Breast Reconstruction Surgery

Breast Reconstruction Surgery

Breast Reconstruction Surgery
Women who have aggressive forms of breast cancer, or who are at high risk of developing the disease, sometimes choose to have a mastectomy, the surgical removal of one or both breasts. Some patients may then choose to have surgery to reconstruct their breasts to restore their form and shape. During this procedure, doctors can replace any skin, breast tissue or a nipple that they may have removed during the surgery. (If you still need radiation therapy after your mastectomy, your doctor may suggest you wait for reconstructive surgery until after you finish treatment.) Breast implants, filled with either silicone or saline, can be used to reshape your breast, or you can even use your own tissue, a procedure called flap surgery. Both breast implants and flap surgery are complex procedures, each with their own risks; they may require second surgeries to position the breasts correctly. Most insurance companies will cover this type of reconstructive surgery. Learn more about breast reconstruction with expert advice from Sharecare.

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    When Is Breast Reconstruction Surgery Performed?
    Breast reconstruction surgery is performed after the diagnosis of breast cancer and cancer operation. Watch this video to learn more from Paige Pennebacker, MD, from Blake Medical Center.
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    A Surgery, answered on behalf of
    Each incision is different, but in general, for at least three weeks, you don't really need to do anything to your incisions. Just keep them covered, depending on how they were closed, and then a gentle scar massage after three weeks can be helpful. Silicone scar strips and some creams may help, but you shouldn’t use those for at least three weeks to a month after surgery.

    Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.
     
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    A Surgery, answered on behalf of
    I think breast cancer reconstructive surgery has gone through a lot of different changes over the years. Initially reconstruction wasn’t the focus—historically the focus was treating the cancer itself. As we've gotten better and better at treating the cancer, we've really started addressing the whole person and recreating the breast as a whole. Today, I would say most patients choose some type of breast reconstruction. As technology has advanced, we can create a better aesthetic breast mound, and as implants have changed and gotten better and better, we have better tools to shape and restore the breast shape to what it was before, and sometimes even better aesthetic outcomes than before surgery.

    Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.
     
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    A answered
    When diagnosed with breast cancer, most women are at the age when they have small areas of skin or excess fat around the belly, and many may have been thinking about having a tummy tuck. A breast reconstruction and tummy tuck can be performed at the same time, and the genius of this procedure is that instead of performing the tummy tuck and throwing the tissue away, the doctor can transfer that tissue to the chest area to simulate the appearance of a breast. This procedure is usually covered by your health insurance company.
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    A Plastic Surgery, answered on behalf of

    A common breast reconstruction technique is called staged reconstruction. In this procedure, your surgeon expands your breast skin and muscle using a temporary tissue expander. A breast tissue expander is an inflatable breast implant designed to stretch your skin and muscle to make room for a future, more permanent implant.

    Your skin usually takes a few weeks to expand sufficiently to remove the expander. Afterwards, your surgeon will either perform microvascular flap reconstruction, or insert a permanent breast implant. During flap reconstruction, your surgeon creates a breast using tissue from other parts of the body, such as the abdomen, back, or buttocks, or thighs. Staged reconstruction requires two separate operations.

    If your surgical oncologist recommends chemotherapy or radiation following your mastectomy, or breast removal surgery, it may your delay your tissue expansion process by approximately four to eight weeks.

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    A Plastic Surgery, answered on behalf of

    Breast reconstruction is like the "light at the end of the tunnel." While cancer treatment such as mastectomy is critically important for your physical health, think of reconstruction as equally important for your emotional health. A recent study from the University of Toronto published just last month (October, 2011) in the Journal "Cancer" showed that women who underwent breast reconstruction after mastectomy had significant improvements in "breast satisfaction, psychosocial wellbeing, and sexual wellbeing." The benefits have been so compelling that for the last 13+ years the federal government has mandated insurance companies to cover reconstructive operations. Moreover, the 1998 Federal Breast Reconstruction Law guarantees insurance coverage for women in need of surgery on the unaffected breast to create symmetry. Therefore, while women don't "need" reconstruction to live a long life, breast reconstruction can fulfill a need for enhanced quality of life. 

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    A , Plastic Surgery, answered

    During delayed autologous tissue breast reconstruction, the mastectomy is first completed by the general surgeon. Sometimes, radiation to the chest wall is required and chemotherapy is commenced. After a reasonable time of healing, usually several months, either a pedicle flap or free flap reconstruction is performed by the plastic and reconstructive surgeon. Most common autologous flaps include the Latissimus Dorsi flap and the TRAM flap from the abdomen. During a pedicle flap, the tissue is transferred into the breast without being transected from its origin. Free flaps require complete removal of the new tissue with its blood supply and nerves for microvascular anastomosis under the microscope.

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    What Are My Options for Breast Reconstruction After a Mastectomy?
    Not all women choose to have reconstruction after a mastectomy, but there are many options for those who choose to do so. Learn more from Virginia Chiantella, MD, from StoneSprings Hospital Center in this video.
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    Breast plastic and reconstructive surgeons at Johns Hopkins Medicine pioneered the lateral septal gluteal artery perforator (LSGAP), or "cushion flap," a modification of the superior gluteal artery perforatory (SGAP) procedure. This flap procedure does not take tissue from the central area of the buttock, so it lifts the side thigh and buttock area while preserving your natural contours.
    This is a significant advantage over the traditional SGAP flap whereby the buttock contour may become indented. Johns Hopkins is one of only two centers in the country, if not the world, performing this specialized version of the SGAP flap.
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    There are many upsides to having bilateral breast reduction or lift at the same time you're undergoing a lumpectomy. These include:

    • You will only need one surgery.
    • Your surgery is completed prior to radiation, so you avoid the risks of wound-healing problems that can occur with post-radiation surgery.
    • You have symmetric breasts after lumpectomy.
    • You get relief from the symptoms of large breasts, if this was a problem before surgery.

    These surgeries generally do not involve drains. They may be outpatient or possibly require one night in the hospital. Recovery time is six weeks, but most people usually feel better and are able to return to work in three to four weeks.

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