There are many options available in breast reconstruction. Your anatomy, your surgeon’s preferences, and your desired results will help determine which method is best for you. The reconstructive breast surgery Dr. Dees offers, is the skin expansion with breast implant.
Skin expansion with a breast
This is the most common method of reconstructing a breast. Following mastectomy, a balloon expander is inserted beneath the skin and chest muscle. Over several weeks, the expander balloon is gradually filled with a salt-water solution in the doctor’s office, causing the overlying skin to stretch. When the skin has stretched sufficiently, the expander is surgically replaced with a more permanent implant. Some expanders are designed to be left in place as the final implant. The nipple and the skin surrounding it, called the areola, are reconstructed in a later procedure. In rare cases, when a sufficient amount of skin is available, an implant can be placed without the preliminary skin-expansion step.
Although flap reconstruction is more involved at the initial procedure than reconstruction with an implant, many women prefer it because it may allow the breast to be rebuilt with natural tissue. Also, unlike the tissue expander method, the breast mound is completed at the initial operation, without the need for expansion over an extended time period. In one method, the breast is reconstructed using a tissue flap, consisting of a portion of skin, fat and muscle, that is taken from the back, or abdomen. The flap, still tethered to its original blood supply, is tunneled beneath the skin to the front of the chest wall. The transported tissue may be bulky enough to create a new breast mound itself. However, sometimes an implant will be inserted as well. In a more complex flap technique, tissue that is removed from the abdomen is surgically transplanted to the chest by reconnecting the flap’s blood vessels to vessels in the chest region. Although more complicated, this microsurgical reconstruction may provide a more natural and less traumatic reconstruction in many women. Although recovery from flap reconstruction may take longer than with implant reconstruction at the initial procedure, it does not require a secondary procedure for placing a permanent implant, nor does it require the weekly office visits needed for tissue expansion. Additionally, a flap procedure may improve the contour of the site from which the borrowed tissue was taken. For example, a protruding abdomen may appear trimmer after tissue is taken from the area and used to rebuild the breast. All of these procedures have the advantages and disadvantages, and many times the choice of procedures is limited by other health factors, such as weight, other medical conditions and previous cancer therapy. Your plastic surgeon will help you to determine which procedure is best for you.
Once the breast mound is restored in the initial procedure, one or more follow-up procedures will be performed to replace a tissue expander with a permanent implant or to reconstruct the nipple and areola. Your surgeon may also recommend an additional operation to lift or reduce the opposite breast to match the appearance of the reconstructed breast.