Following a life-altering mastectomy, one of the traumatic issues left to deal with is the appearance of your breasts. Thanks to advanced technology, there are breakthrough medical methods to make you look and feel like you again. At Renaissance Plastic Surgery, our skilled plastic surgeons can help you on your journey toward recovery.
Breast Restoration for Mastectomy Patients
The ideal breast reconstruction procedure for you will depend on:
- Your current health and medical history
- Your stage of cancer and any ongoing treatments
- Whether or not you smoke
- Your current height-to-weight ratio
- Your cosmetic expectations
- Transverse Rectus Abdominus Musculocutaneous (TRAM) flap
- Latissimus Dorsi (LD) Musculocutaneous flap
- Tissue Expansion
Transverse Rectus Abdominus Musculocutaneous (TRAM) Flap Procedure
The TRAM flap procedure requires moving a flap of tissue from the abdomen and transplanting it to the chest. The section of skin, muscle, fat, and blood vessels from your abdomen is tunneled underneath your skin to its new location. This means that the transplanted tissue is never separated from the body; it contains the original blood supply. One benefit of the pedicle TRAM flap procedure is improved safety and reliability through the use of your own tissues.
Latissimus Dorsi (LD) Musculocutaneous Flap Procedure
During the LD flap procedure, an incision is made in your upper back to harvest donor tissue (skin, fat, muscle). This tissue is then tunneled through the chest wall and reshaped to create a breast mound. This method provides the tissue coverage necessary for a saline or silicone breast implant or tissue expander to be properly placed.
This procedure involves the expansion of the skin and muscle on and around the breast area using a temporary tissue expander. The tissue expander is an inflatable implant that is designed to make room for a permanent implant in the future. The expander will remain intact for a few months, allowing our surgeons to periodically inject a salt-water solution to gradually fill the expander. This allows for a slow and comfortable skin-stretching process. Once your skin over the breast area is stretched just enough, the expander will be removed and an implant will be set in its place.
Direct-to-implant reconstruction eliminates the need for tissue expanders, allowing you to have the breast implant placed in one procedure. This option is most effective for women who undergo a nipple-sparing mastectomy. Direct-to-implant reconstruction can occur at the same time as the mastectomy or at a later date. Our plastic surgeons will work closely with you and your oncologist to determine the best timing for your procedure.
A tissue matrix is used in order to avoid the tissue expansion process. The most common tissue matrix, Alloderm®, is created using donated human skin from a tissue bank that is regulated by the FDA.
During your procedure, our plastic surgeons will detach the lower edge of the pectoralis muscle from the chest and lift it up in order to create the upper portion of the breast pocket that will house the implant. The tissue matrix is placed in the area between the edge of the detached muscle and the chest in order to cover the lower portion of the breast implant.
There are two implant placement options available:
- Submuscular – The breast implant is placed below the chest muscle and the tissue matrix acts as a sling to help ensure the implant stays securely in place
- Pre-Pectoral – The breast implant is placed on top of the chest muscle and the tissue matrix is draped over the implant to provide additional coverage
As with any surgery, recovery times vary. Most patients require at least a month to rest and recuperate from breast reconstruction. Our surgeons might even require that you stay in the hospital for the first 1-3 days. Additional treatments such as breast implant placement or nipple reconstruction may be completed 12 weeks after your surgery.
If you are ready to learn about your breast reconstruction options at Renaissance Plastic Surgery, contact our St. Peters office today to schedule your visit.