Ahmet R. Karaca, MD

Ahmet R. Karaca, MD

Breast Reconstruction Surgery

Through reconstruction, surgeons are able to rebuild a natural looking breast for women who have had theirs removed because of breast cancer. This procedure was developed to simulate the appearance, shape, and size of a natural breast for cancer survivors. While this reconstruction can drastically improve a woman’s physical appearance,  patients should understand the limitations of the procedure and have realistic expectations surrounding results. The procedure will leave visible scars, and the newly reconstructed breast will look and feel differently and will have different sensations than the breast that was removed.

Deciding to undergo breast reconstruction is a personal choice for women who have lost a breast to cancer,  trauma, or other medical conditions.  Through breast reconstruction, women who have lost one or both breasts can enjoy the appearance of a full, natural-looking bosom. The achievements in breast cancer research aid surgeons in developing advanced reconstruction techniques that create more realistic-looking breasts. These reconstruction techniques often help survivors to feel more confident with their appearance.

The Breast Reconstruction Procedure

Patients have several options for breast reconstruction procedure, but the ideal approach depends on their individual anatomy, desired outcome, and the doctor’s recommendation. Reconstruction of a woman’s breast can be done with implants or flaps, but most patients choose the implant technique.

When a patient opts to have her breast reconstructed with implants, the doctor places a tissue expander where the natural breast was removed and fills the expander with a saline solution. This expansion process creates a pocket for the implant and simulates a shape similar to the natural breast mound. Once the skin and muscle have stretched enough to cover the implant, the implant is inserted behind the pectoral muscle, similar to a breast augmentation. This technique leaves the patient with visible scars which tend to fade significantly over time.

During flap reconstruction, the breast is rebuilt by transplanting live tissue from another area of the patient’s body. The breast mound is created from the onset, so there is no need to stretch the skin with a tissue expander over time. Flap reconstruction is more complex and timely than implant reconstruction, and subsequent procedures to reconstruct the nipple, shape the new breast, and lift or reduce the contralateral breast are common.

Recovery

Regardless of which type of reconstruction you undergo, bandages or dressings will be applied to your incisions, and a drainage tube will be placed under the skin to remove excess blood following surgery. The bandages will be removed within three days, and the doctor will remove the drainage tube within one to two weeks.

Breast reconstruction is one of the most invasive breast operations, and recovery is often physically exhausting and uncomfortable for patients. Within a few days, discomfort at the surgical sites should subside, and your energy levels should improve. Patients may resume normal activities after several weeks but should continue their stretching exercises as prescribed by the doctor. Visible scarring will continue to fade over time.

 

Frequently Asked Questions

When is the right time for reconstruction?

Once you choose to have reconstruction, deciding when to undergo the procedure is the second most important decision. Patients may choose to delay their breast reconstruction or have it performed at the time of their mastectomy. Immediate reconstruction is recommended to avoid subsequent surgeries and mitigate the emotional impact of losing one or both breasts.

What are the advantages of flap reconstruction?

Flap reconstruction offers the most advanced approach to breast reconstruction. Since this method uses live tissue, the patient’s body is unlikely to reject the issue and the risk of complications is significantly lower.  Additionally, the newly formed breast has a feel and density similar to a natural breast and lasts for the patient’s lifetime.

How is the nipple reconstructed?

After the breast mound has successfully been recreated, the patient may choose to reconstruct the nipple and areola. The newly constructed breast mound must settle before planning of the nipple and areola reconstruction can take place. Nipples are reconstructed with local tissue from the patient, and medical tattoos are used to darken then areola if necessary.

Which live tissue is used in flap reconstruction?

During flap reconstruction, tissue from the abdomen (TRAM flap), the back (Latissimus Dorsi Flap), and/or the buttock (Gluteal Flap) may be used.

Related Procedures

Before & After

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