Breast Reconstruction Fort Worth
At his Fort Worth, Texas practice, Dr. Louis Strock performs breast reconstruction at the time of mastectomy, after mastectomy, or to repair congenital defects of the breast. Having served the North Texas area since 1996, Dr. Strock is widely known for his expertise in breast reconstruction surgery. He seeks to give women beautiful, natural-looking breasts and the confidence that goes with them. Dr. Strock is an experienced, board-certified plastic surgeon, and he takes the time to carefully explain all of the options available for breast reconstruction.
Patients considering reconstruction at the time of their mastectomy, or who have already undergone a mastectomy and are now interested in having breast reconstruction surgery, can request a consultationrequest a consultation with Dr. Strock using our online form. Or call our office and one of our knowledgeable staff members can schedule your appointment.
“After meeting with Dr. Strock for the first time, I felt much better on what to expect in the months to come before my reconstruction surgery was to take place. Dr. Strock was very thorough and took the time to listen and answer my questions and concerns.”
maryweir, RealSelf.com user
Breast Reconstruction Options
The advanced surgical techniques available to women considering breast reconstruction are very different from the procedures performed 10 to 15 years ago. Breast reconstruction typically involves the insertion of breast implants or use of tissue from another part of the body to provide the volume, shape and overall form of a new reconstructed breast.
Immediate Implant Reconstruction
After the mastectomy is completed, Dr. Strock will create a tissue pocket to allow for a breast implant to be placed. Dr. Strock will frequently use a material called AlloDerm, which allows for a tissue sling to be created internally beneath the skin of your breast. This is most commonly used in combination with the pectoral muscle to optimize tissue cover over a breast implant.
The breast implant used can be of two general types. The first is a permanent breast implant, typically the newest cohesive silicone gel devices that can be round or shaped, that can be placed at the time of mastectomy if the breast skin will permit this at the time of mastectomy. This depends on the cosmetic size goals of the patient as well.
Tissue Expander Reconstruction
Alternatively, a tissue expander can be used. A tissue expander is a temporary implant that is inserted beneath the chest muscle during at the time of the mastectomy. The expander is a special type of breast implant that is filled with saline solution and expanded at intervals. Over the course of several weeks, Dr. Strock injects additional fluid into the implant, gradually expanding it along with the overlying muscle and skin. The injections are performed during routine visits, usually 2 weeks apart. It can take anywhere from 2 to 6 visits, depending upon how much volume was placed in the tissue expander device initially.
This process creates a space for Dr. Strock to insert a long-term breast implant. For some patients, we can accelerate the time needed to adequately expand the tissue by adding a material called AlloDerm®. This material essentially acts as a sling, providing an extra layer of support for implants. The tissue expander is exchanged for a permanent implant about 2 months after the expansion process is completed and the new pocket is stabilized. The exchange is performed as an outpatient procedure, meaning the patient can return home on the day of the operation. For patients who had a unilateral mastectomy, Dr. Strock makes any changes to the other breast during the same procedure so the breasts are symmetrical.
After about 2 more months, nipple reconstruction can be completed if needed. This allows the implant to settle into position and ensures the correct nipple position on the reconstructed breast mound.
Muscle Flap Reconstruction
Muscle flaps taken from another area of the patient’s body have an important place in breast reconstruction following mastectomy. This type of reconstruction — using tissue and muscle from the upper back or the abdominal wall — has been used as part of immediate reconstruction for many years, but has seen continual improvement in techniques and outcomes.
The increased use of radiation treatment following mastectomy, however, has changed the timing of these techniques. For patients who choose flap reconstruction instead of breast implants, immediate reconstruction isn’t recommended if a patient is planning to have radiation treatment following the mastectomy, because tissue flaps typically don’t respond well to radiation. Tissue flap reconstruction is best performed after radiation therapy is complete.
The latissimus dorsi muscle of the back can also be used to convert a radiated mastectomy site into an environment virtually free of radiation where a permanent breast implant can be used in patients following tissue expansion. A TRAM flap (abdominal muscle) can be used in a similar fashion, providing a donor area for soft tissue and skin.
For qualified patients, tissue flap reconstruction can still play an important role in immediate reconstruction following mastectomy.
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