techniques have advanced greatly, allowing plastic surgeons the opportunity to recreate these areas of the breast to give a natural, aesthetically appealing appearance. In a separate procedure, the nipple is created using existing breast skin or from the abdominal or latissimus flap. Using a tattoo technique, the areola is recreated with a skin graft taken from the thigh, abdomen or back.
QUALIFIED SURGEON?
This is a very specialized surgery that requires extensive knowledge, skill and experience. It is very important to research and find a qualified and reputable plastic surgeon who has experience with breast reconstruction surgery.
CAN I DELAY THIS SURGERY?
Yes, delayed breast reconstruction is often chosen by patients who want to complete all post operative chemotherapy and/or radiation treatments before considering reconstruction options. These patients are often happier with their results. In many situations, it is recommended to start the reconstruction process at the same time as the mastectomy. When done together, the soft tissue that surrounds the breast will heal simultaneously with the reconstruction, which can enhance the final results. Because each patient’s journey is different, it is a good idea to have your breast cancer surgeon and your plastic surgeon begin communicating about the steps that will follow.
BREAST SENSATION?
A reconstructed breast will not have the same sensation as the breast did before the mastectomy. However, over time, some of this sensation will return to normal. This will depend on the extent of the reconstruction process and will vary by patient.
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