Breast Reconstruction

Overview

Breast reconstruction is a surgical procedure to restore the shape and appearance of one or both breasts following mastectomy, lumpectomy, or trauma. This can be done using implants, autologous tissue, or a combination of techniques. The goal is to achieve symmetry and a natural aesthetic while preserving health and functionality.

Techniques of Breast Reconstruction

1. Implant-Based Reconstruction

Procedure: Implants (saline or silicone) are placed under or over the chest muscle. Often involves initial skin expansion using a tissue expander, followed by permanent implant placement.

Who It’s For:

• Patients with sufficient skin coverage.

• Those who prefer a shorter surgery and recovery time.

• Not recommended for individuals requiring radiotherapy, as radiation can increase implant-related complications.

Benefits:

• Faster recovery.

• Minimal donor site scarring (no tissue removal from other areas).

Risks:

• Capsular contracture (scar tissue formation).

• Implant rupture or leakage.

2. Autologous Tissue Reconstruction

Procedure: Tissue is transplanted from other body parts (e.g., abdomen, back, buttocks, thighs) to reconstruct the breast.

Subtypes:

• Latissimus Dorsi Flap: Uses back muscle, skin, and fat, leaving a scar concealed by a bra strap. Ideal for small-to-medium breasts.

• TRAM Flap: Utilizes abdominal fat, skin, and muscle; results in a natural breast feel and doubles as a tummy tuck.

• Free TRAM Flap: Completely detached and reconnected using microsurgery.

• Pedicled TRAM Flap: Tissue is moved under the skin to the chest without detachment.

Benefits:

• More natural look and feel compared to implants.

• Permanent solution without risk of implant-related issues.

Risks:

• Longer surgery and recovery time.

• Potential donor site complications (e.g., abdominal weakness, scarring).

Pre-Operative Preparation

• Evaluation: Comprehensive health checks, including imaging and bloodwork.

• Consultation: Discuss goals, options, and timing with the surgeon.

Timing Consideration:

• Immediate reconstruction: Done during mastectomy to minimize emotional and physical impact.

• Delayed reconstruction: Performed months or years later, often if radiation therapy is required post-mastectomy.

Post-Operative Care

• Recovery: Pain management, wound care, and follow-up appointments.

• Monitoring: Regular check-ups for healing, symmetry, and potential complications.

• Revisions: Nipple reconstruction or symmetry adjustments may be done later if desired.

• Imaging: Mammograms or ultrasounds to monitor the remaining breast tissue and reconstructed area.

Benefits of Breast Reconstruction

• Restores physical appearance and body image.

• Improves emotional and psychological well-being.

• Provides a sense of closure after cancer treatment or trauma.

• Options for customization based on individual needs and anatomy.