Performing breast reconstruction surgery has got to be the most rewarding job as a plastic surgeon. This surgery is generally used to reconstruct a woman’s breast after breast tissue is removed because of cancer. With an array of surgery techniques, the surgeon is able to decide the method that is best for each patient.
One or both breasts can be reconstructed, depending on what was affected. If only one breast was affected, it can be reconstructed and the opposite breast can be augmented, reduced or lifted to improve symmetry between the breasts.
Breasts affected by cancer can be reconstructed with the placement of saline or silicone-filled implants.
A tissue expander is a device that resembles an implant. It is placed in the chest area and gradually filled over a long period of time to stretch the breast skin and create room in the tissue to accommodate an implant. Eventually, the tissue expander is removed and replaced with a permanent saline or silicone implant.
Flap-based reconstruction uses a portion of the patient’s own tissue and muscle to recreate the breast. There are a few different types of flaps:
A latissimus dorsi flap uses muscle, fat and skin from the patient’s back to reconstruct the breast. The flap is tunneled underneath the skin to the chest, where it is formed into a breast mound. The latissimus dorsi flap remains attached to its donor site in order to maintain its original blood supply.
A transverse rectus abdominis (TRAM) flap uses muscle, fat and skin from the abdomen to recreate the breast. A TRAM flap may be completely detached and placed on the chest or it may be tunneled underneath the skin and remain attached to its original blood supply.
A deep inferior epigastric artery perforator (DIEP) flap takes skin and tissue from the lower abdomen to reconstruct the breast. An added benefit of the DIEP flap is that it produces a tummy tuck-like effect by removing excess fat and skin from the area underneath the navel. In addition to recreating the breast, this approach also flattens and firms the abdomen.
The oncoplastic rearrangement approach involves completely removing the cancerous tumor and tissue, and sculpting the remaining breast tissue to restore a normal shape and appearance. The opposite breast is modified — reduced, lifted or both — to maintain symmetry between the breasts.
Many times, reconstruction is a possibility directly after a mastectomy surgery. Having the surgery right away allows women to avoid the uncomfortable emotional state of having to see themselves without their breast. There are also a variety of techniques to reconstruct the nipple, with pleasing results. Dependent upon the method and extent of the required reconstruction, more than one procedure may be necessary.
No matter your goal — whether it is to correct naturally misshapen breasts, enhance the size of the breasts, change the look of the breasts after child bearing, alter the breast appearance due to age, or to improve self-esteem — we will help you get your desired results.
For additional information on breast reconstruction, visit the website of the American Society of Plastic Surgeons.