Breast Reconstruction Options
The advanced surgical techniques available to women considering mastectomy reconstruction, double mastectomy reconstruction, and all other breast reconstruction procedures are very different from the procedures performed 10 to 15 years ago. Breast reconstruction typically involves the insertion of breast implants or the use of tissue from another part of the body to provide the volume, shape, and overall form of a newly 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 device 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 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.
The Healing Process
Following breast reconstruction, a period of downtime and recovery is required while the tissues heal. The details of this healing period will vary depending on the exact reconstruction procedure used. Follow the directions of Dr. Strock carefully to make sure healing goes as comfortably as possible.
Generally, it will be important to avoid physically taxing activities like sports and heavy exercise while your incisions heal. You will need to take time off from your job to rest as well. Wearing a surgical bra without an underwire will be necessary for a time, and there will be a degree of temporary swelling and bruising.
Breast Reconstruction Cost
It will be important to discuss breast reconstruction costs with your health insurance provider. Generally, the price of all currently performed breast reconstruction techniques is covered by insurance providers, and understanding the details of this is vital.
Set Up Your Consultation
To schedule your consultation regarding breast reconstruction in Fort Worth, contact Strock Plastic Surgery and arrange your informative consultation with Dr. Louis Strock. During this consultation, you will be able to look at breast reconstruction before and after photos, ask questions, and more.
Ready to see what Dr. Strock can do for you?
Take the Next Step.