Breast reconstruction is a physically and emotionally rewarding procedure for a woman who has lost a breast due to cancer or other condition.
The creation of a new breast can dramatically improve your self-image, self-confidence and quality of life. Although surgery can give you a relatively natural-looking breast, a reconstructed breast will never look or feel exactly the same as the breast that was removed.
Breast reconstruction is a highly individualized procedure. You should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.
* You are able to cope well with your diagnosis and treatment
* You do not have additional medical conditions or other illnesses that may impair healing
* You have a positive outlook and realistic goals for restoring your breast and body image
Breast reconstruction typically involves several procedures performed in multiple stages. It can:
* Begin at the same time as mastectomy, or
* Be delayed until you heal from mastectomy and recover from any additional cancer treatments
It’s important that you feel ready for the emotional adjustment involved in breast reconstruction. It may take some time to accept the results of breast reconstruction.
Breast reconstruction is achieved through several plastic surgery techniques that attempt to restore a breast to near normal shape, appearance and size following mastectomy.
If only one breast is affected, it alone may be reconstructed. In addition, a breast lift, breast reduction or breast augmentation may be recommended for the opposite breast to improve symmetry of the size and position of both breasts.
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Dr. Hakan Gundogan will recommend the best choice for you.
Sometimes a mastectomy or radiation therapy will leave insufficient tissue on the chest wall to cover and support a breast implant. The use of a breast implant for reconstruction almost always requires either a flap technique or tissue expansion.
A TRAM flap uses donor muscle, fat and skin from a woman’s abdomen to reconstruct the breast. The flap may either remain attached to the original blood supply and be tunneled up through the chest wall, or be completely detached, and formed into a breast mound.
Alternatively, your surgeon may choose the DIEP or SGAP flap techniques, which do not use muscle but transport tissue to the chest from the abdomen or buttock.
A latissimus dorsi flap uses muscle; fat and skin from the back tunneled to the mastectomy site and remains attached to its donor site, leaving blood supply intact.
Occasionally, the flap can reconstruct a complete breast mound, but often provides the muscle and tissue necessary to cover and support a breast implant.
Reconstruction with tissue expansion allows an easier recovery than flap procedures, but it is a more lengthy reconstruction process.
It requires many office visits over 4-6 months after placement of the expander to slowly fill the device through an internal valve to expand the skin.
A second surgical procedure will be needed to replace the expander if it is not designed to serve as a permanent implant.
A breast implant can be an addition or alternative to flap techniques. Saline and silicone implants are available for reconstruction.
Dr. Hakan Gundogan will help you decide what is best for you. Reconstruction with an implant alone usually requires tissue expansion.
Breast reconstruction is completed through a variety of techniques that reconstruct the nipple and areola.
Following your surgery for flap techniques and/or the insertion of an implant, a surgical bra will be applied.
Support bra will minimize swelling and support the reconstructed breast. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid.
Healing will continue for several weeks as swelling decreases and breast shape and position improve. Continue to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled.
The final results of breast reconstruction following mastectomy can help lessen the physical and emotional impact of mastectomy.
Over time, some breast sensation may return, and scar lines will improve, although they’ll never disappear completely.
There are trade-offs, but most women feel these are small compared to the large improvement in their quality of life and the ability to look and feel whole.
Careful monitoring of breast health through self-exam, mammography and other diagnostic techniques is essential to your long-term health.
