Breast reconstruction is performed on women who have lost one or both breasts to mastectomy, or who lack breasts due to congenital or developmental abnormalities. The goal of breast reconstruction is to create a breast and nipple that resemble the natural breast as closely as possible in shape, size and position. The reconstruction may be performed at the ime of the initial breast surgery or may be delayed.
Types Of Breast Reconstruction
Breast reconstruction is performed in several steps, but there are essentially two types.
The first type is called autologous and uses the woman’s own tissue to recreate the breast. The second type uses a breast implant or expander to create the breast. . Which one is used is based on patient preference combined with the combined judgment of the breast and plastic surgeons.
Implant/Tissue-Expansion Breast Reconstruction
Implant/tissue-expansion breast reconstruction involves inserting an implant in the chest after the skin has been stretched enough by an expander to contain it. First, the surgeon inserts a balloon expander beneath the skin and chest muscle where the reconstructed breast will be built. Then, during the next few weeks or months, a saline solution is injected through a tiny valve beneath the skin into the expander. As the expander fills with saline, it stretches the skin and creates a pocket for the implant. The expander is left in place to serve as the implant or replaced with a another one, which can be made of saline or silicone gel. A final procedure reconstructs the areola and nipple. Often, some patients do not require tissue expansion, and can immediately be reconstructed with a permanent implant.
Autologous-Tissue Breast Reconstruction
Autologous-tissue breast reconstruction is used either by patient choice or surgical need. . During autologous-tissue breast reconstruction, a breast is created using skin, fat and, sometimes, muscle from other parts of the body. The abdomen, back, buttocks or thighs are all donor sites. The donor tissue, which is called a “flap,” is either surgically removed and reattached (free flap) to the chest, or left connected to its original blood supply and “tunneled” through the body to the chest (pedicle flap). There are a number of different flap techniques; which one is used depends on the individual patient. Factors taken into consideration include how much extra tissue is available for transfer; the width and flexibility of blood vessels; and how large the breast(s) needs to be.
Implants may or may not be used with autologous-tissue breast reconstruction. Constructing a nipple and areola is performed in a separate surgery.
Results Of Breast Reconstruction
A reconstructed breast will often not look the same as the original mature breast. And although a surgeon attempts to match the size, shape, position and other attributes of the remaining breast, an exact match is often not possible. To achieve symmetry, the remaining breast may be operated on to match the size and shape of the reconstructed breast.