Breast Reconstruction Surgery
Breast Reconstruction
Breast augmentation is not always about having “bigger boobs” through breast implants. There are times when a woman just needs to bring herself back to the way she used to be. Breast reconstruction is another field of breast augmentation that allows women to rebuild their breasts after having them removed due to an unavoidable circumstance like breast cancer for example.
Most of the time, women with breast cancer opt to have one or both of their breast removed to avoid further complications of their condition. Women who have undergone a Mastectomy, a procedure that aims to remove one or both breasts, are the best candidates for breast reconstruction. On the other hand, women who just had Lumpectomy, a procedure that removes the breast portion that surrounded the cancer cells, are not recommended to have this kind of procedure.
Facts about Breast Reconstruction
- Everything starts with a choice
Having a breast reconstruction entirely depends upon your choice. You may or may not have it and it’s still alright. If you are considering your options for breast reconstruction, it would be best to ask several cosmetic surgeons and your cancer treatment doctor about it. In the end, it is still you who should decide.
- More ways than one
Breast reconstruction surgery can be done in several ways. Your surgeon should be able to present you with the different options on how to go about rebuilding your breasts. Please take a note of the different methods used for breast reconstruction, which will be carefully detailed on the latter part of this article, and choose which option is best for you.
- Several follow up surgeries
In case you didn’t know, breast reconstruction needs several follow up surgeries. The first surgery only includes placing the saline or silicone implants together with the flap needed to serve as the breast skin. The next surgery entails adding an areola and a nipple to your breasts. If the first two surgeries were successful, no follow up surgeries may be needed.
However, if the shape and size of the reconstructed breast is a bit odd, a follow up surgery may be needed to correct this. Also, in some cases, there would be a need to operate on the opposite breast to avoid asymmetry.
- Breast reconstruction is dependent
Aside from all the other facts for breast reconstruction, there are still several things to consider. You may not always be given the freedom to choose which breast reconstruction procedure you wanted because this kind of procedure will depend on you body type, your age, and the kind of cancer treatment you’re receiving.
If you’re too skinny, the doctor may not recommend breast reconstruction because they won’t be able to transpose any extra skin from the other parts of your body. Also, if you’re still undergoing chemotherapy, a procedure like breast reconstruction may not also be recommended because your body is too weak to repair the wounds incurred for this kind of procedure.
- Reconstructed breasts are not the same as the old one
If you’re considering having your breasts reconstructed, please don’t expect them to feel like the natural ones you once had. They may look natural but they do not possess any sensation of any kind because nerve endings cannot be reconstructed.
When Can Breast Reconstruction Be Done?
There are generally two instances when breast reconstruction can be made. The first one is called Immediate Breast Reconstruction and this can be done the same time when you had a Mastectomy, or the removal of your breasts.
Some women prefer to have this kind of plastic surgery because their chest tissues haven’t been further damaged by radiation therapy just yet and they haven’t scarred for the time being. With Immediate Breast Reconstruction, the reconstructed breasts will definitely look better and this entails lesser surgery for the patient.
If the rebuilding of your breasts will be done after a few months of Mastectomy, this is called Delayed Breast Reconstruction. For women who need to undergo chemotherapy for their breast cancer treatment, this may be a better choice for them. This is due to the fact that radiation may have adverse effects if you already have breast reconstruction prior to the breast cancer treatment.
Types of Breast Reconstruction
- Implant Procedures
There are two kinds of breast implants that could be used in breast reconstruction however, most of the time, saline-filled implants are preferred by breast cancer patients over silicon gel-filled implants to avoid any complications if any leakage happens.
- One-stage immediate breast reconstruction
As mentioned earlier, this kind of procedure may be done at the same time with the Mastectomy procedure. After removing the breast tissues, the plastic surgeon may place the implants where the tissues were once located. This could be very beneficial if the areola and nipples of the breast haven’t been removed so as to avoid a follow up reconstruction surgery of the two.
- Two-stage delayed reconstruction
The two-stage delayed reconstruction is recommended if your skin and chest walls are too tight and flat for the implants’ placement. Again, this could be done after Mastectomy, but instead of placing the implants, the surgeon will use a tissue expander. This tools looks like a balloon and it is placed under the skin and the chest muscle where your implants are going to be inserted.
The tissue expander is injected with sterile saline for about 4 to 6 months before it is removed in a second surgery and replaced with the permanent breast implant.
- Tissue Flap Procedures
There are several kinds of Tissue Flap procedures and all these entail transposing tissue from one part of your body to your chest area. Instead of using breast implants, the plastic surgeon operates on two separate surgical sites – one from the donor area and the other one on the reconstructed breasts. These procedures are called differently, depending on the donor area where the tissues are to be taken from.
- TRAM (transverse rectus abdominis muscle) flap
In a TRAM flap procedure, the plastic surgeon uses the tissues, muscles, and blood vessels from the lower abdominal wall of your tummy and transposes it to the chest and reconstructs a breast from them. The blood vessels from the abdominal muscles are then connected to the existing blood vessels in the chest to allow free flowing of blood into the transposed “new breast” tissues. The abdominal wall, where the donor tissue was taken from, is then closed resulting in a “tummy tuck” procedure.
- Latissimus dorsi flap
This kind of procedure includes moving a flap from your back that is made of skin, fat, muscle, and blood vessels into the front of the chest for the breast reconstruction procedure. It is transposed internally by creating and making use of tunnels until it reaches the chest muscle area where the blood vessels are attached. The area in the back where the tissues have been taken from is then stitched together to close.
- DIEP (deep inferior epigastric artery perforator) flap
DIEP flap procedure is almost the same as the TRAM flap however, this procedure doesn’t include cutting of the abdominal muscles so only the skin, fat, and tissue from the abdomen are transposed into the chest area. It takes longer to do DIEP flap procedure because it requires a microsurgery to connect the tiny blood vessels. Again, the abdominal area where the flap was taken from will be closed with a “tummy tuck” procedure.
- SGAP (superior gluteal artery perforator) flap
The SGAP flap procedure, other times known as gluteal free flap, is one of the newest types of breast reconstruction. Instead of using tissues and muscles from the abdomen or from the back the plastic surgeon uses the tissues from the buttocks and transposes them in the breast reconstruction area.