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Reconstruction of a breast that has been removed due to cancer or other disease is one of the most rewarding surgical procedures available today. New medical techniques and devices have made it possible for surgeons to create a breast that can come close in form and appearance to matching a natural breast. Frequently, reconstruction is possible immediately following breast removal (mastectomy), so the patient wakes up with a breast mound already in place, having been spared the experience of seeing herself with no breast at all. Alternatively, the reconstruction can be performed months or even years after a mastectomy.
There are essentially two different methods of reconstruction: implants vs. autologous tissue. The first method usually involves placing an inflatable device, or tissue expander, under chest skin and muscle. Over a period of months, this device is slowly expanded to the desired size and shape by periodically injecting saline solution during office visits. When fully expanded, the device is removed during a second short operation and replaced with a permanent implant.
The second method of breast reconstruction involves creating a new breast using the patient’s own tissue borrowed from elsewhere in the body. The most common area to borrow from is the abdomen, from which skin, fat, and muscle are removed and transferred to the chest to create a new breast mound. A side benefit to this procedure, called a TRAM flap, is that the patient gets a tummy tuck! Another advantage to the TRAM flap procedure, though recovery is significantly longer, is usually a breast that looks and feels more natural than one reconstructed with implants.
After the new breast shape is obtained, additional procedures can be performed, including nipple reconstruction and lifting the opposite breast to achieve symmetry.
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