Breast Reconstruction
To help patients who have lost one or both breasts due to a mastectomy, Dr. Elisa Burgess is proud to offer a variety of breast reconstruction options in her Lake Oswego, OR practice.
- Reconstructs breasts after a mastectomy
- Restores contour, shape and volume to the breasts
- Improves the patient’s self-image
Am I an ideal candidate for breast reconstruction?
After going through cancer treatment and a mastectomy procedure, women often turn to breast reconstruction to regain a sense of normalcy in their lives. Although placement of breast implants is a common approach to recreate the breast mound, the patient actually has a variety of additional options, such as utilizing their own tissue or a combination of procedures.
Breast reconstruction, which may take place over the course of several procedures is usually covered by health insurance companies and may completed as soon after the mastectomy procedure as the patient wishes.
Ideal patients for breast reconstruction are those who have undergone a mastectomy to remove part or all of the breast or those who have undergone another form of breast conservation surgery, like a lumpectomy. In order to move forward with breast reconstruction in an effort to restore the breasts, the cancer must be fully eradicated and the patient must be mentally prepared to undergo the surgery. If the patient is not yet ready to experience the surgery and the changes it brings to their post-cancer body, the procedure can be delayed to a later time.
What can I expect during the breast reconstruction procedure?
Breast reconstruction is completed under general anesthesia and the procedure can vary based on the needs of the patient and the surgeon’s recommendations.
When undergoing tissue expansion surgery, an incision is made and the tissue expander is placed in a pocket created beneath the skin and tissue. The expander is gradually filled with saline, creating space for an implant to be inserted beneath the chest muscle. In this process, the breast mound is restored, but the nipple will be reconstructed at a later time.
During latissismus dorsi flap method of breast reconstruction, the upper back is used as a donor site. The latissismus dorsi muscle is moved under the skin from the back to the chest. Using the pocket that was created, an implant is inserted to add fullness to the breast.
If the surgeon plans to reconstruct the breast without an implant, skin and fat may be grafted from the back, abdomen or buttocks.
One of the most commonly performed flap breast reconstruction procedures is called TRAM. In this procedure, skin and fat are grafted from the lower abdomen and is removed in a fashion similar to a tummy tuck. Muscle from the area may also be used for this procedure, which can take four to six hours to complete.
The DIEP technique is similar to TRAM, but no removal of abdominal muscle is involved. In addition to the transfer of fat and skin as in the TRAM procedure, blood vessels may be disconnected from the abdomen and reattached in the chest wall.
The final possible procedure is SGAP, which involves transferring a flap from the buttocks. Oftentimes, this procedure is performed on women who lack the tissue in the abdomen to use it as a donor site.
What can I expect during my recovery from breast reconstruction?
After any of these reconstruction procedures, the patient should expect a recovery period of one to two weeks. Any stitches used may be removed after about one week and any discomfort experienced may be managed with medication. Follow-up procedures are common and may include reconstructing the nipple or operating on the breasts to increase symmetry. The breast reconstruction process can be life altering and patients should also be prepared for an adjustment period, physically and mentally after the procedure.
Like any surgery, some side effects are possible following breast reconstruction and may include infection, fluid collection, excessive scar tissue, capsular contracture (if an implant is used) and possible abdominal hernia following the TRAM procedure. Reconstruction of the breast also does not play a role in preventing the reoccurrence of cancer.
Patients who have undergone a mastectomy and wish to explore breast reconstruction options are encouraged to contact Dr. Burgess in her Portland-area plastic surgery practice.
