Your Information to Breast Reconstruction After Breast Most cancers Surgical procedure

To rebuild the breast mound after a mastectomy, the selection is both implant reconstruction or tissue (flap) reconstruction. Which of those procedures you and your physician decide is determined by your physique kind, breast measurement, and desire.

Implant Reconstruction

Throughout implant reconstruction, the plastic surgeon rebuilds your breast with both a saline or silicone implant.

That is the commonest kind of breast reconstruction. “The benefits embrace a better restoration and no useful loss in different areas of the physique,” says Amy Colwell, MD, a plastic surgeon at Mass Common Most cancers Middle in Boston.

Implant reconstruction may be achieved similtaneously a mastectomy (referred to as direct to implant), but it surely will not be the best technique. “The revision price [having additional surgery later] of direct-to-implant is greater than when you do the process in two phases,” says Butler. That’s as a result of the pores and skin over the breast could get pressured or injured throughout a mastectomy. “If I then place a big implant into that pores and skin pocket, I’m stressing the pores and skin much more, which may result in issues corresponding to implant extrusion [when the implant pushes through the skin] or an infection.”

As a substitute, the process is normally achieved in phases. First, the surgeon locations a tissue expander below the pores and skin on the time of the mastectomy. “Then we inflate the tissue expander, type of like inflating a balloon, each few weeks within the workplace till we attain the best measurement. As soon as we attain the best measurement, then we convey the affected person again for a small outpatient process the place we take away the tissue expander and place the implant,” says Lyle Leipziger, MD, chief of cosmetic surgery at North Shore College Hospital and Lengthy Island Jewish Medical Middle in New York.

Flap Reconstruction

The flap reconstruction process makes use of your personal tissues to rebuild your breast(s), typically similtaneously a mastectomy. Your surgeon removes a piece of tissue out of your stomach, again, butt, or thigh, with its blood vessels connected, and connects it to blood vessels in your chest in order that it receives a blood provide.

One benefit to flap reconstruction is that it makes use of your personal tissue as a substitute of a international implant. “A second, smaller surgical procedure is often wanted to regulate the tissue and form the breast,” Dr. Colwell says.

Nipple and Areola Reconstruction

With a mastectomy, typically, the surgeon is ready to protect the pores and skin of the breast and solely removes the tissue beneath. “It’s typically additionally attainable to maintain the nipple of the breast in a nipple-sparing mastectomy process,” says Colwell.

For anybody who doesn’t have a nipple-sparing mastectomy, the final stage within the reconstruction course of is to rebuild the nipple and areola (the ring of coloured pores and skin across the nipple).

“You create the nipple by making little flaps of tissue, turning them and twisting them and elevating them so it has projection and roundness,” says Dr. Leipziger.
Years in the past, plastic surgeons would recreate the areola with a pores and skin graft. In the present day they sometimes use 3D tattoos, that are so lifelike wanting that they’re exhausting to inform other than an actual nipple and areola, says Leipziger.

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