Breast Reconstruction FAQs
Breast reconstruction is performed when women have had a breast surgically removed for either cancer or other disease treatment. There are many different types of procedures used in reconstructing a woman's breast. Dr. Ken Smart specializes in all of types of breast reconstruction and will thoroughly evaluate you to determine which one best suits your body type.
If you have undergone removal of one or both breasts and are considering reconstruction, we can answer andy of your remaining breast reconstruction FAQs during an appointment at our Frisco, TX, office.
What will my consultation be like?
First of all, Dr. Smart will thoroughly review your medical record including biopsies performed on your breast, operative reports from mastectomy, final pathology results, and any chemotherapy and radiation treatments received or planned. He will also review your other medical history. He will then determine what your goals are from breast reconstruction and combine that with a thorough physical examination to determine what is the best type of breast reconstruction for you.
What are the different types of breast reconstruction?
There are many different ways to reconstruct a breast, but three are used most commonly. The most common is a TRAM flap procedure in which tissue is moved from the abdominal wall to the chest wall to reconstruct the breast. The tissue is either left attached to the abdominal muscle or detached and reconnected to blood vessels in the chest. An added benefit of TRAM procedure is that the abdomen is re-contoured and tightened as in a tummy tuck procedure. Many people feel that this gives the most natural appearing breast but it is the most involved procedure and requires the longest recovery time.
Another common type of flap reconstruction is the latissimus dorsi flap. This involves moving skin and fat from the back, attached to the latissimus muscle, and moving it to the chest wall to re-create the breast. Many times an implant or a tissue expander and then an implant is required to produce a breast of adequate size.
The third type involves placing a tissue expander that slowly stretches the skin of the chest wall and then replacing it with a permanent implant. This type of reconstruction is less involved but require several steps. First of all, a tissue expander is placed below the pectoralis muscle and skin of the chest wall. About two weeks after that the expansion process is begun. This is performed in Dr. Smart's office by placing saline, or salt water, into the tissue expander through a port. About 100 mL of saline are placed at each visit on an every other week basis. This is done until the skin is stretched out adequately. Next, you go back to the operating room to have the tissue expander removed and a permanent implant placed. The implant can be either saline or silicon. Tissue expansion involves the least amount of surgery and has the shortest recovery. However, more visits to the office are required during the expansion process.
Can my reconstruction be performed at the same time as the mastectomy?
In some instances it can. Almost all patients with stage I breast cancer, in which the cancer has not traveled to the lymph nodes, are candidates for reconstruction at the same time as their mastectomy. In other patients with more advanced breast cancer, it may be best to delay breast reconstruction until all other treatments have been completed.
Will having radiation treatments affect my reconstruction?
It will have an effect. More and more women are receiving postoperative radiation treatments to complete their cancer therapy. Most plastic surgeons now agree that it is best to delay breast reconstruction if radiation treatments are planned. Radiation treatments can negatively affect the body's ability to heal wounds as well as decrease the overall cosmetic appearance of the reconstructed breast. Also, most women who have had radiation treatments after mastectomy are not good candidates for tissue expansion and implant reconstruction.
Will anything be done to my opposite breast?
By law, it is required that health insurance providers cover the cost of any procedure performed on the opposite breast to attain symmetry after reconstruction. This can include a breast reduction, breast lift, or augmentation. Sometimes, implants are even placed on the reconstructed side if it is smaller than the opposite breast.
How and when is nipple reconstruction performed?
A new nipple can be reconstructed from small flaps of skin on the newly reconstructed breast or from borrowing tissue from the opposite nipple. The darker areolar skin is usually created by a small skin graft or tattooing. This is usually performed about three months after the newly reconstructed breast is completely healed. Nipple reconstruction can be performed at the same time as any other symmetry attaining procedures on the opposite breast, or any small revisions on the reconstructed breast.
A breast reconstruction can give you the restored, feminine figure you desire.
What is my recovery like?
Tissue expansion usually just involves one night in the hospital. The latissimus flap reconstruction will require two to three days of hospitalization. A Tram flap reconstruction can require up to four days in the hospital. Pain is controlled with intravenous medication during hospitalization. For the muscle flap procedures, a special catheter can be placed that ministers and local anesthesia to help control pain. Depending on your type of work and type of reconstruction performed, it can be anywhere from one to four weeks before returning to work. Plan on physical activity being limited for six weeks.
Are any other procedures necessary?
It is very common to perform surgical revisions on the reconstructed breast to obtain the best result. Nipple reconstruction is also desired by most patients. Also, any procedures on the opposite breast to obtain symmetry may be required.
Receive Your Consultation
You'll receive highly personalized care from both Dr. Smart and his entire staff during your journey through the breast reconstruction process. He considers this to be the most fascinating and challenging field of plastic breast surgery in that it combines the artistry of cosmetic surgery and the surgical and technical expertise of reconstructive surgery. If you would like to learn more about breast lift surgery, contact our cosmetic surgeon today. A breast reconstruction can give you the restored, feminine figure you desire.