Breast reconstruction is an option for breast cancer patients who have undergone mastectomy on one or both of their breasts or lumpectomy to remove a cancerous portion of their breast. Breast reconstruction may either be performed immediately following mastectomy or at a later date. Several options exist for breast reconstruction; your plastic surgeon will help determine the most appropriate option for your specific condition.
Breast reconstruction is commonly performed using breast implants. Sometimes tissue flap procedures are done; these reconstruct the breast using tissue from the buttock, back, stomach or thighs. Regardless of whether breast implants or tissue flaps were used, breast reconstruction typically ends with reconstructing the nipple and areola, which is usually done as a separate operation.
Breast reconstruction may be performed with either saline or silicone breast implants. Saline implants are filled with salt water after they are placed into the breast, while silicone implants are already filled. Women with relaxed chest muscles and skin may undergo breast implant surgery immediately after mastectomy, while women with tight chest muscles will need an additional procedure to allow their bodies to support the implants.
The TRAM flap (transverse rectus abdominis muscle) uses tissue from the stomach and may be done two different ways. If a pedicle flap is performed, the tissue remains connected to the stomach and is sent up to the breast from beneath the skin. If a free flap is done, the tissue is removed from the stomach and reattached to the blood supply of the chest region. This procedure results in incisions on both the site from where the tissue was taken and on the breast.
The latissimus dorsi muscle flap approach involves removing a muscle in the back, including skin and fatty tissue. These tissues help produce a more natural-looking breast. A downside to the latissimus dorsi muscle flap is that the flap is only an inch thick, usually requiring the placement of a breast implant as well. As with a TRAM flap, this procedure also results in incisions on the site of the donor tissue and the breast.
Once the reconstructed breast has healed (typically three to four months following surgery), the nipple and areola are reconstructed. Tissue is taken from the ear, buttocks, eyelid, breast, groin or elsewhere on the body. The end result is a natural-looking breast.
Before undergoing breast reconstruction surgery, your plastic surgeon will examine your breasts and review your medical history. It is important to notify your plastic surgeon of all medications you are currently taking, as some may need to be temporarily stopped before surgery. Your plastic surgeon will take all these factors into consideration to develop a customized breast reconstruction plan for your specific body type.
Breast reconstruction surgery is performed using either general anesthesia or intravenous sedation. Once the anesthetic has taken effect, incisions are made into the breast, and if a flap procedure is being performed, the site of the donor tissue. The breasts are then reconstructed; in some cases, implants are inserted into the breasts at this time. When breast reconstruction surgery is complete, incisions will be closed with bandages or gauze and a drainage tube may be temporarily placed at any incision sites.
Patients typically spend two to six days in the hospital following breast reconstruction surgery. For the first few days, you may experience discomfort or soreness; however, this can usually be managed with painkillers. Within two days after surgery, you will be able to walk again. Soreness may persist for three weeks after breast reconstruction. Regular activities can usually be resumed within four to six weeks following surgery.
There are many post-surgical risks associated with breast reconstruction. These may include infection, scarring, abnormal breast sensation, lymphedema, fatigue, poor healing, adverse reactions to the anesthesia, or poor healing. You can minimize the occurrence of complications by choosing a board-certified plastic surgeon for your breast reconstruction and following all pre- and post-surgical instructions closely.
To learn more about breast reconstruction, contact us today to schedule an appointment with our plastic surgeon. Our offices are conveniently located throughout Queens, NY, Long Island, NY, New York City, and Bergen County, NJ.
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