Breast Reconstruction
Cancer, regardless of the type, is mentally, emotionally and physically difficult. For women who suffer from breast cancer, it is especially dispiriting when they lose a breast to it. The surgeons at PAMF's Department of Plastic and Reconstructive Surgery understand this challenge and offer procedures to reconstruct the breast. They work with each patient extensively to make sure that breast reconstruction is right and decide what procedural course is ideal for each individual.
Though a reconstructed breast will never be exactly the same as the breast that a patient lost due to cancer or another condition, breast reconstruction surgery is a physically and emotionally rewarding procedure that can improve quality of life.
Tissue Flap
Tissue Flap procedures use tissue from another part of the body to recreate a breast mound shape. During a pedicle flap procedure, the plastic surgeon takes tissue from the back or lower abdomen and pulls and attaches it to the chest area without cutting its original blood supply. In a free flap surgery, both the tissue and the blood vessels are cut. The blood vessels are then carefully sewn into the blood vessels in the chest area.
The various types of tissue flap surgeries are named after the body where the tissue is taken from. For example, the most common type of flap surgery is a TRAM (transverse rectus abdominis muscle) flap. In this procedure, muscle and tissue is taken from the belly and transfered to the chest area. Other types include the Latissimus Dorsi Flap (tissue from the back), Gluteal Free Flap (tissue from the buttocks) and Deep Inferior Epigastric Perforator Flap (DIEP). Unlike the TRAM, the DIEP method does not use muscle and takes only soft tissue and skin from the abdomen area.
For more information, see this Healthwise article on different types of tissue flap surgery.
Back to top
Implants
Breast implants are another alternative for breast reconstruction. Because no tissue is being transplanted or relocated, it requires the least amount of surgery and recovery time is relatively fast. A disadvantage to this course is it won't recreate the exact feel and look of your natural breast and results are not cosmetically perfect. There is also a risk of leaking and shifting and implants do not last a lifetime.
Plastic surgeons consult with each patient and discuss the options in size, shape, texture and type (saline or silicone) of implants that will best achieve the desired outcome. During the procedure, the plastic surgeon makes an incision and places the implant under the chest muscle to replace the lost breast tissue.
Back to top
Tissue Expansion
Tissue Expansion is done for women who have lost too much skin or their chest wall tissue is too tight for implants to be put in immediately. During the initial procedure, a surgeon inserts a balloon-like implant, called a tissue expander, beneath the skin and chest muscle. For four to six months, at regular intervals, the surgeon injects a saline solution through a tiny valve beneath the skin connected to the expander. This allows for healthy skin to stretch enough to provide coverage for a breast implant. If the expander is not the permanent implant, another surgery is required to replace it with the final implant.
Back to top
Risks
Like all forms of surgeries, breast reconstruction surgery has risks and side effects. Discuss risks and your concerns with your physician and plastic surgeon.
Back to top
