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How is breast reconstruction done?

Breast reconstruction is performed in multiple steps. The reconstruction is performed first to create the general shape of the breast. The second step is to then make subtle revisions to that reconstruction, either to optimize the shape or perhaps to make adjustments to the other side to improve breast symmetry, and then finally to make the nipple and apply the color to recreate the areola.
Breast reconstruction is a surgical procedure to re-create the shape and appearance of a woman’s breast. Most commonly, the procedure is done as part of a mastectomy - the surgery to remove an entire breast with cancer.

The procedure can also be used to help women with congenital conditions and those injured in accidents or burned.

There are two types of breast reconstruction. Using one practice, doctors move tissue from the belly or back to the breast. Though this method is more extensive, it can provide a great emotional benefit and is often performed during the same operation as the mastectomy. The tissue can be moved by keeping it alive on a muscle, or microsurgery can be used to reattach blood vessels to keep the transplanted tissue alive.

Not every woman has the option of using her own tissue. Breast implants or tissue expanders can also be used in breast reconstruction. When tissue expanders are used, they are gradually enlarged over the three months following the surgery. Though some tissue expanders can be permanent, they are typically replaced with permanent breast implants during a second surgery.

Saline and silicone implants are quite safe and present unique benefits. Discuss the alternatives with your doctor.
Stuart A. Linder, MD
Plastic Surgery

Breast reconstruction may be performed by two specific methods: tissue expander/implants or autologous tissue transfer. The most common method involves the use of a tissue expander under the pectoralis muscle immediately after the mastectomy. After several months of weekly serial tissue expansion, the expander is removed and replaced with a permanent silicone gel implant. The other most common method uses direct tissue from the body as either a pedicled flap or a free flap to recreate the breast. The two most common tissue flaps include the Latissimus Dorsi flap (back muscle and tissue) and the TRAM flap (lower abdominal tissue transfer). 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.