Breast Reconstruction After Mastectomy

Breast Reconstruction refers to the surgical procedure of rebuilding the shape and size of the breast after it was removed through mastectomy because of cancer. The procedure is performed by a plastic surgeon. You can ask your surgeon for recommendations on plastic surgeon who has undergone specialized training in breast reconstruction.

The Timing
This procedure can be done right after the mastectomy or at a later time. If there is a need for radiation therapy after the mastectomy, you cannot have your breast reconstruction procedure until the radiation therapy is finished and the tissue has healed. A reconstructed breast doesn't look or feel exactly the same way your original breast did. But many women could attest that they are satisfied with the outcome.

You can discuss this with your surgeon and the plastic surgeon. You can also talk to women who have undergone this surgery to find out about their experiences.

Breast reconstruction comes in two types:
- Breast Implants
- Tissue Flap Surgery

Breast Implants
• Saline-Filled Permanent Implant: The most common implant used for this purpose is the saline-filled implant, which is a salt water filled silicone shell that is implanted to give the chest its old shape.

• Silicone-Filled Permanent Implant: The shell can also be filled with silicone. It's another option for breast reconstruction but it's not often used as silicone leakage can lead to immune system diseases.

• One-Stage Immediate Reconstruction: The procedure called one-stage immediate breast reconstruction is done at the same time of the mastectomy. After the breast tissue is removed by the general surgeon, it is replaced by a permanent implant by the plastic surgeon.

• Two-Stage Reconstruction: At the two-stage reconstruction, the procedure of implanting the shell is done if the skin and chest wall tissues are tight and flat. With this, an implanted tissue expander is used under the skin and chest muscle. Then through a tiny valve under the skin, the surgeon would inject salt-water solution to fill the expander over time. By the time the breast area has already stretched enough, a second surgery will be done to remove the expander and replace it with a permanent implant.

Tissue Flap Surgery
With these procedures, tissue from the tummy, back, thighs and buttocks are used to rebuild the contour of the breast. There are three types of tissue flap surgeries.

1) TRAM Flap
The first one is TRAM Flap (also called Transverse Rectus Abdominis Muscle Flap). This one uses tissue from the tummy area.

2) Latissimus Dorsi Flap
The second one is Latissimus Dorsi Flap which utilizes tissue from the upper back.

Possible risks with above two surgeries are:
- muscle damage and weakness
- abdominal hernias

3) There's a new type of flap procedure called DIEP flat. This one uses fat and skin in the same area where the TRAM flap gets. Unlike the TRAM flap, however, the DIEP flap preserves all the abdominal muscles.

 


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