Reconstruction of a breast following mastectomy can produce a very aesthetically pleasing result, but more importantly, for most women it helps them feel "whole again." The procedure may be performed at the same time as the mastectomy (immediate) or sometime later (delayed). By Congressional mandate health insurance companies are required to cover this procedure and any surgery on the opposite breast which may be needed to obtain symmetry.
There are two basic techniques for breast reconstruction. One utilizes a saline-filled implant to recreate a breast mound. The other uses a patient's own tissue, also known as a "flap," for the reconstruction. Your best option will depend upon your body type, breast size, age, overall general health and your personal goals. This will be fully discussed during your initial consultation with our Board Certified plastic surgeons.
Although some women will not require tissue expansion prior to implant insertion, more commonly this reconstruction process generally requires two stages. First, an inflatable device known as a tissue expander is positioned in the area of the missing breast tissue. The expander is gradually inflated with saline during weekly office appointments until a match is achieved with the opposite side. While there are some expanders designed to be left in place, more commonly the expander is replaced by a permanent saline-filled implant. (Breast Augmentation)
Flap reconstruction involves transferring muscle, fat, and skin from another body area such as the abdomen, back or buttocks in order to reproduce the missing breast mound. Because this approach often requires the reconnection of the blood vessels to new ones in the breast area, it is important that your surgeon is also experienced in the microvascular requirements of the procedure. The TRAM (transverse rectus abdominis myocutaneous) flap using tissue from the lower abdomen is the most commonly used.
The recovery period will generally take longer than the implant procedure because there will be healing in the donor as well as the reconstructed site. However, unlike implants, this is a one-stage procedure and does not carry the risks associated with the use of implants.
Any type of breast reconstruction procedure will generally take several hours and is performed under general anesthesia. The recovery period will vary by individual but will take longer (up to six weeks) for the flap procedure.
Reconstruction of the nipple-areola area can be started once the breast mound reconstruction is complete. Skin flaps are used to create a nipple projection with color correction added by a tattooing process at a later time.
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