What is Breast Reconstruction?

Breast reconstruction is achieved through several plastic surgery techniques that attempt to restore a breast to near normal shape, appearance and size following mastectomy.

Enhancing your appearance with Breast Reconstruction

Breast reconstruction is a physically and emotionally rewarding procedure for a woman who has lost a breast due to cancer or other condition.

The creation of a new breast can dramatically improve your self-image, self-confidence and quality of life. Although surgery can give you a relatively natural-looking breast, a reconstructed breast will never look or feel exactly the same as the breast that was removed.

Is Breast Reconstruction right for me?

Breast reconstruction is a highly individualized procedure. You should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

Breast Reconstruction is a good option for you if:

  • You are able to cope well with your diagnosis and treatment
  • You do not have additional medical conditions or other illnesses that may impair healing
  • You have a positive outlook and realistic goals for restoring your breast and body image

Breast Reconstruction typically involves several procedures performed in multiple stages. It can:

  • Begin at the same time as mastectomy, or
  • Be delayed until you heal from mastectomy and recover from any additional cancer treatments

It’s important that you feel ready for the emotional adjustment involved in breast reconstruction. It may take some time to accept the results of breast reconstruction.

What happens during breast reconstruction surgery?

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – Flap techniques reposition a woman’s own muscle, fat and skin to create or cover the breast mound.

Sometimes a mastectomy or radiation therapy will leave insufficient tissue on the chest wall to cover and support a breast implant. The use of a breast implant for reconstruction almost always requires either a flap technique or tissue expansion.

A TRAM flap uses donor muscle, fat and skin from a woman’s abdomen to reconstruct the breast. The flap may either remain attached to the original blood supply and be tunneled up through the chest wall, or be completely detached, and formed into a breast mound.

Alternatively, your surgeon may choose the DIEP or SGAP flap techniques which do not use muscle but transport tissue to the chest from the abdomen or buttock.

 
 

A latissimus dorsi flap uses muscle, fat and skin from the back tunneled to the mastectomy site and remains attached to its donor site, leaving blood supply intact.

 
 
 

Occasionally, the flap can reconstruct a complete breast mound, but often provides the muscle and tissue necessary to cover and support a breast implant.

 
 
 
 

Step 3 – Tissue expansion stretches healthy skin to provide coverage for a breast implant.

Reconstruction with tissue expansion allows an easier recovery than flap procedures, but it is a more lengthy reconstruction process.

It requires many office visits over 4-6 months after placement of the expander to slowly fill the device through an internal valve to expand the skin.

A second surgical procedure will be needed to replace the expander if it is not designed to serve as a permanent implant.

Step 4 – Surgical placement of a breast implant creates a breast mound.

A breast implant can be an addition or alternative to flap techniques. Saline and silicone implants are available for reconstruction.

Your surgeon will help you decide what is best for you. Reconstruction with an implant alone usually requires tissue expansion.

Step 5 – Grafting and other specialized techniques create a nipple and areola.

Breast reconstruction is completed through a variety of techniques that reconstruct the nipple and areola
 

 

Breast Reconstruction

Reconstructing a woman’s breasts following a mastectomy is one of today’s most rewarding procedures for the patient and for the surgeon. The innovative medical devices and techniques that Fort Lauderdale plastic and reconstructive surgeon Dr. John Michael Thomassen uses makes it possible for him to create breasts that are nearly identical in their form and appearance to the natural breast.

The Benefits of Breast Reconstruction

When a woman loses her breasts to cancer, or any other disease, her self-image and confidence typically suffer. However, once her new breasts are created, she usually regains some of the confidence lost following her mastectomy.

A Successful Breast Reconstruction Requires the Skills of an Experienced Reconstructive Surgeon

To ensure a successful result, the surgeon must have knowledge and skills related to advanced reconstructive techniques; furthermore, the surgeon must also be familiar with the cosmetic discernment of the natural form of the breast. Fort Lauderdale board certified plastic and reconstructive surgeon Dr. John Michael Thomassen has the knowledge, skills and experience necessary to provide women with the best result possible.

Furthermore, if a woman has had a single mastectomy, Dr. Thomassen can reconstruct the missing breast and, when necessary, perform a breast reduction, lift or augmentation of the opposite breast to improve the symmetry of the position and size of both the patient’s breasts.

The Breast Reconstruction Time frame

Dr. Thomassen appreciates the emotional adjustment that women experience following a mastectomy. Since reconstructing a breast usually involves several procedures that are performed in stages, women may choose to delay their breast reconstruction surgeries until they heal from their mastectomy and completely recover from any other cancer treatments they receive. Alternatively, women can begin their breast reconstruction procedures at the same time they receive their mastectomy.

The Perfect Candidate for a Breast Reconstruction Procedure in Fort Lauderdale

Breast reconstruction surgery is an option for women who:

  • are coping well with their diagnosis and treatment;
  • have realistic goals, and feel optimistic about what a breast reconstruction procedure can accomplish for her; and
  • do not have any other medical condition or illness that could impair her ability to heal.

A Breast Reconstruction Initial Consultation at Thomassen Plastic Surgery in Fort Lauderdale

To ensure a safe and successful procedure, a patient needs to be completely honest with Dr. Thomassen during her initial consultation. Dr. Thomassen will ask questions related to the patient’s lifestyle choices, health and what she would like to achieve with her breast reconstruction surgery. Other information he will want to know relates to the medications and supplements she takes, whether she smokes, drinks alcohol or uses recreational drugs. He will also want to know if she has any drug or latex allergies.

Patients should expect Dr. Thomassen to discuss:

  • the various breast reconstruction surgery options he offers;
  • the course of treatment he recommends, including any procedures he believes would help achieve breast symmetry following a breast reconstruction surgery; and
  • likely outcomes of the procedure.

Dr. Thomassen may also:

  • examine the patient’s breasts, which may include taking measurements, noting the placement of the patient’s nipples and areola, as well as documenting the quality of the skin on the breasts;
  • evaluate the patient’s general health;
  • address any risk factors or pre-existing health problems; and
  • take photos of her chest for reference.

Preparing for Breast Reconstruction Surgery in Fort Lauderdale

Before a patient’s procedure, Dr. Thomassen may ask her to:

  • Have specific lab tests performed and/or visit her family physician for a medical evaluation.
  • Smoking makes it difficult for the body to heal, therefore, Dr. Thomassen requests that his patients stop smoking for at least two-weeks before their surgical procedures.
  • In addition, patients should avoid taking anti-inflammatory medications (NSAIDS), aspirin and supplements than can thin the blood.

Breast Reconstruction Surgery in Fort Lauderdale – Procedure Steps

1. Anesthesia

Patients receive medications designed to keep them asleep during their breast reconstruction surgery.

2. Dr. Thomassen Will Perform a Flap Technique to Reposition Muscle, Fat and Skin or Place a Tissue Expander

Many times, radiation therapy and/or the surgical removal of the breasts leaves an inadequate amount of tissue on the woman’s chest wall. Insufficient tissue makes covering and supporting the breast implant impossible; therefore, the expansion of tissue or a flap technique is almost always necessary.

In Fort Lauderdale, the following flap techniques can be used to cover or create the breast mound:

  • A Free TRAM Flap refers to a procedure where Dr. Thomassen excises skin, fat, muscle and blood vessels from the wall of the lower abdomen and then moves it up to the patient’s chest. Dr. Thomassen takes care to reattach the blood vessels using microsurgery techniques.
  • A Muscle-Sparing Free TRAM Flap refers to a procedure where Dr. Thomassen only uses a portion of the rectus abdominis muscle to create the flap.
  • A Pedicled TRAM Flap involves moving the patient’s fat, blood vessels, skin and muscle from the wall of the lower abdomen to the chest: These tissues remain attached to their original blood supply. Dr. Thomassen gently moves these tissues beneath the patient’s skin from her abdomen to her chest. It may take longer to recover from a pedicled TRAM flap than it will to recover from a muscle-sparing free TRAM flap procedure because it requires the use of a larger portion of the rectus abdominis muscle.
  • SGAP or DIEP Flap Techniques do not use muscle: Instead, the tissue is transported from the patient’s buttock or abdomen.

A tissue expansion can be used to stretch healthy skin:

  • Although reconstructing the breast via tissue expansion offers an easier recovery for women in Fort Lauderdale than the recovery experienced following a flap procedure, the reconstruction process itself is lengthier. Breast reconstruction through tissue expansion requires numerous visits to Thomassen Plastic Surgery in Fort Lauderdale. These visits occur over a period of 4 to 6 months. During these visits, a previously placed expander is slowly filled via an internal valve; thus, promoting skin expansion.

If the expander itself is not meant to serve as the implant, a second surgical procedure is necessary.

3. Implant Placement

Patients who want reconstruction with just an implant will need to have tissue expansion techniques performed prior to their breast reconstruction surgery. Once tissue expansion is complete, a breast implant can be used an alternative to flap techniques in the creation of the breast mound. Furthermore, an implant can be used in addition to the flap technique.

4. Dr. Thomassen Uses Specialized Techniques and Grafting to Create the Patient a Nipple and Areola

To complete the breast reconstruction procedure, Dr. Thomassen uses a variety of techniques to reconstruct the nipple and areola.

5. Recovering from a Breast Reconstruction Procedure

Following the surgery, bandages and/or gauze is applied to the incisions. Patients also receive a support bra or elastic bandage to reduce swelling and support their reconstructed breasts. Dr. Thomassen may place a small tube just beneath the skin to drain extra fluid and blood. Patients may also receive a pain pump.

All patients receive specific instructions that relate to their particular surgery. These instructions include information about medications, follow-up appointments and symptoms that indicate the patient needs to seek medical attention.

Results

It takes several weeks for inflammation to decrease and the breasts’ shape and position to improve. As time passes, many women will experience the return of some breast sensation, scar lines will become less visible; however, they will never disappear completely.

If you have had a mastectomy and are interested in learning more about the breast reconstruction procedures that are available in Fort Lauderdale, contact Thomassen Plastic Surgery today.