Reconstruction
It may be useful to talk to other women who have had breast reconstruction to give a realistic expectation about the results.
Breast reconstruction is a procedure where the breast is rebuilt either using implants, tissue from another part of the body or a combination of both techniques. It is performed by a breast or plastic surgeon with expertise in breast reconstruction. There have been many recent improvements in this procedure.
However, reconstruction after mastectomy to reduce cancer risk is not the same as having surgery to enlarge the breasts for cosmetic reasons. After a preventive mastectomy and reconstruction the breast will look ‘lifelike’ under clothing but will actually look and feel different than it did originally.
There are different types of reconstruction procedures available. You will be given options and your preference may depend on the amount of time you can devote to the surgery, in terms of hospital and recovery time when you will not be able to lift things, do housework, drive etc.
Although your preference is important, the type of surgery and method used will depend on many additional factors, some of which include your weight and body shape and whether or not you are a smoker. If breast reconstruction is a consideration, it is recommended the woman talks to her surgeon before the mastectomy.
Tissue Expander - Breast implants:
This is the most common technique used worldwide. The surgeon inserts a tissue expander beneath the pectoralis major muscle of the chest wall. In a process that can take weeks or months, saline solution is injected to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a more permanent implant. Reconstruction of the areola and nipple are usually performed in a separate operation after the skin has stretched to its final size.
Flap reconstruction:
The second most common procedure uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen.
The latissimus dorsi muscle flap is the donor tissue available on the back. It is a large flat muscle which can be employed without significant loss of function. It can be moved into the breast defect still attached to its blood supply under the armpit (axilla).
Abdominal flaps: The abdominal flap for breast reconstruction is the TRAM flap. The DIEP flap and free-TRAM flap require advanced microsurgical technique and are less common as a result. Both can provide enough tissue to reconstruct large breasts.
Above is a video of Dr Garry Buckland (Plastic and Reconstruction Surgeon) he discusses Reconstruction process after a preventive mastectomy.
|