Breast reconstruction is for those women who have had a mastectomy because of breast cancer or any other disease. Many times, it is possible to have the reconstruction done immediately after the mastectomy and is considered to be more advantageous.
The reconstruction is only suited for those women who do not have to undergo any further treatment to eliminate their disease.
The procedure involves creating a breast mound with a nipple and areola; and the opposite breast can be matched to the reconstructed one by way of augmentation, reduction or lifting. Usually the procedure is covered by insurance so women do not have to worry about shelling out money from their own pockets. There is no age limit for the procedure and choice for reconstruction depends on the affected woman. But the woman should be physically capable of withstanding a major surgical procedure.
The two most techniques used in the reconstruction are tissue expander/implant technique and transverse abdominus musculocutaneous (TRAM) flap. There is another technique known as latissimus dorsi musculocutaneous flap with breast implant but is rarely used.
The surgeon chooses the most appropriate technique for the reconstruction after taking into account what the woman wants, her health, and her anatomy.
The tissue expander/implant technique is a two part surgical procedure. In the first stage, a tissue expander is inserted just below the chest muscles. This can be done at the time of the mastectomy as it adds around an hour to the surgical time. In the second stage of the procedure, the expander is removed and saline or silicone breast implant is inserted. This procedure involves general anesthesia and take less than an hour if not work has to be done on the opposite side of the breast.
The TRAM flap technique uses the woman’s own tissue to form a breast mound. Besides the time for the mastectomy, it takes an additional 5 hours to complete the procedure. The woman would have to stay in the hospital for 5 days on an average and the recovery time would be approximately 5 weeks. Here the abdominal skin above the belly button is lifted and then stitched to the pubic area skin and the belly button is replanted. The five weeks recovery time is necessary to strengthen and straighten the abdominal walls and thereafter women can return to normal activity.
The latissimus dorsi musculocutaneous flap technique is used in women who have undergone radiation therapy and as a result do not have abdominal fat for recosntruction. The flap is made from the latissimus muscle and a breast implant is necessary to get the shape and volume. A tunnel is made at the base of the armpit and through this the latissimus muscle is brought to the chest wall.
In all three techniques, the nipple and areola are constructed in the second stage after the body heals from the first stage procedure. The nipple is formed using skin graft while the areola is created using the skin from the inner and upper thigh. This skin is pigmented and textured to give it a realistic appearance.