Breast reconstruction
is performed to recreate the breast mound that is lost at the time of
mastectomy. Reconstruction must
come second to treating the breast cancer.
While there may be some convenience and efficiency in scheduling
reconstruction at the same time as the mastectomy, it is not a necessity
– especially if further treatment of the breast cancer is required.
Reconstruction is more appropriately scheduled once the cancer has been
eliminated.
There are two surgical
options to consider after
mastectomy. The first option
is a two stage process. Initially, a tissue expander is surgically placed where the
breast mound was. It is injected
with saline several times over several weeks or months (during office
visits) to gradually stretch the skin and tissue to prepare it for the
placement of the full-sized implant during a second surgery.
For patients who have undergone radiation therapy, a latissimus
flap (using muscle from the back) is used at the time of expander
placement.
The second surgical
option involves the use of excess lower abdominal tissue (TRAM flap) to
recreate the breast. Candidates
for this option must have enough excess abdominal tissue for the flap.
Both surgical options
require nipple and areola reconstruction as a final stage.
A skin graft, usually taken from the abdomen, is used to create
the areolar complex. Tissue from
the breast mound is raised to create the nipple.
After the nipple and areola has healed, it may be darkened by
tattooing, which is done in the office.
With any breast
reconstruction, there is the possibility that further surgical
intervention will be required, either to modify the initial result or to
accommodate for changes over time.
If implants are used, there are
some additional risks, including
infection around or inside the implant, rupture of the implant, or scar
tissue forming around the implant.
If you would like to
schedule a consultation to discuss breast reconstruction with Dr. Stieg,
please call our office at 407-647-4601.
For patients who do
not wish to undergo reconstructive surgery, external prostheses may be
used.
