Breast Reconstruction Revision
Las imágenes de la cara y el cuerpo que no sean del personal y los pacientes de la Dra, Rodríguez son modelos estándar
Today, there are so many great options for patients when it comes to breast reconstruction. As breast cancer treatment has advanced, so has breast reconstruction surgery. It is now more about combining reconstruction procedures with aesthetic techniques to give the best results possible.” - Houston breast reconstruction surgeon Dr. Abigail Rodriguez
Why Is Breast Reconstruction Sometimes Necessary?
Breast cancer treatment frequently necessitates the removal of breast tissue with surgery. Some patients have a portion of one breast removed with a partial mastectomy or “lumpectomy.” Others have the entire breast removed with a mastectomy.
Sometimes, breast skin is removed during the mastectomy, possibly including the nipple and areola. While some women have one breast removed with surgery, others may have both removed with a bilateral or “double” mastectomy.
There are so many breast cancer treatment options and just as many (if not more!) different approaches to breast reconstruction. The goal is to maintain or restore a woman’s sense of femininity and wholeness by reconstructing the breast.
Am I a Good Candidate for Breast Reconstruction Surgery?
Most women who need or have had a mastectomy, either partial or total, are candidates for breast reconstruction. It can be done either at the same time as the breast cancer surgery (immediate) or at a later time (delayed). Women who are candidates for immediate reconstruction will awaken from their breast cancer surgery having already taken a step forward on their reconstruction journey.
Women who undergo delayed reconstruction will complete their breast cancer surgery, and then the skin will be stitched closed. The tissues are allowed to heal and recover fully for several weeks or months before embarking on their reconstruction.
The decision about when the breast reconstruction surgery can be done will depend on your breast cancer surgeon’s recommendations, Dr. Rodriguez’s informed medical decision, and your preferences and goals. She will take significant time to discuss all the various options available to you.
Breast Reconstruction Surgery Tools Available
There are many tools available for breast reconstruction surgery:
Implant-based:
This type of reconstruction ultimately relies on an implant to recreate the shape of the breast. In the majority of cases, placing a breast implant immediately at the time of the mastectomy will put the tissues under too much tension and risk jeopardizing the blood supply to the skin.
For this reason, a tissue expander is usually placed before a breast implant. A tissue expander is like a deflated implant that gets filled up with saline over time. This allows the breast skin to recover and establish a better blood supply before gradually stretching it out by filling up the tissue expander. In a separate, second surgery, the tissue expander is removed, and the implant is placed.
Autologous
Autologous reconstruction uses your own natural tissue to recreate the shape of the breast. This is a tissue transplant from your own body, to your own body. When the tissue is transferred, it is called a flap. The location where the tissue is taken from is called the donor site.
Commonly used flaps include:
DIEP (Deep Inferior Epigastric Perforator) Flap
This flap is usually donated from the lower part of the abdomen. It is quite popular because it usually provides ample volume for recreating the breast shape while also leaving the abdomen with a smoother and tighter appearance.
SIEA (Superficial Inferior Epigastric Artery) Flap
The tissue for this flap is also taken from the lower part of the abdomen, and its benefits are similar to those of the DIEP flap. SIEA is sometimes chosen over DIEP due to blood vessel requirements in the reconstructed breast.
PAP (Profunda Artery Perforator) Flap
The donor site for this flap is the upper inner thigh. This is often a secondary option to the DIEP or SIEA flaps due to some limitations of the flap anatomy.
LD (Latissimus Dorsi) Flap
The tissue for this flap is taken from the mid back. It is very reliable and typically requires less time to perform.
Oncoplastic Reconstruction
Oncoplastic surgery aims to preserve the natural breast tissue whenever possible while still thoroughly treating the breast cancer. Usually, this is achieved by removing the area of the breast with cancer with a partial mastectomy or lumpectomy. Then, the breast tissue and skin are re-arranged so that the volume loss is not noticeable.
This is frequently achieved by doing a modified breast lift (mastopexy) or breast reduction (reduction mammoplasty) surgery. This preserves a nice shape to the breast while lifting it up on the chest, giving it a more youthful appearance. A similar procedure can be performed on the other breast to improve symmetry.
Breast Reconstruction Recovery
Since there are so many different options for breast reconstruction surgery, the recovery period and activity restrictions can vary depending on which surgery you have. For implant-based and oncoplastic reconstruction, most patients stay overnight in the hospital. For autologous reconstruction, most patients are admitted for a few days before going home.
Benefits of Breast Reconstruction
- Restores breast shape and appearance
- Helps clothes fit better
- Offers personalized reconstructive options
- Boosts self-confidence
- Provides closure and restores a sense of normalcy after cancer treatment
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Breast Reconstruction FAQs
Are implants or natural tissue better for reconstruction?
Both options have pros and cons. The best choice depends on your medical situation, aesthetic preferences, and lifestyle. Your surgeon will help you decide what works best for you.
Do I need to quit smoking?
It is critical to stop any nicotine use before and after breast reconstruction surgery. Nicotine and other chemicals found in cigarettes interfere with the body’s post-op healing process and increase the risk of surgical complications.
Will I have visible scars after breast reconstruction?
Yes, breast reconstruction typically leaves some visible scars, but their appearance is designed to fade over time with proper care. Dr. Rodriguez always aims to strategically place incisions to minimize visibility, and scar treatments can improve their appearance.
Can I exercise after breast reconstruction surgery?
Light activities are usually permitted within a few weeks, but strenuous exercise should be avoided for at least 6-8 weeks. Always follow Dr. Rodriguez’s advice on when and how to resume workouts.
Does breast reconstruction affect the ability to detect a cancer recurrence?
Reconstruction does not increase the risk of cancer recurrence or interfere with detection. Regular monitoring with your healthcare team remains essential.
Related Procedures
Breast Lift
Breast Reduction
