Breast Reconstruction

About Breast Reconstruction

Breast reconstruction surgery is a procedure performed to restore one or both of the breasts to a normal size, shape, and appearance after a mastectomy or lumpectomy. It is also used to repair a breast damaged by trauma or a birth defect. Advances in breast reconstruction surgery make it possible for women to feel whole again and attain a natural looking breast even after they have been removed. This surgery generally involves several procedures and various stages that can either start at the beginning of cancer treatment or delayed until a later date. Houston, TX board-certified plastic surgeon, Dr. Edward Lee, creates a personalized treatment plan and uses a compassionate approach as he works with patients to restore their physical appearance and confidence.

Ideal Candidates

Breast reconstruction is a very individualized procedure. If you have been diagnosed with breast cancer and are considering reconstruction, it is important that you are able to emotionally cope with treatment and have realistic expectations. While your newly reconstructed breast will take on a natural appearance, it will not have the same look, feel, or sensation as your original breast. However, they will still look beautiful. Having a positive outlook is something we discuss during your consultation. Your cancer treatment is the most important aspect of this process. In addition, you should be physically healthy and not have any other medical conditions that could impair healing.

Surgical Techniques

There are many techniques available today for breast reconstruction. In addition, there are many factors to consider when making the decision as to which approach is best. Some of these factors include cancer diagnosis, reconstruction timing, whether the patient will use natural tissue or implants, and if nipple-sparing and nipple reconstruction is a part of the process. In order to rebuild the breast there must be enough tissue to adequately create the breast mound. Flap techniques accomplish this by using your own skin, muscle, and fat to create, cover, and build the mound. The most common flap techniques include:

TRAM Flap

This method uses muscle, skin, and fat from your abdomen to rebuild the breast. The tissue used to create the new breast can be detached from the abdomen, or it may remain attached to the donor location keeping the original blood supply.

Latissimus Dorsi Flap

This method uses muscle, skin, and fat from your back. During this procedure, tissue is moved from the back to the mastectomy site through a surgically created tunnel and remains attached to the donor location, which leaves the original blood supply intact.

PAP Flap

Another flap alternative is the PAP flap (profunda artery perforator). This technique takes tissue taken from your inner thigh to reconstruct your breast.

LTP Flap

While the TRAM flap tends to be one of the more common methods used during reconstruction, sometimes there is simply not enough tissue that can be taken from the abdomen. In these situations, the LTP flap can be used which takes tissue from the lateral thigh area.

Composite Flap

Also known as composite stacked flap, this method combines flaps from various areas on your body to reconstruct the breast.

Additional Considerations

Flap procedures are very successful and common methods used today in breast reconstruction. Some women may not need to have a flap surgery and instead are conditions for reconstruction with tissue expansion. This involves placing a tissue expander under the breast wall and then slowly filling it with saline over the course of 4-6 months until the skin is properly stretched. Whether a flap has been created, or the skin stretched through an expander, you can then decide whether you want to use a natural fat transfer for breast volume, or use breast implants. The final stage of breast reconstruction is completed nipple and areola reconstruction. There are numerous methods to restore the nipple and areola so that it looks natural in appearance.

What To Expect

Breast reconstruction surgery is performed in various stages. During certain phases, such as creating a flap, inserting an expander or implants, general anesthesia is generally used. Some patients will require overnight stays, depending on the actual phase of treatment. One the final step has been completed in the breast reconstruction process, patients will wear a medical support bra and will be given medication to help control swelling, bleeding, and discomfort. Over time, some sensation will return, but overall, the breasts will look as normal as possible and allow you to feel whole again. Ongoing monitoring with mammograms and breast checks are essential and recommended for your ongoing health.

Reclaim Your Self-Confidence

While the breast reconstruction process can be lengthy, it is one of the most worthwhile surgeries for our patients. It helps decrease the emotional and physical impact of mastectomy and allows you to reclaim your self-confidence and figure. If you have been diagnosed with breast cancer, or have one or both breasts that have been impacted by trauma, we invite you to call our office and schedule your consultation today.