BREAST RECONSTRUCTION
Breast reconstruction is available for patients following mastectomy for breast cancer and for congenital defects. Surgery for congenitally small or absent breasts is performed usually around age 18, after development has completed. Reconstruction for mastectomy may be performed immediately following breast removal, or at a later date. Immediate breast reconstruction allows the patient to awaken from surgery with a breast mound already in place, sparing her the experience of seeing herself without a breast. There are several options for reconstruction, which include implant reconstruction or reconstruction with your own tissues (usually abdomen or back). The determination of the appropriate reconstruction for a given patient is dependent upon your body type, preference, and additional therapy that may be required for the treatment of breast cancer.
Initial Consultation for Breast Reconstruction Procedure
Patients who are candidates for mastectomy are referred to Dr. Hyman prior to their breast cancer procedure. At that time, he will review your medical history, perform an examination of the breast and body, and make a recommendation based upon these factors. Your questions and concerns regarding breast reconstruction will be addressed fully. All options will be discussed.
Implant Breast Reconstruction
The most common type of breast reconstruction is implant reconstruction. Following mastectomy, there is a relative skin deficit. Therefore, implant reconstruction requires a period of tissue expansion to stretch out the remaining skin and allow placement of permanent implant at a later time. The tissue expander is a “balloon” that is placed beneath the skin and pectoralis muscle. Through a small valve in the expander, sterile saline is periodically injected to gradually fill the expander over several months. After a three month waiting period, which allows the skin to accommodate to its new size, the expander is replaced at a second operation with a permanent implant. Both saline and silicone implants are available for use. Reconstruction of the nipple-areola complex is generally performed at a third stage several months later. Often, surgery of the contra-lateral breast is needed for symmetry.
TRAM Flap Breast Reconstruction
The TRAM (transverse rectus abdominus myocutaneous) flap is a procedure that involves the transfer of skin, fat, and muscle with its blood supply from the lower abdomen to the chest to create a new breast. This type of surgery is more complex than skin expansion and implant placement, and scars will be present on both the abdomen and the breast. However, the TRAM flap generally produces a more natural feel and appearance of the breast. In addition, your abdomen will appear slimmer and flatter from the removal of tissue. Reconstruction of the nipple-areola complex is performed at a second stage several months later.
Post Breast Reconstruction Surgery
Recovery varies depending upon the procedure and the individual patient. Implant reconstruction patients generally return to normal activities more quickly than autologous breast reconstruction patients. Additional surgery may be required for minor revisions to the reconstructed breast. Because the goal of reconstructive breast surgery is to match your opposite breast, an additional operation to enlarge, reduce, or lift the unaffected breast may be suggested.
How Do I Get Started?
Dr. Hyman and his staff will be happy to discuss this procedure with you. Please feel free to call for a private consultation with Dr. Hyman, or you can request an appointment online.