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. Call (636) 896-0600 today to book a one-on-one appointment with our team to learn more!
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
Not all women choose to undergo breast reconstruction surgery following breast cancer, but many feel their scars are a constant reminder of the past. Breast reconstruction can restore your confidence and help you move forward after cancer. At Renaissance, our plastic surgeons perform four types of breast reconstruction:
- 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
Who is an Ideal Candidate for Breast Reconstruction?
If you are dealing with breast cancer and know that you will have a mastectomy, now is a great time to start considering your breast reconstruction options. You can still be a good candidate for breast reconstruction even if your breast cancer treatment took place years ago. As long as you are in good general health and do not have an existing medical condition that could impair your healing, you may qualify for a reconstructive procedure. Our surgeons recommend reconstructive procedures based on your goals, age, lifestyle, weight, profession, and other details. If you smoke, you will need to quit. Your doctor will also talk with you at length to ensure that you have realistic expectations regarding the anticipated outcome of your reconstruction.
How to Prepare for the Breast Reconstruction Procedure?
Your care team will help you fully prepare for your breast reconstruction as needed based on your situation. If you are having a reconstructive procedure done at the same time as your mastectomy, you will have an extended care team to answer questions and provide concise information before as well as after your procedure. Generally, the best time to begin preparing for breast reconstruction is well ahead of your surgery date. Once you have found a qualified plastic surgeon whom you trust to manage your care, your job gets much easier. As surgery approaches, your focus will be on establishing your support system at home and preparing for your recovery. Gather at least a few reliable friends or loved ones who can be present with you as you recover. Some days you may just need some good company. Other days, you may need someone to cook or care for the pets or children. It can help to make a list of the tasks that need to be managed and then delegate from there. Please remember that your emotional wellness during your reconstruction journey is as important as having help with the laundry! Have people that you can reach out to and who understand how to be with you, and also be prepared to accept the help that is offered to you.
How Long Does the Breast Reconstruction Procedure Take?
You can expect your breast reconstruction to be an all-day event. It can take a couple of hours just to get you all ready for surgery, including your pre-surgical review and administering your anesthesia. Your procedure can take from one hour to six hours, depending on the type of reconstruction you are having done. This is something that your surgeon will discuss with you at your consultation and pre-surgical visits. The vast majority of breast reconstruction procedures are performed on an outpatient basis. After your surgery is done, you will remain in the monitored recovery area for an hour or two, where nursing staff will help you as you wake up from anesthesia. Once you are alert and stable on your feet, you will be released to a loved one to take you home and get you settled.
Will the Results of My Breast Reconstruction Look Natural?
Your surgeon will plan your breast reconstruction to achieve the very best shape, size, symmetry, and scarring possible. Advances in surgical techniques have significantly improved the cosmetic outcomes for breast reconstruction patients. That said, there may be slight differences in the feel and overall appearance of the reconstructed breasts. This may depend on the nature of the mastectomy, how much tissue was removed, and how much scarring resulted from that surgery. Our surgeons are careful to discuss their anticipated outcomes from breast reconstruction. It is our intent to set realistic expectations for you based on your breast shape and the reconstructive technique that you select.
Will I Have Any Scars After My Breast Reconstruction Procedure?
Yes. Scarring is inevitable after mastectomy and breast reconstruction. Once your incisions have fully healed, you can talk to your surgeon about starting a scar treatment program. This may include applying a topical scar product like a cream or a silicone sheet or it may involve clinical treatments. Breast reconstruction incisions are placed strategically as much as possible so that the resulting scars can be hidden beneath clothing or a bathing suit. The goal of surgery is to restore as much of your natural appearance as possible, including having smooth, clear skin around the breasts.
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.
Schedule Your Breast Reconstruction Consult in St. Peters!
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. Call (636) 896-0600 or fill out the form in our contact page. Our experienced team of plastic and cosmetic surgeons look forward to serving you!