Breast Reconstruction

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An expander is filled with saline through a tube to stretch the skin enough to accept an implant beneath the chest muscle.

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A TRAM flap uses tissue from your abdomen to reconstruct the breast. The flap can remain attached to the original blood supply and be tunneled up through the chest wall, or be completely detached and formed into a breast.

 

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A Latissimus Dorsi flap uses tissue from the back tunneled to the mastectomy site and remains attached to its donor site, leaving blood supply intact.

 

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Tissue can be taken from the back and tunneled to the front of the chest wall to support the reconstructed breast.

 

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The transported tissue forms a flap for a breast implant, or it may provide enough bulk to form the breast without an implant.

 

Through breast reconstruction, plastic surgeons can restore breasts after mastectomy or lumpectomy, closely matching the removed breast.

It is now possible for surgeons to perform the procedure immediately following mastectomy, so a patient can wake up with a new breast in place.

There are also many new techniques to meet the needs of different patients, including advanced tissue flaps and different types of breast implants.

What to Expect in Breast Reconstruction

What is it?

A reconstructive procedure to restore breasts after mastectomy or lumpectomy. May use a breast implant or natural tissues (i.e. flaps).
Inpatient / Outpatient Inpatient
Surgery time: Varies depending on the technique performed. Flap techniques require 4 hours or longer. Surgery is frequently done in stages.
Recovery time: 2-5 day hospital stay. Drains or stitches removed in 7-10 days. Normal recovery time is about 6 weeks, but varies depending on the method of breast reconstruction.

How Breast Reconstruction Works

The first stage of breast reconstruction, whether it's done immediately after mastectomy or not, will be performed in a hospital under general anesthesia. Later stages of the procedure are often done at an outpatient facility with local anesthesia.

Two types of breast reconstruction are performed: tissue expansion and flap reconstruction.

Tissue Expansion

In tissue expansion, Dr. Alfaro inserts a balloon expander underneath your skin and chest muscle. Through a tiny valve, saline is injected, which gradually fills the expander. This process can take several weeks. The expander stretches the skin over the breast area, which creates a space for the breast implant.

After the skin has stretched adequately, the expander is removed and the doctor inserts the implant. Some specially designed expanders can be left in place as the final implant. A third procedure is required to reconstruct the nipple and the dark skin surrounding it, called the areola.

In some cases, the patients doesn't need tissue expansion for a breast implant. The surgeon could then insert the breast implant as the first step.

Flap Breast Reconstruction

Flap reconstruction is a technique an increasing number of patients are seeking out. The procedure involves the transfer of a tissue flap from another part of the body such as the back, abdomen or buttocks.

The tissue flap, made of skin, muscle and fat, is tunneled beneath the skin to the chest. Once there it creates a pocket for a breast implant, or creates the breast mound itself. The blood supply for the flap can come from the donor area or it can besourced from vessels in a nearby region.

Breast reconstruction frequently involves different stages. The initial reconstruction is typically the most complex part, and later procedures involve refinements like nipple/areola reconstruction and improvement of breast symmetry.

Breast Reconstruction FAQ

How do I prepare for breast reconstruction?

As soon as you are diagnosed with breast cancer, you can begin the discussion about breastreconstruction. Your surgical oncologist and plastic surgeon should work together to develop a strategy that will put you in the best possible condition for reconstructive surgery.

The doctor will explain which reconstructive options are most appropriate for your age, health, anatomy and tissues.

Does health insurance cover breast reconstruction?

In most cases, health insurance will cover most or all of the cost of post-mastectomy reconstruction. Check your policy to see if there are any limitations on what types of reconstruction are covered.

How will I look and feel after breast reconstruction?

After surgery, gauze or bandages will be applied to your incisions. An elastic bandage or support bra will minimize swelling and support the reconstructed breast.

A small tube may be temporarily placed under the skin to drain any excess blood or fluid. A pain pump may also be used to reduce the need for narcotics.

You will be given specific instructions about caring for your surgical sites, medications, specific concerns to watch for, and when to come in for a follow-up appointment.

What are the risks of breast reconstruction?

The possible risks of breast reconstruction include, but are not limited to, bleeding, infection, poor healing of incisions, and anesthesia risks.

Flap surgery includes the risk of partial or complete loss of the flap and a loss of sensation at both the donor and reconstruction site.

The use of implants carries the risk of breast firmness (capsular contracture) and implant failure.

To Learn More About Breast Reconstruction in Tucson

If you are ready to discuss breast reconstruction with a board certified plastic surgeon, we encourage you to call the office of Dr. Armando Alfaro in Tucson, AZ. Dr. Alfaro can answer your questions and discuss the details of this procedure. Call our office at 520-323-9720 to schedule a consultation about breast reconstruction.