Oftentimes it becomes necessary to remove a breast for either cancer, infection, or trauma. When this situation occurs, reconstructing a natural looking breast becomes a woman’s top priority. Fortunately a variety of techniques exist which can be used to reconstruct a breast.
(This type of breast reconstruction uses a person’s own tissue for reconstruction.) Autologous reconstruction techniques include:
1. Flap Reconstructions:
- T.R.A.M.(Trans-Rectus Abdominal Myocutaneous) Flap Reconstruction – Tissue from the Abdomen is moved up to reconstruct the breast. This can be performed either via a pedicle flap (artery and vein are left in place and the tissue is rotated with the vessels in place) or via a Free Flap approach (the artery and vein are disconnected and then the entire flap and blood vessels are reconnected to new vessels in the chest area.)
- Latissimus Dorsi Flap – Skin and Fat from the back are moved to the chest area.
- Gluteal Free Flap – Skin and Fat from the Buttocks are used to reconstruct a breast
2. Fat Transfer – Fat is harvested from the abdomen and used to fill the lost breast volume. This often takes several treatments to complete.
(This type of reconstruction uses synthetic materials for reconstruction.)
Alloplastic Reconstructions include:
1. Expander Reconstruction:
- In this technique an expander is initially placed and slowly filled over a few months to stretch the chest tissue. A permanent implant is then placed to give volume.
2. Immediate Implant Reconstruction
- In this technique an implant is directly placed after the breast is removed in order to restore the lost volume.
WHAT TO EXPECT AFTER SURGERY:
Immediately after surgery the incision site and the chest will be tender. A drain or two may be temporarily left in place to help remove excess fluid. These are usually removed within 1-2 weeks after the surgical procedure. Within 3 weeks the initial expander fill is usually performed and this occurs at regular intervals which are determined by the surgeon. For flap reconstructions the tissue is initially swollen and this usually begins to improve at 2-3 weeks and progresses for several months. Revisional surgery may be required regardless of which technique is used for reconstruction.