What reconstruction techniques are available after breast cancer surgery?
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Dr. Gedge Rosson of Johns Hopkins Medicine answered:Your surgeon can reconstruct your breasts in one of two ways: implants or flaps.
- Implants -Made out of silicone or saline or a combination of both, your surgeon can insert implants during or after a mastectomy. Your surgeon places them underneath the chest muscle, as opposed to on top of it, as in the case of breast augmentation.
- Flaps - Plastic and reconstructive surgeons who specialize in microsurgery perform flap procedures. During flap reconstruction, your surgeon creates a breast using tissue taken from other parts of the body, such as the abdomen, back, or buttocks, or thighs. Your surgeon then transplants the tissue to the chest by reconnecting the blood vessels to new ones in the chest region. Due to the high level of skill required for microsurgery, as well as the equipment and staff needed, these techniques are available only at specialized centers.
Most breast centers are still performing flap surgery the "old fashioned" way if they do not have surgeons with these skills. These older procedures (TRAM Flaps and latissimus dorsi flaps) result in the patient sacrificing either her abdominal muscles or her upper back muscles. While those procedures were the best options decades ago, today we know that there is a higher risk of hernia, weakness, abdominal bulging, and limits on physical activity with these older procedures. At Johns Hopkins, our breast reconstructive surgeons will recommend the most advanced reconstructive surgery you can have, so you are assured of the best possible result.
Your surgeon can reconstruct your breasts in one of two ways: implants or flaps. Implants -Made out of silicone or saline or a combination of both, your surgeon can insert implants during or after a mastectomy. Your surgeon places them underneath... More -
Dr. Erik A Hoy answered:Unlike in the not-so-distant past, there are many options available to women after mastectomy, or breast cancer surgery. At the most basic level, there are two types of reconstructive options available: prosthetic (implant) reconstruction, or autologous (muscle, fat, skin) reconstruction. The decision to have either of these types of reconstruction is a personal one, and should be carefully considered with your physicians, and if possible, your family. There are risks and benefits to either type of reconstruction. Both may require multiple procedures, and which is “best” for you is dependent on multiple factors.
Specifically, implant-based options carry implant-related concerns (type, size, silicon vs. saline, and the slight possibility of device failure), whereas autologous (your own tissues) reconstructions carry donor-site concerns. In transferring fat or muscle from one area to another, your surgeon can obtain a stable, realistic result for your reconstructed breast. Moving a muscle from its native site can result in a functional weakness or bulge in your abdomen. However, some recent studies have shown that the functional impact of these surgeries is less than surgeons previously believed. Both reconstructions can achieve excellent results, and techniques and devices are improving all the time. Breast cancer is increasingly diagnosed and treated: the art and science of reconstruction is something a plastic surgeon can assist you and your surgical oncologist with; cancer treatment and recovery should be a team-approach.
Unlike in the not-so-distant past, there are many options available to women after mastectomy, or breast cancer surgery. At the most basic level, there are two types of reconstructive options available: prosthetic (implant) reconstruction, or... More -
Dr. Stuart Linder answered:There are two major techniques in constructing the breast.
1. Implant placement. Silicone gel implants are most often used reconstructing the breast to maintain a volume, especially in nonradiated breasts.
2. Flap reconstruction. Flaps include transferring tissue from the abdomen or back area normally in order to reposition those tissues of skin and fat into the breast to reconstruct a breast mound. A free flap may include the use of a microscope to perform microvascular reanastomosis, bringing the blood vessels back to the chest wall and creating a new blood supply to the flap. Most common flaps include TRAM flaps and latissimus dorsi myocutaneous flap. Normally these reconstructive surgeries or flaps are performed at university-based hospitals where patients can be monitored for several days.
There are two major techniques in constructing the breast. 1. Implant placement. Silicone gel implants are most often used reconstructing the breast to maintain a volume, especially in nonradiated breasts. ... More -
Dr. Mark Sisco of NorthShore University HealthSystem answered:After breast cancer surgery there are a variety of options available to the patient to reconstruct the breast. Learn more from Dr. Mark Sisco on behalf of NorthShore University HealthSystem about reconstruction surgery.
After breast cancer surgery there are a variety of options available to the patient to reconstruct the breast. Learn more from Dr. Mark Sisco on behalf of NorthShore University HealthSystem about reconstruction surgery. More -
Dr. William Owens of Aurora Health Care answered:Plastic surgery reconstruction after breast cancer surgery is becoming more common in the United States. Once a woman is diagnosed with breast cancer, she usually has options for surgical therapy. She can choose to have the cancerous lump removed (a lumpectomy), usually followed by radiation, or she can choose to have the entire breast removed (mastectomy), usually without need for radiation after surgery. If she chooses lumpectomy, there is usually modest change in the form of the breast, and plastic surgery afterwards isn't needed. There are some cases of lumpectomy, however, where the breast form may change enough that plastic surgery helps, including work on the opposite breast to achieve symmetry, is worthwhile. If the patient chooses mastectomy, she can usually be offered plastic surgery reconstruction to create a new breast "mound." The plastic surgery can be delayed for months or even years after the mastectomy, but such reconstruction is technically more difficult as a large amount of skin and tissue needs to be brought in to create a mound from a flat surface. So, the plastic surgery is usually started immediately, at the time of the mastectomy.
When the breast surgeon performs mastectomy and immediate reconstruction is planned, he or she leaves as much of the breast skin envelope as possible for the plastic surgeon (a skin sparing mastectomy), "scooping" the breast tissue out from beneath the skin. Sometimes even the nipple and areola can be left (a nipple sparing mastectomy). While the patient is still under anesthesia, the plastic surgeon can then fill the space for reconstruction. In the United States, 80% of immediate reconstruction is done using implants, either salt water filled or silicone gel type. In the other cases, tissue from other parts of the body is recruited to fill the space, such as muscle from the abdomen or flank, or fatty tissue from the abdomen. This reconstruction may involve a few surgical steps to complete. Federal law has mandated that all plastic surgery done in the course of treatment for breast cancer has to be covered by insurance, including Medicare and Medicaid. There is no age limit for reconstruction.
Plastic surgery reconstruction after breast cancer surgery is becoming more common in the United States. Once a woman is diagnosed with breast cancer, she usually has options for surgical therapy. She can choose to have the cancerous lump removed (a... More
