Breast Reconstruction Procedures
The reconstruction of a breast that has been removed in a mastectomy, due to cancer or other disease, is one of the most rewarding surgical procedures available today. At the Zannis Center for Plastic Surgery of New Bern, NC, we take pride in offering outstanding breast reconstruction surgeries for patients throughout our region. New medical techniques and devices have made it possible for surgeons to create a breast that can come close in form and appearance to matching a natural breast.
Most mastectomy patients are medically appropriate for reconstruction, and many are able to be performed at the same time that the breast is removed. The best candidates for breast reconstruction are women whose cancer, as far as can be determined, seems to have been eliminated by mastectomy. Frequently, reconstruction is possible immediately following breast removal procedure, also called a mastectomy. This way, the patient wakes up with a breast mound already in place, having been spared the experience of seeing herself with no breast at all.
Still, there are legitimate reasons to wait. Many women aren’t comfortable weighing all the options while they’re struggling to cope with a diagnosis of cancer. Others simply don’t want to have any more surgery than is absolutely necessary. Some patients may be advised by their surgeons to wait, particularly if the breast is being rebuilt in a more complicated procedure using flaps of skin and underlying tissue. Women with other health conditions, such as obesity, high blood pressure, or smoking, may also be advised to wait before considering a breast reconstruction surgery.
In any case, being informed of your reconstruction options before surgery can help you prepare for a mastectomy with a more positive outlook for the future.
The Breast Reconstruction Procedure
While there are many options available in post-mastectomy breast reconstruction, you and your surgeon will discuss the one that’s best for you. At Zannis Center for Plastic Surgery, we specialize in two main types of breast reconstruction procedures: the skin-expansion technique and the flap-reconstruction technique. These two approaches to breast reconstruction are described in greater detail below.
The Skin-Expansion Technique
The most common breast reconstruction technique combines skin expansion and subsequent insertion of an implant. Following mastectomy, your surgeon will insert a tissue expander beneath your skin and chest muscle. Through a tiny valve mechanism buried beneath the skin, he will periodically inject a saline solution to gradually fill the expander over several weeks or months. Once the skin over the breast area has stretched enough, the expander is removed in a second operation, and a permanent implant will be inserted. The nipple and the areola are reconstructed in a subsequent procedure.
Some patients do not require preliminary tissue expansion before receiving a breast implant. For these women, the surgeon will proceed with inserting an implant as the first step, often using a product called Alloderm®.
The Flap Reconstruction Technique
An alternative approach to implant-based breast reconstruction involves the creation of a skin flap using tissue taken from other parts of the body, such as the back or abdomen. In one type of flap surgery, the tissue remains attached to its original site, retaining its blood supply. The flap, consisting of the skin, fat, and muscle with its blood supply, are tunneled beneath the skin to the chest, creating a pocket for an implant These are known as latissimus flaps. Alternatively, at TRAM flap can be used by using a skin flap to create the breast mound itself without the use of an implant. Another skin flap technique uses tissue that is surgically removed from the abdomen, thighs, or buttocks and then transplanted to the chest by reconnecting the blood vessels to new ones in that region.
Regardless of whether the tissue is tunneled beneath the skin on a pedicle or transplanted to the chest as a microvascular flap, flap reconstruction surgeries are more complex than skin expansion techniques. Scars will be left at both the tissue donor site and at the reconstructed breast, and recovery will take longer than with an implant. On the other hand, when the breast is reconstructed entirely with your own tissue, the results are generally more natural and there are no concerns about a silicone implant. Also, autologous tissue reconstruction is often the only viable option in women who have had radiation therapy. In some cases, you may have the added benefit of an improved abdominal contour.
Most breast reconstruction surgeries involve a series of procedures that occur over an extended period of time. Usually, the initial reconstructive operation is the most complex of the procedures. Follow-up surgery may be required to replace a tissue expander with an implant or to reconstruct the nipple and the areola. Occasionally, an additional operation to enlarge, reduce, or lift the natural breast to match the reconstructed breast is recommended.
Recovery from Breast Reconstruction
It may take up to six weeks to recover from a combined mastectomy and breast reconstruction procedure, and it can take this long to recover from a flap reconstruction alone. If implants are used without flaps and reconstruction is done apart from the mastectomy, recovery time is usually less. Reconstruction cannot restore normal sensation to your breast, but in time, some feeling may return. Most of the surgical scars will fade substantially over time, though it may take as long as one year before their appearance is minimized.
Follow your Zannis breast reconstruction surgeon’s advice regarding when it’s best to begin stretching exercises and normal activities. As a general rule, you’ll want to refrain from any overhead lifting, strenuous sports, or sexual activity for at least three to six weeks following your reconstruction procedure.
Chances are, your reconstructed breast may feel firmer and look rounder or flatter than your natural breast. It may not have the same contour as your breast before mastectomy, nor will it exactly match your opposite breast. Fortunately, these differences will be apparent only to you. For most mastectomy patients, breast reconstruction surgeries dramatically improve their appearance and quality of life following their procedures.
If you’re interested in talking to the friendly, knowledgeable experts at the Zannis Center for Plastic Surgery about your options for breast reconstruction, just contact us today or call us at (252) 633-1197 to schedule your consultation.