Breast Reconstruction

This reconstructive surgery was designed to restore the shape of the breasts after removal of tissue. Breast reconstruction can be performed during or post mastectomy. Although breast reconstruction can rebuild your breast, the reconstructed breast will not have the same sensation and may feel different from your natural breast. In addition, visible incision lines will always be present in the breast and possibly in the donor site (which is commonly in a less-exposed area of the body).

Sometimes breast reconstruction can require several separate surgical procedures. When appropriate, breast implants—silicone or saline—or transferring a patient’s own tissue may be an option. If only one breast needs reconstruction, it can be done alone, or the opposite breast can also be modified to improve symmetry.

Who Is a Good Candidate?
A good candidate for breast reconstruction has realistic expectations and has breasts that are fully developed. You are a good candidate if:

  • You are coping well with your diagnosis and treatment of breast cancer.
  • You do not have other medical conditions or illnesses that could hinder healing.
  • You have a positive outlook and realistic goals.
  • You feel ready for the emotional adjustment that is often part of breast reconstruction recovery.

What to Expect
If a mastectomy, double mastectomy or radiation therapy has left insufficient tissue on the chest wall to cover and support a breast implant, a flap technique or tissue expansion technique can be used.

The flap technique options include:

  • Transverse rectus abdominis myocutaneous (TRAM)—the flap uses muscle, fat and skin from your abdomen to reconstruct the breast.
  • Deep inferior epigastric perforator (DIEP)—the flap does not use muscle but instead tissue from the abdomen to reconstruct the breast.
  • Superior gluteal artery perforator flap (SGAP)—the flap does not use muscle but instead tissue from the buttock to reconstruct the breast.

Your plastic surgeon will discuss which technique is most appropriate for you.

Tissue expansion:

  • Reconstruction with tissue expansion often provides an easier recovery than flap procedures, but it is a more lengthy reconstruction process.
  • Tissue expansion requires many office visits over four to six months after placement of a tissue expander.
  • Your physician will use an internal valve to expand the skin by slowly filling the expander with saline.
  • Sometimes the expander is designed to serve as a permanent implant.
  • For a saline or silicone implant, a second surgery is required.

To create a nipple and areola, your surgeon can use a variety of techniques.

Initially after surgery, dressings or bandages may be applied to your incisions. An elastic bandage or support bra may be worn to minimize swelling and support the breasts as they heal. A small, thin tube (drain) may be temporarily placed under the skin to remove any excess blood or fluid. A pain pump may also be used to reduce the need for narcotics.

Recovery Information
You will be given specific instructions after plastic surgery, including:

  • How to care for your breasts following surgery
  • Medications to apply or take orally
  • Specific concerns to look for at the surgical site or in your general health
  • When to follow up with your surgeon

Resources
For more information about this cosmetic procedure, visit The American Society of Plastic Surgeons.

Find a Doctor
To locate a board-certified cosmetic surgeon affiliated with Gwinnett Medical Center–Duluth, search the online physician database or call 678-312-5000.

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Cosmetic Surgery Special