How Do They Do Breast Reconstruction Surgery?
The breast reconstruction surgery is a major surgery and involves some intricate techniques and steps for its success. The procedure for breast reconstruction surgery is explained in the following steps:
Anesthesia: In order to do such a massive surgery, anesthesia is required. The choice whether to give general anesthesia or intravenous sedation depends on the doctor and he will recommend the best for the patient. Medications are given for the comfort of the patient prior to the breast reconstruction surgery.
Tissue Expansion: A flap technique or tissue expansion may be required in case of insufficient tissue due to mastectomy or radiation therapy.
TRAM Flap: A TRAM flap generally uses a donor muscle, some amount of fat and skin from the patient’s lower abdomen in order to be reconstructed in the breast. This flap will remain attached to the original blood supply and is tunneled up through the chest wall.
SIEA Flap: Sometimes, the surgeon may choose SIEA flap in place of TRAM flap. Such flaps do not use abdominal muscles. It only involves transfer of skin and fat from the abdomen to the chest. In case of insufficient muscles in lower abdomen, skin can be taken from thighs or even buttocks.
Latissimus Dorsi Flap: Another type of flap may be called as the latissimus dorsi flap, which usually uses muscles, fat and skin from the back to the reconstruction site. This remains attached to its donor site, keeping the blood supply intact.
In some cases flap can reconstruct a breast mound completely, but most often latissimus dorsi flap provides the muscle and tissue required to cover and support a breast reconstruction procedure.
Implant Based Reconstruction: In cases where women do not need breast radiation, they prefer avoiding other donor sites. In such cases implant-based reconstruction is a good option. This procedure ensures easy recovery than flap procedures although it can be a lengthier process.
Saline: Such breast reconstruction procedure may require visit to the doctor over 2 months after the placement. This is done in order to gradually fill the device with saline with the help of an internal valve to expand the skin.
Second Surgical Procedure: In some cases a second surgical procedure for breast reconstruction may be required in order to replace the expander in case it is not designed to be a permanent one.
Surgery: Next, the breast implant has to be placed surgically in addition or as an alternative to flap method. Such implants may be used as a temporary placeholder during breast cancer treatment.
Implant Reconstruction: Reconstruction with the implant alone requires tissue expansion. For women who have undergone mastectomy with certain tumor characteristics and breast shapes, direct-to-implant breast reconstruction may be a good option.
Nipple and Areola Reconstruction: Finally the nipple and areola will be reconstructed. Techniques of nipple construction involve folding of skin to create a shape of the nipple followed by tattoo.
Sometimes, revision procedures are included like liposuction with fat grafting to improve the appearance of the breast so reconstructed.
What Are The Two Main Forms Of Breast Reconstruction Surgery?
The forms of breast reconstruction surgery involve:
Implant Filler: Implant reconstruction which involves insertion of an implant filled with saline water or silicone gel. Sometimes it may have a combination of the two.
Tissue Transplant: Flap reconstruction involving tissue transplant from another part of the body such as abdomen, thigh or buttock.
Where is Breast Reconstruction Surgeries Usually Performed?
Usually the breast reconstruction surgery is performed in a hospital setting. This may be followed by a short period of stay in the hospital. Follow up procedures are performed in order to ensure proper recovery from the surgery. Proper precautions are to be taken by the patient and the caregiver for a speedy recovery.
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