Breast Reconstruction with Women Surgeons
Facing breast cancer can be very physically and emotionally draining. If your breast cancer results in a mastectomy, a whole new set of emotions can arise. You may feel like you’re not complete due to the loss of your breasts or feel unbalanced if you only lost one breast or a partial breast. Self esteem and body image is generally very important to women, and having a mastectomy can sometimes take that away from you.
A common procedure many women have after a mastectomy is breast reconstruction. Breast reconstruction consists of a surgeon constructing and inserting an implant or tissue flap that is similar in size and shape to your original breast. The nipple and areola of the breast can also be added for a more realistic look. Based upon your preference and post-surgery treatment, you can have either immediate breast reconstruction or delayed breast reconstruction surgery. Immediate reconstruction surgery is preformed at the same time as the mastectomy. If you will need radiation treatment after your mastectomy, then it’s advised you have delayed breast reconstruction surgery so that no problems arise.
There are five procedures done in breast reconstruction. These are saline-filled implants, transverse rectus abdominis muscle flap (TRAM), latissimus dorsi flap, deep inferior epigastric artery perforator flap (DIEP) and gluteal free flap. The tissue flap procedures will leave two scars; one located where the tissue was removed and the second where the reconstructed breast is placed. Since healthy blood vessels are needed for all flap procedures, women who have diabetes, connective tissue or vascular disease or who smoke are advised to not undergo such procedures.
Saline-filled implants are a silicone shell that is filled with salt water. These can be inserted immediately following a mastectomy or after radiation treatment ends. The downside to having saline-filled implants is that they can rupture causing the solution to leak into your body. They also may not last forever causing you to have additional surgery to replace them.
During TRAM flap surgery, the surgeon uses skin, fat, blood vessels and muscle from the lower abdominal wall of your stomach to construct a new breast and then attaches it to your chest by tunneling it under your skin to the breast location. This type of surgery can decrease muscle strength in your stomach and isn’t recommended if you’ve had previous abdominal surgeries.
The latissimus dorsi flap procedure uses skin, fat, blood vessels and muscle from your upper back to construct the new breast. It’s also tunneled under the skin to the breast location. It’s possible to feel weakness in your back, shoulders or arms for a few days after surgery.
The DIEP flap procedure uses fat and skin from the lower abdominal wall of your stomach. These tissues are cut completely off of the abdominal wall, molded and then attached to the breast location. This type of surgery is time consuming; however, you should still retain muscle strength in your stomach.
The gluteal free flap procedure uses skin, fat, blood vessels and muscles from the buttocks to create the new breast. These tissues are cut completely off of the buttocks and attached to the breast location. This is a good option if you don’t want to run the risk of loosing muscle strength in your stomach.
To give the new breast a more realistic look, you might want to have nipple and areola reconstruction. This type of procedure is done three to four months after breast reconstruction surgery. Tissue to recreate the nipple and areola can be taken from places such as your new breast, inner thigh, buttocks, ear or eyelid. This type of surgery isn’t as invasive as breast reconstruction and can be done in outpatient form.
As with any type of surgery, there are some possible risks involved. Some of these risks are, but not limited to, swelling and pain in breast area, bleeding at incision sites, infection and loss of sensation in breast and/or nipple. If you experience these or any other unusual side effects, contact your doctor as soon as possible.
Recovery from breast reconstruction surgery generally takes six to eight weeks. After eight weeks, you will want to resume monthly self breast examinations. Your plastic surgeon can show you what to look for in your newly created breast so you can report anything abnormal as soon as possible.
Having breast reconstruction surgery after a mastectomy is a personal choice and should be thoroughly discussed with your surgeon so you can make a decision that is right for you.