RECONSTRUCTION 212 369-5300
- GENERAL INFO
- BEST CANDIDATE
- THE PROCEDURE
- RECOVERY TIME
- ADDITIONAL INFO
Breast reconstruction surgery involves multiple plastic surgery techniques to restore a breast to its normal shape, appearance and size following mastectomy.
Most cases involve implant reconstruction in two stages. At the time of mastectomy, tissue expanders are inserted below the muscle , often with the use of sterile skin matrices for bulk. In the second stage, silicone implants are inserted and, depending on the type of mastectomy, nipple/areola may need to be reconstructed as well.
Soft tissue, or flap reconstruction, is an option for select patients as well. This is a single step procedure usually involving abdominal wall excess. There is some loss of muscle/fascia in order to rebuild the breast with flaps.
Dr. LaTrenta will advise you about which breast reconstruction method will best suit your case.
A woman who has lost a breast due to cancer or other condition may benefit both physically and emotionally from breast reconstruction surgery.
Patients with the following have greater risk to themselves with reconstructive surgery:
Multiple previous scars
Generalized medical conditions such as diabetes and hypertension
The two basic reconstruction methods are implants and flaps. Implants are either saline or gel silicone filled prostheses which mimic the substance of the breast. Flaps are developed from the body’s naturally excessive soft tissue (generally taken from the abdomen - a “tummy tuck” bonus.)
Most cases involve implant reconstruction in two stages. At the time of mastectomy, tissue expanders are inserted below the muscle , often with the use of sterile skin matrices for bulk. In the second stage, silicone implants are inserted and, depending on the type of mastectomy, the nipple/areola may need to be reconstructed as well.
Soft tissue, or flap reconstruction, is another option for some patients. This is a single step procedure usually involving abdominal wall excess. There is some loss of muscle/fascia in order to rebuild the breast with flaps.
If only one breast has been affected, a breast lift, breast reduction or breast augmentation may be used on the opposite breast to improve symmetry of the size and position of both breasts.
Please click the "additional information" tab to read an article Dr. LaTrenta wrote on the subject of breast reconstruction.
You may also wish to visit the website of the American Society of Plastic Surgeons for for more details, including risks, of this procedure.
Recovery time from breast reconstruction surgery varies depending upon the patient and the type of procedure that was used to reconstruct the breast.
However, you should expect it to take at least three to six weeks before you can resume strenuos activity.
You should also consider that follow-up surgeries may be required in order to construct a new areola and nipple.
Dr. LaTrenta advises most patients that it may be a full year before the breast appears completely normal.
Breast Reconstruction New York
The following is an article Dr. LaTrenta wrote for the Breast Cancer Alliance, published in the annual report.
Building a Better Breast
Any woman facing mastectomy also faces another difficult decision: reconstructive surgery. The most basic decision is for whether to reconstruct the breast at all. If that is your choice, as it is for may women, you need to determine whether to reconstruct the breast at the same time as the mastectomy( simultaneous reconstruction ) or wait until the initial operation heals.
Simultaneous breast reconstruction offers several distinct emotional advantages: avoidance of unnatural and uncomfortable prosthetics, a diminished period of postoperative depression, and an improved sense of long term well being and sexual sensibility. Having the procedure immediately also offers several surgical advantages: preservation of native breast skin on the reconstructed breast, most symmetry in shape and volume, and the avoidance of another major general anesthetic procedure.
The two basic reconstruction methods are implants and flaps. Implants are either saline or gel silicone filled prostheses which mimic the substance of the breast. Flaps are developed from the body’s naturally excessive soft tissue (generally taken from the abdomen- a “tummy tuck” bonus.)
Implants are generally best for patients considering bilateral breast reconstruction, for women who don’t have much lower abdominal tissue, and for menopausal and post-menopausal patients who wish to keep reconstruction as simple as possible. Implant reconstruction is also preferable for young women who have never been pregnant and who have an inheritable form of bilateral breast cancer.
Implants are not without drawbacks, however. First, implants need to be replaced over time- the recommendation is every 10 to 15 years to avoid rupture. Second, implants have a hardening, or capsular contracture, rate of 2 to 3 %, although that is usually correctable with a minor surgical procedure. Third, implants have a rare incidence of infection, like all implantable devices. Because of this, implant patients should take prophylactic antibiotics prior to “dirty” procedures, such as colonoscopy and dental cleanings.
It may be somewhat misleading to call implant reconstruction simultaneous or immediate. In fact,implants require several different procedures and temporary prostheses to achieve a high quality, durable, long term result. As I tell all my implant reconstruction patients, if it takes God nine months to make a breast, it’s going to take Dr. LaTrenta a year.
The lower abdominal flap procedure, known as a TRAM, is often advisable for women with ample lower abdominal wall tissue who desire a natural tissue reconstruction. The TRAM procedure also works for patients with breast cancer recurrence who have undergone previous breast lumpectomy and radiotherapy and for women with a considerable amount of lower abdominal excess who are contemplating bilateral mastectomy.
TRAMS often result in a temporarily weakened abdominal wall, but one year after surgery most [patients are doing sit-ups again. If the TRAM procedure is performed for bilateral breast reconstruction, however, the lower abdominal wall is permanently weakened and bulging sometimes ensues. Overall, the TRAM flap is an extremely reliable breast reconstructive technique which produces natural post-mastectomy long-term results with minimal risk.
Post-op bilateral breast reconstruction with implants following removal of tissue expanders
More women who undergo implant surgery today are choosing to reconstruct their breasts with gel silicone implants rather than saline because the gel implants have a softer texture and lower incidence of rippling. Another trend we’re seeing is the increase in prophylactic mastectomies. Many at risk young women are now seeking genetic testing and some choose bilateral prophylactic mastectomies with simultaneous implant reconstruction.
These technical advances provide patients with far superior bilateral breast reconstruction results and far greater satisfaction than reconstructive surgeon could produce even a few years ago. As diagnostic and surgical procedures continue to improve, we anticipate that we will also make strides in reconstruction techniques, resulting in smaller wounds, faster healing, and the most natural looking results possible.