Mastectomy Reconstructive Surgery

Breast reconstruction is rarely done with only one surgery. Even if you have the procedure started during your mastectomy, you will still need to have a second procedure. Breast reconstruction procedures include breast implants, tissue expanders, and tissue reconstruction.

Breast implants are silicone shells filled with either saltwater or silicone. They are either tear shaped or round and it is placed behind the pectoral muscle in your chest. This is similar to the procedure when a breast expansion is done. Most women will need to have tissue expanders placed in the chest area before the implant is placed.

Tissue Expansion

Tissue expanders stretch the remaining tissue to allow room for the implant. Tissue expansion will take place over several months. The tissue expander has a small valve that your doctor will use to insert saline solution in with a needle. The balloon is filled gradually and allows the skin to stretch. There may be a feeling of pressure or slight discomfort while the tissues are expanding.

Once the expander has reached the correct size, the doctor performs a second operation to put in the permanent implant. Some doctors use an expander that will be permanent and a second surgery wont be needed. An implant may be inserted into the other side of the breast area to insure both breasts are similar in size and shape.

Tissue Reconstruction

Another procedure uses tissue reconstruction. This method is complex but does have its positive points. Using tissue from your own body removes any danger from leakage of the saline filled balloon, or any reaction from the silicone. Women are given two choices of surgical methods. The first method transfers muscle, skin, and fat to the chest area by keeping it all attached to the blood supply. This is pedicle flap surgery. Tunnels beneath the skin carry this tissue to the chest area and its moved into a pocket your surgeon has prepared for the implant.

The second procedure removes the tissue from the area while disconnecting it from its blood supply. The surgeon then reattaches the tissue with microsurgery to the blood vessels near your chest. This procedure takes longer to perform because of the delicate nature of reattaching all the blood vessels. This procedure is called the free flap surgery.

Skin Flap Surgery

Tissue used for the free flap surgery can be taken from donor areas from your back, buttocks, or abdomen. Taking the tissue from the abdomen can serve a duo purpose because it takes excess muscle, fat, and tissue from the abdomen and is considered a little “tummy tuck.” This may appeal to some women who have excess fat and tissue in their abdomen area. This procedure takes a small portion of the abdominal muscle to allow you to keep as much abdominal strength as possible after surgery. The appeal of the “tummy tuck” sways many women to choose for this second procedure even though it may mean a longer time in the operating room.

Consult your doctor and plastic surgeon for help in choosing the best method of reconstruction for your body.