Breast reconstruction is a surgical procedure commonly performed after a mastectomy to offer patients psychological and aesthetic benefits when recovering from breast cancer. This procedure allows many women to fully return to the life they enjoyed before being diagnosed with breast cancer, with barely any signs of the cancer treatment remaining. Although the treatment of cancer is the main focus for both patient and doctor, restoring your appearance after breast cancer can often help ensure a complete recovery of body and mind.
How is breast reconstruction performed?
There are two basic types of breast reconstruction: those that use a breast implant to replace the removed breast tissue, and those that use skin and fat from another area of the body (known as autologous tissue reconstruction).
- Implant-based breast reconstruction is performed similar to a breast augmentation, with the use of a silicone or saline-filled implant to replace breast tissue. A breast implant requires coverage with the patient's breast skin, some of which may have been removed during the mastectomy. If additional skin coverage is needed, a tissue expander may be first placed to stretch the remaining breast skin over a period of several months before the tissue expander is replaced by a permanent implant. If there is adequate skin a single stage breast reconstruction may be done where the permanent implant is placed in the breast at the time of mastectomy. Usually in a single stage reconstruction acellular dermis (such as FlexHD™ or Alloderm®) is used to support the lower pole of the breast. During your discussion with Dr. Downey you will learn more about the options for breast reconstruction and which option(s) are available for you in order to help you make the best choice for you.
- Autologous tissue-based breast reconstruction uses a flap of the patient's own skin and fat from another part of the body which is transported to the chest to create the reconstructed breast. This flap may remain attached to its original blood supply or can be reattached to another part of the body. There are several different types of flaps that can be used during breast reconstruction, the most common of which is a flap from the abdominal area (TRAM flap) or a flap from the back (Latissimus flap).
Can the opposite breast be treated during the same procedure?
If the patient wants the opposite breast can indeed be treated during the same procedure as the reconstruction. Insurance companies will cover the surgery done on the opposite breast in order to achieve symmetry. Since breast come in a variety of sizes and shapes achieving symmetry can be accomplished by enlarging (augmenting), reducing or lifting the opposite breast.
How do breasts look and feel after breast reconstruction?
The results of breast reconstruction vary depending on the patient's individual case and the type of procedure used. While Dr. Downey strives to achieve the most natural-looking results for your reconstructive procedure, reconstructed breasts will not have the same sensation and feel of a real breast. It is important for patients to remember this and to have realistic expectations before undergoing the reconstruction procedure.
Is breast reconstruction right for me?
Although breast reconstruction is a beneficial procedure for many women, it is not right for everybody and doing reconstruction at the same time as the mastectomy may not be right for everyone as well. However if you had a mastectomy years ago reconstruction is an option still for you and if you decide to delay your reconstruction until after your cancer treatment you are still a candidate for reconstruction and your insurance will still cover the procedure!
If you are interested in learning more about breast reconstruction, and to find out if this procedure is right for you, please call us today to schedule a consultation.
Breast Reconstruction with Larger Implants
Dr. Downey is pleased to be a principle investigator for a study involving breast reconstruction with larger implants. This study will evaluate the safety and effectiveness with the mentor MemoryGel larger size Ultra High profile Breast implants for primary and revisionary reconstructive breast surgery. For further information please visit https:/clinicaltrials.gov/ct2/show/NCT02724371.
TRAM FLAP Breast Reconstruction
This procedure uses the rectus abdominis muscle and the lower abdominal skin and fatty tissue to make a breast. The flap is then shaped into a new breast. This is an autologous (your own tissue) tissue – based breast reconstruction, creating a breast that feels natural and is more symmetrical in weight and shape to the opposite breast. This can be done as a pedicle flap, keeping the vessels attached, or as a free flap, using specialized microsurgical technique to attach the flap to the breast area.
Latissimus Flap Breast Reconstruction
The latissimus flap (latissimus dorsi myocutaneous flap) is another reliable method of breast reconstruction. This procedure uses muscle and skin from the back to reconstruct the breast. The latissimus flap is transferred through a tunnel in the armpit from the back to the front and placed at the site of breast restoration. Sometimes it is necessary to place an implant or tissue expander under the latissimus flap to achieve the most desirable result.
