Breast reconstruction
Breast reconstruction is a series of surgical procedures performed to recreate a
breast. Reconstructions are commonly done after one or both breasts are removed as a
treatment for breast cancer. Also, a breast may need to be refashioned for other reasons,
such as trauma or abnormalities that occur during breast development.
Why a Breast reconstruction is performed
Many authorities consider reconstruction an integral part of the therapy for breast
cancer. A breast that appears natural offers a sense of wholeness and normalcy, which can
aid in the psychological recovery from breast cancer. It eliminates the need for an
external prosthesis (false breast), which many women find physically uncomfortable as well
as inconvenient.
General information about a Breast reconstruction
Breast reconstruction is done in two stages, with the ultimate goal of creating a
breast which looks and feels as natural as possible. It is important to remember that
while a good result may mimic a normal breast closely, there will inevitably be scars and
loss of sensation. The reconstructed breast cannot be exactly like the original.
The first step is to form a structure called a breast mound. This can be accomplished
using artificial materials called breast implants, or by using tissues from other parts of
the woman's body. The second step involves creating a balance between the newly
constructed breast and the breast on the opposite side. The nipple and areolar complex
(darker area around the nipple) are recreated. This is usually done several months after
the mound is created, to allow swelling to go down. Other procedures may be necessary,
such as lifting the opposite breast (mastopexy), or making it larger or smaller to match
the reconstructed breast.
Types of breast reconstruction
There are two basic choices for breast reconstruction. The breast tissue can be
replaced with an implant or the breast is created using some of the woman's own tissues
(autologous reconstruction).
Artificial implants
In general, implant procedures take less time, and are less expensive than autologous
ones. Implants are breast shaped pouches. They are made of silicone outer shells, which
may be smooth or textured. The inside may contain silicone gel, saline (salt water), or a
combination of both.
Autologus reconstruction
Attached flap and free flap are two types of surgery where a woman's tissue is used in
reconstruction. An attached flap uses skin, muscle, and fat, leaving blood vessels
attached to their original source of blood. The flap is maneuvered to the reconstruction
site, keeping its original blood supply for nourishment. This may also be known as a
pedicle flap. The second kind of surgery is called a free flap. This also uses skin,
muscle, and fat, but severs the blood vessels, and attaches them to other vessels where
the new breast is to be created. The surgeon uses a microscope to accomplish this delicate
task of sewing blood vessels together. Sometimes the term microsurgery is used to refer to
free flap procedures. Either type of surgery may also be called a myocutaneous flap,
referring to the skin and muscle used.
The skin and muscle used in autologous reconstruction can come from one of several
possible places on the body, including the abdomen (TRAM flap or "tummy tuck"),
the back (latissimus dorsi flap), or the buttocks (gluteus maximus free flap). |