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Breast Reconstruction

Breast reconstruction is not performed by the breast surgeon.  It is performed by a plastic reconstructive surgeon.  Breast reconstruction can be performed immediately (at the time of mastectomy) or delayed (some time after completion of breast cancer treatment).  Immediate breast reconstruction:

  • Is safe,
  • Does not increase your risk of recurrence,
  • Is considered part of your cancer treatment and hence most insurance plans will cover it
  • Results in a better cosmetic outcome

The majority of women with early stage breast cancer are candidates for immediate breast reconstruction.  If you are interested in reconstruction, you will be referred to a plastic surgeon who will describe the various procedures, show you photos of women who have different types of reconstruction, and discuss which type of reconstruction might be best for you.  The following is a brief overview of the most common types of breast reconstruction:

Tissue expander/implant
Although the skin is preserved at the time of a skin-sparing mastectomy, the implant is ultimately placed underneath the pectoralis muscle.  In order to create a large enough space to place the implant, a submuscular pocket is created at the time of mastectomy and a tissue expander is placed.  2-3 weeks after surgery, tissue expansion begins.  The plastic surgeon periodically (every 1-2 weeks) adds saline to the tissue expander to stretch open the pocket.  Once enough the desired size is reached, a second outpatient operation is performed to exchange the tissue expander for the permanent implant.
Tissue expander/Implant

  • Avg length of surgery:  4.5 hours
  • Avg length of hospital stay:  1 night
  • Avg length of overall recovery:  2-3 weeks

Abdominal free flap (a.k.a. “the tummy tuck”)
The skin and fat from the lower abdomen are cut and moved up to the chest to recreate the breast.  The blood vessels are carefully dissected out and preserved from the abdomen and reconnected to blood vessels in the chest using microsurgery.  As a result, the belly is tighter and flatter, like a tummy tuck. 

Tummy Tuck

  • Avg length of surgery:  6-8 hours
  • Avg length of hospital stay:  4-5 nights
  • Avg length of overall recovery:  6-8 weeks

Latissimus flap + implant
An oval flap of skin, fat, muscle, and blood vessels from the upper back are used to reconstruct the breast. This flap is moved under the skin from around from the back to the chest to rebuild the breast. The blood vessels of the flap are left attached to their original blood supply. In most cases, an implant is placed under the muscle flap to give the reconstructed breast projection and volume.

http://www.sakhanplsurgery.com/images_content/lat_graphic%20display_pics.jpg

  • Avg length of surgery: 4-5 hours
  • Avg length of hospital stay: 2-3 nights
  • Avg length of overall recovery: 3-4 weeks

For information on the different types of breast surgery, please click HERE

For information on lymph node surgery, please click HERE

 

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