Reconstruction of the breasts done at the same time as surgery to remove the cancer. The patient wakes up with a breast mound already in place, having been spared the experience of seeing herself with no breast at all. The process is done in the shortest time possible and is not a series of complex surgeries over a length of time.
This reconstruction involves placing a temporary tissue expander either under or over the muscle at the time of your mastectomy. The expander gradually stretches the muscle and skin in preparation for either an implant or flap reconstruction. The overall result is more symmetric, natural and aesthetically pleasing. It allows a woman to complete radiation treatment while having a “placeholder” implanted. It allows enough time to make sure all the cancer has been treated.
This reconstruction happens after all treatment to treat the cancer has been completed. Whether it’s been 20 days or 20 years since a woman’s lumpectomy or mastectomy, she is likely a candidate for delayed breast reconstruction.
A breast implant is a silicone shell filled with either silicone gel or a salt water solution known as saline. The recovery from the initial expander placement surgery and from the permanent implant placement surgery is usually quicker than flap surgery. It may be easier to control the final size of the reconstructed breast with implant reconstruction. There are no additional scars on the patient’s body other than those on the breasts. For patients without excess fatty tissue and who do not require radiation treatment, implants are a good choice and yield good final results. With implants most patients require placement of an expander first, followed by replacement of the expander with an implant. This type of reconstruction almost always requires at least two surgical stages and multiple visits to the plastic surgeon’s office between these stages for tissue expansion. it is important to realize that for patients who are having a unilateral (one-sided) mastectomy, matching the other natural breast with an implant can be difficult. The shape and “feel” of an implant is not exactly like that of a natural breast.
DIEP, SIEA, SGAP Flaps
The DIEP flap is the technique where skin and tissue (no muscle) is taken from the abdomen in order to recreate the breast. Other flap techniques, called the SIEA flap, the LSGAP flap and the SGAP flap, take tissue from the lower abdomen or lateral buttock regions. Since the reconstruction involves using the patient’s own tissues, the risks of implant reconstruction are avoided, particularly in the case of radiation.
