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Each year, thousands of women (and hundreds of men) are diagnosed with breast cancer. Many times, a mastectomy or lumpectomy is necessary to beat breast cancer. Afterward, patients often report feelings of loss, decreased self-confidence and concerns about their physical appearance.
Breast reconstructive surgery recreates the breast lost after mastectomy or lumpectomy. Sometimes the reconstruction process takes more than one surgery to get the desired results.
Breast reconstruction options include using implants or tissue from another part of the body, such as the lower belly, to create the new breast. Reconstruction may take place immediately after breast cancer surgery, such as a partial or full mastectomy. It may happen months or years later. Surgery can reconstruct one or both breasts. Your plastic surgeon may perform reconstruction on one breast, then shape the other to match.
Reasons to have reconstruction surgery include:
There are two main types of postmastectomy reconstructive breast surgery:
Flap reconstruction, also called autologous reconstruction, is when the surgeon takes tissue from elsewhere in your body and creates a new breast. The tissue is taken from the lower belly, hip, thigh, back or buttocks. There are many kinds of flap reconstruction, each taking various tissue, skin, fat and blood vessels from different parts of the body. These include:
Skin, fat and blood vessels are taken from the lower belly; none of the underlying abdominal (belly) muscle is removed. The DIEP name is short for deep inferior epigastric perforator, a blood vessel used in the procedure.
Skin, fat, blood vessels and muscle (transverse rectus abdominis) are taken from the lower belly.
Tissue and muscle are taken from the back; the LD flap (which is still connected to its own blood supply) is moved through the back to the breast area
Tissue is taken from your buttocks and a new breast is created. The name comes from a blood vessel (inferior gluteal artery perforator) that is used.
Tissue (not muscle) is removed from your buttocks, and the procedure uses a different blood vessel (superior gluteal artery) than the IGAP flap procedure
Tissue is removed from the inner and back of your thigh, and it is used it to form a breast. The name comes from the profunda artery perforator, a vessel that is used.
Similar to a PAP flap, uses tissue from the thigh but also transplants muscle (transverse upper gracilis) as well
This breast reconstruction option uses a synthetic implant. The implant has a silicone outer shell and is filled with either salt water (saline) or silicone gel. Sometimes, the surgeon will use a combination of implants and tissue from your body. The procedure can be done at the same time as a mastectomy or after. The three main types of breast implant reconstruction are:
If you have a lumpectomy, you may be a candidate for oncoplastic surgery. Breast conserving surgery aims to leave as much of the remaining breast tissue intact and reconstructs the breast to appear less asymmetric or misshapen. The surgeon will perform a breast lift or breast reduction to create a natural breast silhouette.
Some types of mastectomy leave the nipple and areola in place. In some cases, surgeons can create a new nipple and areola. Skin from other parts of the body is grafted in place to shape a new nipple.
You may also wish to have a 3D tattoo of a nipple and areola done by a specially trained tattoo artist.
Your breast surgeon will discuss breast reconstruction options with you. It will depend on several factors, including:
All surgical procedures, including plastic surgery, carry risks, such as infection and bleeding. The goal of reconstruction surgery is to create a natural silhouette after lumpectomy or mastectomy. Common risks include:
The choice to have breast reconstruction surgery is very personal. These procedures can improve confidence and self-esteem after a lumpectomy or mastectomy. Talk to your health care providers about your desired appearance and be candid about your goals and lifestyle.
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