Breast reconstruction is an option for women whose breast has
been removed due to cancer or other disease. New medical
techniques and devices have made it possible for surgeons to
create a breast that can come close in form and appearance to
matching a natural breast. Frequently, reconstruction is
possible immediately following breast removal (mastectomy), so
the patient wakes up with a breast mound already in place.
While there are many options in post-mastectomy reconstruction,
you and your surgeon should discuss the one that is best for
you.
Skin Expansion. The most common technique combines skin
expansion and the subsequent insertion of an implant. With skin
expansion, the surgeon inserts a tissue expander beneath your
skin and chest muscle following mastectomy. Over a period of
time, the expander is filled with saline until the skin has
stretched enough to allow the insertion of the implant.
TRAM Flap Reconstruction. In TRAM flap surgery, the tissue
remains attached to its original site, retaining its blood
supply. The flap, consisting of the skin, fat and muscle with
its blood supply, are tunneled beneath the skin to the chest,
creating the breast mound itself, without need for an implant.
Most breast reconstruction involves a series of procedures that
occur over time. Follow-up surgery may be required to replace
the tissue expander with the implant, or to reconstruct the
nipple and the areola. Also, many surgeons recommend an
additional operation to enlarge, reduce, or lift the natural
breast to match the reconstructed breast.
