Fighting breast cancer is difficult enough. But its aftermath, where a woman has lost one or both of her breasts to mastectomy, can leave her feeling that she’s lost important part of being a woman and her self-confidence can take a real hit. The team at Elite Plastic Surgery reconstructs patient breasts with the goal of making our patients feel whole again.
Timing of reconstruction surgery
Breast reconstruction can be performed at the time of the mastectomy or at a later date. Often the timing has a direct relationship with the specific type of breast cancer and other treatments that may still be required, such as radiation treatment or chemotherapy.
Types of reconstruction techniques
Reconstruction can be done a few different ways, either employing an implant or using the patient’s own tissue. There are various options of surgery involving the patient’s own tissue. These are two of the methods we use most often:
- DIEP flap reconstruction — In a DIEP flap reconstruction (DIEP stands for deep inferior epigastric perforator artery) fat, skin, and blood vessels are cut from the wall of the lower belly and moved up to the chest to rebuild the breast. Once in place, our surgeons reattach the blood vessels of the flap to blood vessels in the chest using microsurgery. DIEP flap reconstruction is popular because it doesn’t move or cut muscle. Plus, because fat and tissue is removed from the belly, the patient will end up with a flatter, tighter lower abdomen, similar to results from a tummy tuck. Of course, there will be a lengthy horizontal scar just below the bikini line as well.
- Latissimus dorsi flap reconstruction — In a latissimus dorsi flap reconstruction, an oval flap of skin, fat, muscle, and blood vessels from the upper back is used to reconstruct the breast. This flap is moved under the skin from the back around to the chest to rebuild the breast. The blood vessels stay attached to their original blood supply. A latissimus dorsi flap reconstruction is considered a muscle-transfer type of flap. This method is a good option for women with small- to medium-sized breasts because the area of the back where the tissue originates doesn’t have a great deal of fat. In most cases, a breast implant has to be placed under the flap to achieve the desired shape, size, and projection. A downside of the latissimus flap method is that the patient may have partial loss of strength of function that makes it hard to lift things and twist, affecting activities such as swimming, golf, tennis, and the ability to turn and manipulate objects.
When reconstruction is based around the use of saline or silicone implants, the procedure often first involves a saline-filled tissue expander to stretch the skin so it can accept the implant beneath the chest muscle.
- Implant-based reconstruction — In implant-based reconstruction, an implant is used to rebuild the breast. This method requires less surgery than flap reconstruction, because it only involves the chest area and not a tissue donor site. Surgery time and recovery time are usually shorter with implant reconstruction than flap reconstruction. The implant is placed under the pectoral chest muscle. The one unknown here is how long the implant(s) will last. Whether filled with saline solution or silicone gel, breast implants usually last from 10 to 20 years. Implant-based reconstruction is a good option for thin women with small breasts because these women often don’t have enough extra tissue on their bellies, backs, thighs, or buttocks to form a good breast shape as required in flap surgery. It is also a good option if you want to avoid the incisions and recoveries required with flap procedures.
Regardless of the method you choose, the expertise of the Elite Plastic Surgery team will deliver the breast reconstruction that will make you feel like yourself again. Whether you’ve had a mastectomy, or are just beginning your breast cancer treatments, we can answer any questions you have. Call us at 616-459-1907.
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