What is breast reconstruction surgery?
Breast reconstruction is a surgical procedure to recreate symmetrical, natural-looking breasts after complete (mastectomy) or partial (lumpectomy) removal of the breasts of breast cancer patients. Breast reconstruction is also considered for patients with inborn deformities of the breasts and certain patients who have had a serious injury to the breast.
What type of breast reconstruction is best?
Breast reconstruction falls into three broad types:
1. Implant-based reconstruction: This procedure uses breast implants to help form a new breast mound. In expander-implant breast reconstruction, a balloon-like sac is used. The expander-implant starts flat and is slowly expanded to the desired size to allow the skin to stretch. Once the skin over the breast area has stretched enough, a second surgery is done to remove the expander and put in the permanent implant. Expander-implant breast reconstruction allows time for other cancer treatment options to be given. For example, the expander can be filled during chemotherapy. However, the final placement of the implant is postponed if radiation treatment is needed until radiation treatment is complete.
Two types of expanders are available. In one type, the surgeon injects a salt-water solution through a tiny valve under the skin at regular intervals (every 1, 2, or 3 weeks) to fill the expander over several months. In the other type, the expander uses compressed carbon dioxide gas. The patient uses a remote control to release small amounts of the gas into the expander several times a day over 2 to 3 weeks.
2. Flap (autologous) reconstruction: This procedure uses the patient's tissue from another part of the body for breast reconstruction.
3. Reconstruction of the nipples and areolae
Several factors are considered when choosing which breast reconstruction option is best:
- Type of original breast removal: Complete/partial
- Cancer treatments planned
- Patient's body type
- Whether the patient wants reconstructive surgery on one or both breasts
- Desire to match the look of the other breast
What to expect before the breast reconstruction surgery?
- The patient is evaluated in the upright position.
- The surgeon evaluates the patient’s general health status and any pre-existing health conditions or risk factors.
- Breasts are examined and measurements are taken of their size and shape, skin quality, and placement of nipples and areolas.
- Photographs are taken.
- The doctor will discuss the likely outcomes of breast reconstruction and any risks or potential complications.
- The size of the tissue expander is estimated.
- Routine preoperative precautions, such as antibiotic prophylaxis and deep vein thrombosis (DVT) prevention therapies, are used as needed.
What happens during an expander-implant breast reconstruction?
- After the completion of the mastectomy, a pocket is created below the chest muscles for placement of the implant.
- Care is taken to preserve or recreate the fold below the breasts.
- The upper two-thirds of the implant is covered with muscles while the lower one-third has only skin over it.
- Following complete expansion, the expander-implant is removed through a cut.
- The permanent implant is inserted and filled with saline.
- The wound is closed in layers.
What are the complications of an expander-implant breast reconstruction?
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Breast Anatomy PictureThe breast refers to the front of the chest or, more specifically, to the mammary gland. See a picture of Breast Anatomy and learn more about the health topic.
Breast cancer is an invasive tumor that develops in the mammary gland. Breast cancer is detected via mammograms, breast self-examination (BSE), biopsy, and specialized testing on breast cancer tissue. Treatment of breast cancer may involve surgery, radiation, hormone therapy, chemotherapy, and targeted therapy. Breast cancer risk may be lowered by managing controllable risk factors.
What you should know about breast cancer
- Breast cancer is the most common cancer among American women.
- One in every eight women in the United States develops breast cancer.
- There are many types of breast cancer that differ in their capability of spreading (metastasize) to other body tissues.
- The causes of breast cancer are unknown, although medical professionals have identified a number of risk factors.
- There are many different types of breast cancer.
- Breast cancer symptoms and signs include
- a lump in the breast or armpit,
- bloody nipple discharge,
- inverted nipple,
- orange-peel texture or dimpling of the breast's skin (peau d'orange),
- breast pain or sore nipple,
- swollen lymph nodes in the neck or armpit, and
- a change in the size or shape of the breast or nipple.
- Breast cancer can also be symptom free, which makes following national screening recommendations an important practice.
- Breast cancer is diagnosed during a physical exam, by a self-exam of the breasts, mammography, ultrasound testing, and biopsy.
- Treatment of breast cancer depends on the type of cancer and its stage (0-IV) and may involve surgery, radiation, or chemotherapy.
Breast Cancer SlidesLearn about breast cancer causes, symptoms, tests, recovery, and prevention. Discover the types of treatments such as surgery and drug therapies as well as the survival rate for breast cancer.
Breast Cancer Symptoms and SignsIn most cases, there are no early warning signs of breast cancer. Breast cancer may not produce any early symptoms, and in many cases, it is first discovered on screening mammography. The most common sign of breast cancer is a new lump or mass in the breast.
Breast ReconstructionAfter a mastectomy, breast reconstruction is performed to replace the skin, breast tissue, and the nipple. A patient's goals, medical conditions, cancer treatment, and previous surgery affect the type and timing of the reconstructive surgery.
Breast Reconstruction Without ImplantsIf a woman doesn't want to have breast implants after a mastectomy, she may have her breast(s) reconstructed with her own body tissue. This is commonly known as a flap procedure. There are two methods of flap procedures: tunneling and free-flap. Side effects include pain, itching, numbness or tingling, and fluid collection under the wound.
How Long Does It Take to Recover from TRAM Flap Surgery?TRAM stands for Transverse Rectus Abdominis Myocutaneous, a muscle and tissue of the lower abdomen between the waist and pubic bone. TRAM flap surgery uses the flap (graft) from this skin, fat, and the TRAM muscles for breast reconstruction. TRAM flap surgery is done for various conditions, including for patients who have undergone breast removal surgery (mastectomy) as part of breast cancer.
What Is an Endoscopic Breast Augmentation?Breast augmentation is performed to increase breast size and structure by inserting implants under the breast tissue or chest muscles. Silicone bags filled with silicone gel are most often used as implants. Endoscopy has significantly advanced breast augmentation techniques. Endoscopic breast augmentation is classified based on the incision employed.