Know your Breast Reconstruction Options

Breast reconstruction is a surgery aimed at restoring a woman’s breast to the standard shape and size after lumpectomy (removal of part of the breast) or mastectomy (removal of the entire breast). This can be done using implants (prosthetics) or using your tissue. If the nipple and areola (the dark area surrounding the nipple) are also excised, they can also be reconstructed after completion of the breast mound reconstruction.

WHY CHOOSE BREAST RECONSTRUCTION?

You might have breast reconstruction for several reasons:

• To permanently regain the shape of your breast
• To make your chest look balanced when wearing a swimsuit or bra
• To be happy with your body and how you feel about yourself
• So you won’t have to use an external prosthesis

After a mastectomy, breast reconstruction surgery can renew your self-confidence and help you feel better about how you look. But remember that the reconstructed breast will not be a perfect substitute or match for your natural breast.

IDEAL CANDIDATES FOR BREAST RECONSTRUCTION

If you are expecting a mastectomy, or you already had a mastectomy, you may be a suitable candidate for breast reconstruction. Age is not a limiting factor for breast reconstruction. If you are healthy enough to undergo surgery, most likely, you are a suitable candidate for breast reconstruction.

HOW TO PREPARE FOR BREAST RECONSTRUCTION

When preparing for breast reconstruction surgery, your doctor may ask you to:

• Get a medical evaluation or lab testing
• Avoid taking anti-inflammatory drugs, herbal supplements, and aspirin because they can increase your bleeding
• Stop smoking
• Take particular medications or adjust your current medications

TYPES OF BREAST RECONSTRUCTION PROCEDURES

A typical breast reconstruction surgery is done in a hospital setting and may include a short hospital stay. Often, your doctor will administer general anesthesia before the surgery. You may also undergo follow-up procedures done on an outpatient basis, and local anesthesia with sedation may be applied. Your doctor will make these decisions depending on the requirements of your particular method and also considering your preferences and the doctor’s best judgment.

Autologous Reconstruction

The autologous, also known as flap reconstruction, uses your body tissues to reconstruct your breast after mastectomy. This reconstruction appears more natural than implant reconstruction. It is a more durable treatment and, therefore, possibly avoids additional operations.

• Deep Inferior Epigastric Perforator (DIEP) flap: Your surgeon only removes your skin and fat and leaves the abdominal wall muscles, and this results in less abdominal muscle weakness and shorter recovery duration. With the appropriate anatomy, your doctor may perform this procedure and avoid the TRAM flap procedure.
• Transverse Rectus Abdominus Myocutaneous (TRAM) flap: Your doctor will move a flap of skin, blood vessels, muscle, and fat from your abdomen to your breast area. The surgeon can also do this procedure as a free flap whereby he or she reconnects blood vessels in the chest.
• Other microvascular reconstructive techniques include modifications of these flap procedures: Reuben, TUG, SIEA, and SGAP.

Prosthetic Implant Reconstruction

Using silicone or saline implants can be an excellent choice for breast reconstruction. If you lack sufficient autologous tissue in the lower abdomen to produce an adequate breast volume and don’t require radiation therapy, you may be the right candidate for this form of reconstruction.

After a mastectomy, your surgeon will insert a skin expander below your chest muscle or skin. During the next few weeks, your surgeon will adjust the expander, and finally, perform a second surgery to fit the implant and then reconstruct the surrounding skin and areola. If you don’t need a tissue expansion, your surgeon will provide a breast implant immediately after the mastectomy. With the advancement of science and technology, most patients achieve excellent reconstructions.

Whether you receive reconstructive surgery or wear an external prosthesis, you need to take breast exams to monitor the reconstructed chest or breast monthly. If there is any concern or anything that seems abnormal, inform your plastic surgeon immediately. If you have questions regarding breast reconstruction or are considering undergoing the procedure, contact Dr. Earle, of Pure Plastic Surgery to schedule a free consultation at 305.876.6043.