When Is The Best Time For Breast Reconstruction?
Reconstructive surgery should be planned and discussed prior to the mastectomy with your breast surgeon and Dr. Pfeifer. Ideally, reconstructive breast surgery should be performed during or immediately after the mastectomy, when the chest wall is unaffected by radiation or scarring.
Unfortunately, for various reasons, some patients don’t consider immediate breast reconstruction. Such reasons may be personal, or it may be the case that radiation in the chest is needed post-mastectomy, in which case it is usually advised to delay reconstruction until after the completion of radiation treatment.
Breast Reconstruction Techniques
There are two general techniques plastic surgeons utilize for breast reconstruction; one technique may use a synthetic implant, while another may use the patient’s own tissue.
Reconstruction With Breast Implants
When breast implants are used, a saline or silicone gel implant is placed and the new breast shape is molded around it. Surgery may require several stages and the use of a tissue expander, especially when the chest wall tissues are tight and/or flat.
Reconstruction With Existing Tissue
There are several breast reconstruction methods that use skin, fat, or muscle to form a “tissue flap” that helps recreate the breast.
- TRAM: the transverse rectus abdominis muscle flap uses abdominal tissue as a donor site. The procedure is comparable to an abdominoplasty, or “tummy tuck.”
- Latissimus Dorsi: this tissue flap uses tissue of the upper back as a donor site.
- DIEP: the deep inferior epigastric artery perforator tissue flap is comparable to the TRAM, but handles tissues of the abdominal muscles differently.
- SGAP: the superior gluteal artery perforator tissue flap uses the buttocks as a donor site.
