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Types of Breast Reconstruction
Recent medical advances in techniques have given breast cancer patients more choices when it comes to breast reconstruction, including the option to have breast reconstruction during the same operation in which the breast is removed. This removes the trauma of two major surgeries. Breast reconstruction is most often an option for women who have had masectomy. One should go in for research in treatment and reconstructive options before making any decision.
What are your options?
Missing breast skin can be replaced only with the patient’s own skin, either by expanding (stretching) the remaining skin already present on the chest wall or by transferring it from somewhere else using a flap. The missing breast tissue volume, however, can be replaced either by a prosthetic implant or by the patient’s own tissues (autologous tissues). Each of these two types of reconstruction has certain advantages and disadvantages.
A. IMPLANT PROCEDURES:
- Saline filled implants
- Silicon gel filled implants
One-stage immediate breast reconstruction may be done at the same time as mastectomy. Two-stage delayed reconstruction is performed if one’s skin and chest wall tissues are tight and flat. An implanted tissue expander, (usually a balloon), is placed beneath the skin and chest muscle. Full expansion with saline occurs after about six weeks. At the next stage, the tissue expander is exchanged for a permanent breast implant to match the opposite breast, and the nipple-areola is reconstructed, too.
Risks:-
- Implants at times may not last a lifetime.
- Local complications such as rupture, pain, capsular contracture (scar tissue forms around the implant), infection.
- Occasionally, breast implants leak fluid.
B. TISSUE FLAP PROCEDURE
The breast volume is replaced by the patient’s own skin and fat, so an implant is unnecessary. The breast is much softer and more natural as compared to an implant, A successful breast reconstruction with autologous tissue often looks and feels much like a real breast.
- TRAM flap (transverse rectus abdominis muscle flap), which uses tissue from the tummy area - It is the most popular of all reconstruction options, especially for obese women. You end up with a "tummy tuck" as a fringe benefit.
- Latissimus dorsi flap - muscle and skin from the patient's back is transferred to the intended breast area. This creates a pocket where an implant is usually inserted.
- DIEP (Deep Inferior Epigastric Artery Perforator) flap: consists only of skin, fat, and blood vessels. No muscle is transferred (although some may be damaged), so the patient has less postoperative pain and a stronger abdominal wall.
Risks:
- Because muscle flap reconstruction involves the blood vessels, women who smoke or have diabetes, vascular, or connective tissue diseases cannot undergo this type of breast reconstruction.
- Transplanted tissue can form lumps called "fat necrosis," which may or may not go away
Nipple reconstruction:-
The decision to have your nipple and areola reconstructed is up to you. You can go in for:
- A new nipple created from your own body tissue.
- Tattooing the skin graft of the newly created nipple.
- A stick-on latex nipple.
Learn the basics about breast reconstruction before you go in for any method. Understand and make yourself agree to the risks that might come in way.