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Breast reconstruction surgery can be performed to recreate and restore breasts that have been removed due to mastectomy or injury, or to correct a congenital abnormality. Breast reconstruction can rebuild one or both breasts to appear as natural as possible in size and shape, restoring balance and contour.
The decision to undergo breast reconstruction surgery is deeply personal, and there are various circumstances that impact the decision making process. Breast reconstruction can be done at the same time as a mastectomy, or it may be delayed for months or years. Adjunct cancer treatments such as radiation or chemotherapy can affect the type and timing of reconstruction offered. The plastic surgeons at Healing Waters offer a complete range of breast reconstruction services and are dedicated to providing you with exceptional care. Your plastic surgeon will work closely with you to determine the best approach for your reconstruction, and are happy to coordinate with your other treating providers when needed.
Tissue expander: Tissue expansion reconstruction involves the placement of a temporary implant in the breast tissue to slowly stretch the skin before a permanent implant is placed. See our breast implant procedure page for more information about the types of implants our plastic surgeons work with.
Latissimus flap reconstruction: This type of reconstruction takes muscle and tissue from the back and rotates it to the chest wall, forming a flap that is used to provide coverage over an implant. A tissue expander is typically placed under the flap initially. After adequate expansion, the expander is removed, and a permanent implant is placed. Nipple reconstruction can be done at the time of flap surgery or delayed and performed at a later time.
TRAM flap reconstruction: During a TRAM flap reconstruction, muscle, skin and tissue are taken from the abdomen and rotated to the chest wall to reconstruct the breast. There are various factors to consider for this type of procedure, and as each patient is unique, your plastic surgeon will consult with you personally to identify whether you are a candidate for this type of reconstruction.
Other methods or considerations: : On occasion, if a patient is having a lumpectomy, the remaining breast tissue can be rearranged to reshape the breast. Autologous fat injections can also help to correct defects that occur after removing tissue from a lumpectomy. Fat is extracted with liposuction from another part of the body (often the abdomen) and then injected into the breast to add volume. Patients that choose to have a single mastectomy may benefit from a procedure such as breast augmentation or breast lift (mastopexy) to the opposite breast to achieve better symmetry. Nipple reconstruction may also be performed sometime after reconstruction surgery if desired. (See our FAQ for more information).
For more information about breast reconstruction, and for a personalized consultation with a plastic surgeon, contact Healing Waters today.
What is Breast Reconstruction?
There are many variables to consider when deciding upon the best timing and plan for breast reconstruction. Sometimes, reconstruction is performed at the same time as mastectomy. In other cases, patients may opt to wait several months or years. Certain cancer therapies such as radiation and chemotherapy can delay or affect the approach to reconstruction. It is best for reconstruction patients to be medically fit for surgery, nonsmoking, free of health conditions and medications that may interfere with the healing process, and for any cancer to have been eliminated, either through mastectomy or other treatment.
If you are facing mastectomy or lumpectomy, it can be a great help to know your breast reconstruction options prior to surgery. Whether you have recently received a cancer diagnosis or are exploring your options long after mastectomy, the caring, knowledgeable plastic surgeons at Healing Waters can help. For more information, contact Healing Waters today to schedule a plastic surgery consultation.
Recovery from breast reconstruction surgery may take several weeks or longer depending upon the nature and extent of the procedure. Following surgery, you can expect swelling, pain, and discomfort that can be managed with rest and medication. Dressings may be applied, and a support garment or bra may be worn. Reconstructed breasts may feel firmer and may not fully regain normal sensation. With TRAM or latissimus flap surgery, physical therapy may sometimes be needed to help increase muscle strength in the abdomen or back. Your plastic surgeon will provide you with detailed post-operative instructions as well as advice on when to resume exercise and normal activity.
Full reconstruction may involve more than one procedure. Breast reconstruction can significantly improve appearance and help to restore body confidence. Most patients find the results rewarding.
With any surgery, there are potential complications such as bleeding, hematoma, fluid build-up, problems with anesthesia, and unfavorable scarring. Some of the other known complications of breast reconstruction include infection, capsular contracture (tightening of the scar tissue around an implant), shifting of an implant, or flap rejection. Certain complications may require additional surgical correction.
As there are many potential methods of breast reconstruction, your plastic surgeon will thoroughly discuss your specific procedure and associated risks with you, and provide you with pre and post-operative guidance to help ensure the smoothest possible recovery.
There are advantages and drawbacks with each method of breast reconstruction. Your Healing Waters plastic surgeon will work closely with you to determine the best strategy for your unique wishes, needs, anatomy, health, and risk factors.
Breast reconstruction is highly individualized and is often performed in multiple stages. Reconstruction can be done at the same time as mastectomy, or after recovery from mastectomy or cancer treatment. When a tissue expander is placed, an additional surgery will be performed later for placement of the permanent breast implant(s). The TRAM flap method usually requires one main procedure. In single mastectomy cases, additional procedures such as augmentation, breast lift or reduction are sometimes performed on the unaffected breast to improve symmetry. Nipple (areola) reconstruction is a minor, optional procedure that is usually performed several months after reconstruction to allow swelling to resolve and the breasts to settle. The complete reconstruction process is flexible in terms of timing and can be worked around the patient’s schedule.
Breast reconstruction surgery results in scarring that is permanent. The location of the scars will depend upon the surgical methods used.
Some patients are prone to problematic scarring and could develop keloid (red or raised) or hypertrophic (dark in color) scars. You should inform your plastic surgeon prior to surgery if you are aware of a tendency toward unfavorable scarring.
Additionally, smoking can interfere with healing and make scars worse.
On average, patients return to work within three to eight weeks of the main procedure. The timing will vary considerably with the patient, the occupation, and the breast reconstruction procedure. Your plastic surgeon will tailor post-operative instructions and advice to your specific circumstances.
Patients receiving chemotherapy or radiation are usually recommended to wait at least six weeks after their last treatment before having any type of surgical procedure. Your plastic surgeon and oncologist can offer specific, individual advice.
Nipple (areola) reconstruction is usually done some time after the breast reconstruction procedure is complete. The procedure can be performed in the office with local anesthetic, but can also be done in the operating room. Flaps of skin on the breast are manipulated to create the appearance of a nipple. After approximately six weeks of healing, tattooing may be used to provide pigmentation to create the areola.
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Financing is available for this procedure at participating locations and for qualified applicants.
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