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Breast Reconstruction

Recent advances in breast cancer diagnostic and management allow for breast preserving treatments. However, a large group of patients require mastectomy which adds significantly to the emotional and physical stress of breast cancer diagnosis and treatment. Depression after mastectomy is very common and resembles mourning in the same way as individuals would mourn the loss of a loved one. Negative psychological consequences of mastectomy can be significantly reduced by breast reconstruction.

The following is a brief review of modern breast reconstruction. Please feel free to contact us if you have any questions about the content of this review article:
Modern Concepts in Breast Reconstruction: Lessening the Psychological Trauma for Women With Breast Cancer

Breast Reconstruction is physically and emotionally a rewarding procedure for a woman who has lost one or both breasts because of cancer or other disease. Breast reconstruction is possible through several methods. These procedures attempt to restore a breast to near normal appearance. These techniques may include:

1-     The use of patient’s own tissue (autologous) reconstruction to create or cover the breast mound.

2-     Expansion of the remaining skin and tissue over the chest area to provide coverage for a breast implant.

3-     Placement of an implant to create a breast mound.

4-     Various techniques for recreation of the nipple and areola.

Breast reconstruction typically requires more than one procedure. It can begin at the same time as mastectomy or can be delayed until a patient has healed from mastectomy and recovered from any additional cancer treatment.

Patients need to be emotionally ready for breast reconstruction. Similar to losing a breast it may take some time for a woman to accept the results of breast reconstruction.

At times, additional procedures may be required for the unaffected side to achieve better symmetry. These procedures include breast lift, breast reduction or augmentation.

Through hard work of the American Society of Plastic Surgeons (ASPS®) and many breast cancer support groups, health insurance companies are required by law to provide coverage for breast reconstruction and related procedures to adjust the opposite breast.

The following is an excerpt from the text of law providing health insurance coverage for breast reconstruction after cancer treatment:
''Women's Health and Cancer Rights Act of 1998''

You may also click HERE to visit a page for Q&A about the law.

Ideal Candidates

Breast reconstruction can be performed at any time following mastectomy. Most frequently it is performed immediately following tumor removal (mastectomy). This enables the patient to wake up from surgery with a breast mound in place, sparing a woman the experience of seeing herself with no breast at all. Virtually any woman who must lose her breast to cancer is a candidate for reconstructive surgery.

Reconstruction has no known effect on recurrence of disease in the breast, nor does it impair the detection of recurrent disease. Breast reconstruction also does not generally interfere with postoperative chemotherapy or radiation treatments, if needed.

Bilateral breast reconstruction is possible is certain candidates. Both implant and autologous methods may be suitable for this purpose.

The Preoperative visit

The patients are usually referred to the plastic surgeon as soon as they are diagnosed with breast cancer. Consultation for breast reconstruction is usually performed in conjunction with the other physicians involved in the treatment of your breast cancer. This team approach usually involves your primary doctor, surgeon and oncologist. The Consultation consists of a thorough discussion of the patient's history, expectations and concerns. A thorough physical examination and evaluation of the patient's breasts will be performed. A discussion of the available reconstructive options, including their advantages and disadvantages, will be reviewed, including possible results, limitations, and risks involved. Certain variables affecting patient’s options, risks, and outcome are discussed. These variables include the patient's medical history, age, height and weight, body shape, and the size and shape of the breast to be reconstructed. Photographic examples of the possible procedures will be reviewed with the patient at the time of her consultation.

Options:

Implant reconstruction combines the technique of skin expansion with subsequent insertion of a permanent implant.

Autologous Reconstruction (Flap reconstruction) involves creation of the breast mound using the patient's own tissue. This tissue may come from the back or, more commonly the abdomen. The tissue remains healthy because it has its own blood supply. When a woman's abdominal tissue is used to reconstruct the breast, it is referred to as a TRAM flap. The abdominal wound is then closed, giving the woman a "tummy-tuck". There are variations in the surgical technique used to transfer the tissue. Please refer to the sections under TRAM, DIEP, SGAP, and Latissimus on this website for more information

 

 

Face

Breast

  • Breast Augmentation
  • Breastlift
  • Breast Reconstruction

  •          DIEP
             TRAM
             Implant
             Latissimus
             Nipple Sparing mastectomy
  • Breast Reduction
  • Body

    Excessive Sweating

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