Breast Reconstruction

Breast reconstruction involves the replacement of breast tissue (lost during mastectomy, trauma or congenital defects) and the creation of a new breast form. This can be achieved by placing an implant under the skin and chest muscle or by moving tissues from another part of the body to the chest area, or by a combination of these techniques.

Several different techniques can be utilized in breast reconstruction, but all share a common goal: to mitigate the stigmatizing effects of breast cancer and breast removal

Prior to the mastectomy with your breast surgeon, your reconstructive surgery should be planned and discussed with Dr. Dry. In many cases, it’s recommended that you undergo reconstructive surgery during or immediately after the mastectomy, while the chest wall is still unaffected by radiation or scarring. In other cases, immediate breast reconstruction is not appropriate or the patient chooses to postpone the procedure for personal reasons.

Surgical Techniques in Breast Reconstruction

Plastic and reconstructive surgeons can use different methods to restore breast shape; some use a synthetic breast implant while others use the patient’s own tissue.

Implants

Saline or silicone gel breast implants can be surgically placed and the new breast shape is then molded around it. This surgery may require several stages and techniques in tissue expansion, especially when the chest wall tissues are tight and/or flat.

Autologous Methods

Autologous breast reconstruction methods use the patient’s skin, fat, or muscle to form a tissue flap that helps recreate the breast. Such methods include the following techniques:

• The transverse rectus abdominis muscle flap (or TRAM) uses abdominal tissue as a donor site. The procedure is comparable to an abdominoplasty, or “tummy tuck.”
• The Latissimus dorsi tissue flap uses tissue of the upper back as a donor site.
• The deep inferior epigastric artery perforator tissue flap (or DIEP) is comparable to the TRAM, but handles tissues of the abdominal muscles differently.
• The superior gluteal artery perforator tissue flap (or SGAP) uses the buttocks as a donor site.

After Breast Reconstruction: How will I look and feel?

Recovery time after breast reconstruction varies. If breast implants are used, the patient will experience some fatigue and discomfort for 1-2 weeks after surgery. With tissue flap surgeries, the recovery often takes longer.

A few months after the patient has recovered from breast reconstruction, the nipple can be reconstructed. Like the reconstruction procedures, there are multiple ways to achieve this, all of which can be discussed during your consultation with Dr. Dry.

A successful breast reconstruction will restore the breast and come close to its natural shape, but it is unlikely that your breasts will match their pre-mastectomy appearance. During your consultation, you can review photos with Dr. Dry to gain an understanding of the cosmetic results that can be expected.

For more information on breast reconstruction, contact the office of Kirkland/Seattle area plastic surgeon Dr. Gavin Dry.