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Breast Reconstruction after Mastectomy

By Brian Kobienia, MD, FACS on April 02, 2011


Scary.  The feeling a woman gets when she is told that her mammogram was abnormal is scary.  Statistically 1 in 8 women will be diagnosed with breast cancer in their lifetime.  Family history, previous breast cancer, and hormone replacement therapy are but a few risk factors women have for breast cancer.

In 2010 just over 93,000 women underwent breast reconstruction procedures in the United States. One of the most gratifying procedures plastic surgeons perform is breast reconstruction.  The ability to restore the feminine shape to all it glory really is a priveledge.  This really helps a woman feel whole after the devasting diagnosis of cancer.

BREAST HEALTH

Women of Minnesota have excellent options for their breast health care.  The Piper Breast Center at Abbott Northwestern Hospital, Minnesota Breast Care, Minnesota Hematology & Oncology and even your own gynecologist can be excellent source of information and counseling.  Remember self exams and mammograms are important.

 

CANCER DIAGNOSIS

Once the cancer treatment has been outlined by your general surgeon you should be offered a chance to meet with a board certified plastic surgeon to learn about your breast reconstruction options.  In general, women of have several choices for breast reconstruction. 

RECONSTRUCTION TECHNIQUES

The first option is no reconstruction.  This was the option your grandmother had.  This means if you want a breast you wear an external prosthesis.  This affords you the quickest recovery.  Unfortunately, this is the least natural in appearance.  If a woman has a very bad cancer this is a reasonable option as the attention needs to be on fighting the cancer and not on reconstruction.

Tissue expander and implant reconstruction is another option.  This process has many steps.  There are at minimum four operations.  Each one is easier than the last.  First, a tissue expander (a balloon-like device) is inserted into the chest.  This is inflated over several weeks.  A final breast implant is placed in a quick outpatient operation and nipple reconstruction and tattoo are performed later.

A TRAM (transverse rectus abdominus myocutaneous) flap is another variety of breast reconstruction.  In this process, extra skin and fat from the lower abdomen is used to reconstruct the missing breast.  This is a big operation and recovery.  The advantage is that the breast is made with the womans own tissue – no implant is involved.

Another option is a combination your own tissue and and implant.  This is commonly called the back flap technique.  Also known as the latissimus dorsi flap. There are several reasons this technique may be recommended – some aesthetic, some practical.

OTHER BREAST

Operations to upsize, reduce or lift the other breast may be performed and are covered by your insurance company.

Stay tuned for more detailed information at this blog.
 

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