What are the most common reasons for breast reconstruction?
The most common reason to reconstruct a breast is when all or part of the breast has to be removed for cancer. We may reconstruct a breast when someone is born without a breast or their breasts are deformed. We also reconstruct breasts when cosmetic surgery has gone wrong or there is significant asymmetry between the breasts.
What are the options for a woman who has had a mastectomy?
There are several options for breast reconstruction, and they can be performed at the time of the mastectomy or in a delayed fashion if the patient wishes (though most prefer immediate/concurrent reconstruction). The options range from a prosthesis in a bra (i.e. no surgical reconstruction), to placing a tissue expander and slowly expanding it to a desired volume of breast then exchanging it for a silicone implant, to performing a TRAM flap where part of the abdominal fat and muscle are used to make the breast, to "free flaps" where we take distant tissue and sew the blood vessels with a microscope to make a new breast mound.
What does the process involve?
Depending on which option the patient chooses, the reconstruction can be completed at the time of the mastectomy. If utilizing a tissue expander, it may take a few months to reach the final volume and then a second procedure to exchange the expander for the silicone implant. Nipple areolar reconstruction is also performed commonly in a delayed fashion. In all, the reconstruction may take several months, and more than one procedure, to achieve the final desired aesthetic result.
Does reconstruction interfere with radiation or chemotherapy?
If we know that radiation will be needed, then performing a flap surgery should be delayed or another form of immediate reconstruction should be entertained because we don't know how the radiation will affect the reconstructed tissue/flap. We can do radiation therapy on a tissue expander-based reconstruction, although it may increase the risk of some complications. Reconstruction does not interfere with chemotherapy, but if there is delayed healing in association with the reconstruction for any reason, then chemotherapy might be delayed until healing is complete.
Asaf Yalif MD, FACS
(404) 822-4402 | Available for Consultations
Roswell: 2500 Hospital Blvd., Suite 410 | Roswell, GA 30076
Woodstock: 145 Towne Lake Pkwy, Suite 101 | Woodstock, GA 30188
Dr. Asaf Yalif is a triple board-certified plastic surgeon who specializes in cosmetic and reconstructive surgery of the face and body. Utilizing the most recent developments, both surgical and nonsurgical, he will help you create a unique plan to achieve your goals.