Breast Reconstruction
The Basics
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.
The Ideal Candidate for Breast Reconstruction
Breast reconstruction is a good option for you if:
- You are able to cope well with your breast cancer diagnosis and treatment
- You do not have additional medical conditions or other illnesses that may impair healing
- You are a non-smoker
- You have a positive outlook and realistic goals for restoring your breast and body image
Breast Reconstruction
Breast reconstruction typically involves several procedures performed in multiple stages. It can begin at the same time as mastectomy or may be delayed until the patient has healed from mastectomy and recovered from any additional cancer treatments that may be necessary. There are multiple reconstruction techniques, which differ in process and outcome.
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.
The Flap Technique
The flap technique involves repositioning a woman's own muscle, fat and skin to create or cover the breast mound. Flap techniques may result in a more natural feel breast and are necessary when little tissue or muscle remains following mastectomy. Incision lines appear at both the donor and reconstruction sites and a lengthy recovery follows. Depending on the patient's size, a breast implant may be used to augment the breast.
A TRAM flap uses 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 tunneled up through the chest wall, or be completely detached, and formed into a breast mound.
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.
The Prosthetic Technique
The prosthetic technique involves the use of saline or silicone breast implants to create the breast mound. Unless the patient had a Skin-Sparing Mastectomy, tissue expansion is necessary before the implant can be placed. This involves placement of a tissue expander inside the removed breast to expand the skin and create adequate healthy tissue. Over the course of 4-6 months, many office visits are necessary to slowly fill the device through an internal valve to expand the skin. Through a second surgical procedure, the tissue expander is replaced by a permanent implant.
The Results
Breast reconstruction is completed through a variety of techniques that reconstruct the nipple and areola.
The final results of breast reconstruction can help lessen the physical and emotional impact of mastectomy. Over time, some breast sensation may return, and scar lines will improve, although they'll never disappear completely. There are trade-offs, but most women feel these are small compared to the large improvement in their quality of life and the ability to look and feel whole. Careful monitoring of breast health through self-exam, mammography and other diagnostic techniques is essential to a breast reconstruction patient's long-term health.
Recovery
Following your surgery for flap techniques and/or the insertion of an implant, gauze or bandages will be applied to your incisions. An elastic bandage or support bra will minimize swelling and support the reconstructed breast. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid. A pain pump may also be used to reduce the need for narcotics.
Click Here For Recommended Post-Mastectomy Exercises
Insurance and Costs
Breast reconstruction surgery is considered a reconstructive procedure and insurance companies are required by law to provide at least partial coverage for breast reconstruction. Financing plans are available to cover the remaining fees. Costs may include:
- Surgeon's fee
- Facility costs
- Anesthesia fees
- Prescriptions for medication
- Post-surgery garments
- Medical tests and x-rays
Breast Cancer Support Groups:
Dr. Bolitho supports breast cancer awareness and research.
Patient Testimonials
"From the moment I first interviewed with you, I have felt I was in very kind, gentle, sophisticated and extremely talented hands. It is very exciting to find a hidden treasure in a sea of cosmetic surgery offices. My heartfelt thank you to you all."
- GS
"I feel so fortunate to have had somebody who not only performed my surgery exceptionally well but also did it with compassion. I will forever be grateful for your efforts."
-PH
"I had a surprisingly positive experience! Dr. Bolitho's work is top notch and I am completely pleased with the results. He and his staff were exceptionally caring, attentive to detail and knowledgeable. My surgery and recovery went off without a single complication. I will be recommending Dr. Bolitho to anyone who asks for a referral. I couldn't be happier with the care I received!"
