Breast Reconstruction after Mastectomy

What is Breast Reconstruction?

Breast Reconstruction It involves the restoration of breast size, shape, and appearance after a mastectomy. It includes nipple areolar reconstruction. Dr. Thomassen has significant experience in Breast reconstruction in Fort Lauderdale.

Unfortunately, over 1 in 9 women in the United States are diagnosed with breast cancer. As a result, this field of plastic surgery has become very common. But thankfully, advancements in the field have improved the results of this treatment. Women no longer have to sacrifice their appearance when facing breast cancer diagnosis and treatment.

Enhancing your appearance with Breast Reconstruction

Breast reconstruction is a physically rewarding procedure. It is also emotionally rewarding for a woman who has lost a breast due to cancer or other conditions.

The creation of a new breast can dramatically improve your self-image, self-confidence and quality of life.

Your plastic surgeon has a crucial role in this process. They need not only perform an excellent reconstruction but also choose the right procedure for your particular situation.

Breast Reconstruction Techniques

Tissue Expander and Implant Technique

Tissue expansion reconstruction involves stretching the skin and soft tissue on the patient’s chest wall. This occurs after a mastectomy. A temporary implant called an expander does this. The surgeon places the expander on your chest wall at the time of the mastectomy.

Implant breast reconstruction
The expander and final implant are usually placed behind the pectoralis major muscle

The expander is placed with very little fluid inside of it. Once the overlying skin is healed, it is gradually filled with saline on a weekly basis. As the expander fills, it stretches the overlying skin and forms a breast mound.

Details of Tissue Expander Reconstruction

The entire expansion process takes approximately 3-4 months to finish. When the expander reaches the desired breast size, it is removed in a second surgery. Then, a soft, silicone gel implant replaces it. The opposite breast is usually treated with a lift or augmentation to help match the reconstructed. breast.

This type of reconstruction is the most common type used in the United States today. Benefits include safety and ease of surgery, reliability, and high patient satisfaction.

Drawbacks include the need for a 2nd surgical procedure to remove the expander. It is also necessary to check the final implant for symmetry. Additionally, there is a need to check for capsular contracture and any complications stemming from the use of an implant.

Breast Reconstruction with tissue expander and implants and after nipple areolar reconstruction
Breast Reconstruction with staged Tissue Expander/Implant technique and Nipple-Areolar reconstruction
Breast Reconstruction with staged Tissue Expander/Implant technique in patient with Nipple Sparing Mastectomy
Breast Reconstruction with tissue expanders and implants, after nipple areolar reconstruction.
Unilateral Breast Reconstruction with staged Tissue Expander/Implant technique and Nipple-Areolar Reconstruction with matching procedure on opposite side using an Augmentation Mammaplasty

Autologous Tissue or Flap Techniques

A mastectomy or radiation therapy can leave insufficient tissue on the chest wall. This makes it difficult to cover and support the use of a breast implant. In these cases, tissue from other body parts is transferred to the chest wall. This creates a breast mound.

Autologous refers to your own tissue being used to reconstruct the breast. This can be added to implants to carry out a hybrid type of reconstruction.

A flap is a term used in plastic surgery. It refers to a tissue or a group of tissues with a specific blood supply. This tissue is used to reconstruct a defect in the body.

DIEP and Tram Flaps

DIEP and TRAM flaps use abdominal donor muscles, fat and skin from a to reconstruct the breast. The surgeon detaches the flap completely from the abdomen. Then, using microsurgical techniques, the surgeon reattaches the flap on the chest wall. This procedure is called a DIEP flap.

In a TRAM flap technique, the surgeon uses the same flap of tissue. However, the surgeon leaves it attached to its blood supply. Then, they tunnel the flap to the chest wall. Once the tissue is placed on the chest wall, it is formed into a breast mound.

TRAM or DIEP Flap
In TRAM or DIEP Flap techniques, abdominal tissue is transferred to the chest wall
TRAM or DIEP Scars
Scars associated with a TRAM or DIEP flap technique

Latissimus Dorsi Flap

A latissimus dorsi flap uses muscle, fat, and skin from the back. The surgeon lifts these tissues form their underlying attachments, leaving the blood supply intact. The surgeon then tunnels the tissue to the anterior chest wall where the reconstruction is required.

Occasionally, the flap itself can reconstruct a whole breast mound. However, it is more commonly used with an implant to give more volume.

Latissimus flap technique
Back tissue including skin and muscle is transferred to the anterior chest wall
Latissimus flap technqiue2
The skin from the back is used to create a breast mound
Latissimus flap back scar
Back scar after a Latissimus flap breast reconstruction
Breast Reconstruction with Latissumus doors flap and expander. Before nipple areolar reconstruction
Breast Reconstruction with Latissimus Flap and Tissue Expander on Side affected by Radiation Therapy. Opposite side reconstructed with Tissue Expander and Wise pattern mastectomy.

Other Flap Techniques

Alternatively, one choose to use the SGAP flap techniques which uses tissue from the Buttock Region.

Nipple and Areola Reconstruction

Breast reconstruction is completed through a variety of techniques that reconstruct the nipple and areola. These procedures are minor and can be done in the office. The areaola is usually reconstructed with a tattoo.

nipple areolar tattoo
Nipple areolar reconstruction with tattoo after reconstruction with implants

Recovering from a Breast Reconstruction Procedure

After the surgery, Dr. Thomassen applies bandages and/or gauze to the incisions. Patients also get a support bra or elastic bandage to reduce swelling and support their reconstructed breasts. Dr. Thomassen will place a small tube just beneath the skin to drain extra fluid and blood.

All patients get specific instructions that relate to their particular surgery. These instructions include information about medications, follow-up appointments and symptoms that show the patient needs to seek medical attention.

Results

It takes several weeks for inflammation to decrease and the breasts’ shape and position to improve. As time passes, many women will experience the return of some breast sensation, scar lines will become less visible.

If you are interested in learning more about breast reconstruction in Fort Lauderdale, contact Thomassen Plastic Surgery.

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